A microfluidic route for synthesis of scandium oxide microspheres, their characterization and neutron activation

Radioactive scandium-46 microspheres have applications in mapping flow in a chemical reactor through a technique known as radioactive particle tracking (RPT). In the present study a novel microfluidic method has been developed for synthesis of controlled size scandium oxide microspheres. An inline/in-situ mixing of the scandium precursor and gelling agents was implemented which makes the microfluidic platform amenable for truly continuous operation. Microspheres of size varying from 937 to 666 μm were produced by varying O/A ratio from 10 to 30. Perfectly spherical and monodispersed (PDI <10 %) microspheres were obtained at O/A 15 and beyond. The morphology, elemental composition, and structure of the microspheres were analysed by SEM, EDS and XRD, respectively. Subsequently the microspheres were irradiated with thermal neutrons in a nuclear reactor to obtain radioactive Sc-46 oxide microspheres. The activity produced on each Sc-46 microspheres with different sizes was in the range 19.5-34.0 MBq.

Prevalence of Amoebiasis and Associated Complications in India: A Systematic Review

PURPOSE

Intestinal protozoan parasites are responsible for diarrheal diseases causing significant morbidity and mortality. Entamoeba histolytica is the principle protozoan parasite associated with diarrheal infections. The infection is often associated with inaccessibility to clean drinking water and poor sanitary conditions in low- and middle-income countries including India. A comprehensive systematic review was performed to evaluate a reliable nationwide estimate for prevalence and geographic distribution of amoebiasis in India and the complications associated with it.

METHODS

We used the PRISMA guidelines to perform a systematic review and meta-analysis of articles published between the year 2001-2020. Two English language databases PubMed and Web of Science were searched to achieve relevant studies.

RESULTS

Initial searches resulted in 467 studies out of which 64 eligible articles involving data from 289,659 human subjects from 12 states and 4 union territories were included in the final analysis. Prevalence of amoebiasis ranged from 3-23% in asymptomatic population, 0.64-11% in symptomatic patients and 1-17.5% in HIV-infected patients. Highest prevalence was seen in Tamil Nadu, Andaman Nicobar Island and North East India. Extra intestinal invasion of Entamoeba histolytica leading to complications such as amoebic liver abscess, amoebic colitis, colonic perforation and ameboma were also reported. Such complications have the potential to increase healthcare burden and may prove to be fatal.

CONCLUSION

Amoebiasis remains a significant public health issue in India responsible for diarrheal diseases causing significant morbidity and mortality. Entamoeba histolytica is the principle protozoan parasite associated with amoebiasis. Public health efforts should be directed towards its control and better diagnostic methods should be employed for distinguishing between pathogenic and non-pathogenic species of Entamoeba.

Rain garden infiltration rate modeling using gradient boosting machine and deep learning techniques

Rain garden is effective in reducing storm water runoff, whose efficiency depends upon several parameters such as soil type, vegetation and meteorological factors. Evaluation of rain gardens has been done by various researchers. However, knowledge for sound design of rain gardens is still very limited, particularly the accurate modeling of infiltration rate and how much it differs from infiltration of natural ground surface. The present study uses experimentally observed infiltration rate of rain gardens with different types of vegetation (grass, candytuft, marigold and daisy with different plant densities) and flow conditions. After that, modeling has been done by the popular infiltration model i.e. Philip's model (which is valid for natural ground surface) and soft computing tools viz. Gradient Boosting Machine (GBM) and Deep Learning (DL). Results suggest a promising performance (in terms of CC, RMSE, MAE, MSE and NSE) by GBM and DL in comparison to the relation proposed by Philip's model (1957). Most of the values predicted by both GBM and DL are within scatter limits of ±5%, whereas the values by Philips model are within the range of ±25% error lines and even outside. GBM performs better than DL as the values of the correlation coefficients and Nash-Sutcliffe model efficiency (NSE) coefficient are the highest and the root mean square error is the lowest. The results of the study will be useful in selection of plant type and its density in the rain garden of the urban area.

Status of glaciers and climate change of East Karakoram in early twenty-first century

This study aims to assess the glaciers change status in Shyok basin, East Karakoram in terms of area and mass balance, and to ascertain if glaciers in this part of Karakoram also display similar anomaly like central or western counterparts. The spatio-temporal monitoring of glaciers during the time frame of 24 years (1990/2000/2014) suggests major percentage of stable glaciers and insignificant retreat in the total glaciated area. The percentage of retreating glaciers has increased after year 2000. Area change analysis of glaciers having size >1 km² (569 glaciers) suggests the number of fluctuated glaciers have substantially increased i.e. overall 56% glaciers remained stable, 35% retreated and 9% advanced during 1990-2014. The geodetic based findings using SRTM-C (2000) and Cartosat-1 (2010/2011/2014) stereo-imageries for 201 glaciers suggest the mass loss at the rate of -0.10 ± 0.07 m w.e. a^-1. To better apprehend the status of glaciers changes in the region, climatic studies using in-situ observations as well as reanalysis dataset (ERA-I) were also undertaken of past 30 years. Therefore, this study is also a maiden attempt to ascertain if along with Karakoram anomaly, a climatic anomaly exists in the Eastern parts of Karakoram or not. A long term field collected snow-meteorological data of East Karakoram region suggests overall warming trend in annual temperature and no trend for snowfall during 1985-2015. The statistically significant increased rates of warming and decreased snowfall after year 2000 support the spatial variations in glaciers of East Karakoram and marginal mass loss. The observations of the marginal mass loss along with warming temperatures indicate that no Karakoram or climatic anomaly is existent over the East Karakoram region. Our study further refutes the prevalence of the elevation-dependent warming (EDW) over East Karakoram region vis-à-vis North-West Himalayan ranges. The impact of hiatus in global warming was also not observed over studied region.

Evaluation of forewarning models for mustard aphids in different agro-climatic zones of India

Mustard aphid, Lipaphis erysimi (Kaltenbach), is the most serious pest of Rapeseed-Mustard which is known to be responsible for a tremendous loss in yield and oil content, under various agro-climatic conditions of India. Information support on aphid occurrence and intensity is necessary for effective management by the farmers in the mustard-growing belt. In this study, an effort is made to develop forewarning model using the field data on aphid for 12 consecutive rabi seasons from 2003-2004 to 2014-2015 under different agro-climatic locations in India. Three main components of aphid-related stages were identified for which necessary forewarnings were needed to be issued: (1) severity, (2) the time of reaching the economic threshold level (ETL) for decision-making on pesticide application, and (3) time of occurrence of peak population. To address these, three different models were developed/used and validated using incident field dataset. Those field observations when the infestation level were below severe category (< 60) during rising phase of the aphid population were found to indicate highest R sqr. (0.82) for the model-I during validation. When model-II was used, 11 out of 14 locations (78.57%) stood validated. The assumptions made in model-III also got validated when humidity thermal ratio (HTR) of the week of peak population ranged between 1.5 and 4 (lowest among the weeks considered), and population reached severe category. The models showed better results during real-time validation in seasons 2016-2017 and 2017-2018, thus suggesting that these three models can be used to ascertain the severity, week of ETL, and week of peak aphid population for Brassica juncea varieties all over the mustard belt in India and can be operationalized spatially to forewarn against the aphid pest population in future under Gramin Krishi Mausam Sewa (GKMS) scheme.

P5434P300-mediated inactivation of p53 protects against doxorubicin-induced cardiotoxicity

Introduction

Doxorubicin is amongst the most widely prescribed chemotherapy drugs due to its effectiveness in cancer treatment. However, progressive treatment using doxorubicin severely increases the risk of congestive heart failure. Mechanistically, researchers have shown that doxorubicin (i) intercalates into DNA and disrupts topoisomerase-II-mediated DNA repair and (ii) generates free radicals which then causes damage to cellular membranes, DNA, and proteins. Ultimately these cellular insults induce cardiomyocyte (CM) death mediated by the tumour suppressor, p53. Currently, there are no clinically applicable preventative treatments for doxorubicin-induced cardiotoxicity and so, extensive research is being done in discovering a potential therapy. One such candidate is curcumin – a natural polyphenol compound non-toxic to humans. We have previously demonstrated that curcumin inhibits lysine acetyltransferase activity of p300, therefore reducing both histone and non-histone protein acetylation. To induce CM death, p53 requires acetylation by p300. Therefore, we hypothesize that curcumin protects against doxorubicin-induced CM death and cardiotoxicity via p300-mediated inactivation of p53.

Methods

Rat H9c2 cardiomyoblast cells were cultured and treated with a 2.5 μM dose of doxorubicin for 16 hours. One group of cells were pre-treated with curcumin (15μM) 4 hours prior to doxorubicin treatment, and controls were cultured with only diluent added. Following treatment, the cells were harvested for total protein. At end point, we performed immunoblotting to measure protein expression of key proteins involved in DNA damage (y-H2A.X, p53), and apoptosis (cleaved-Caspase 3).

Results

Our findings show that following doxorubicin treatment, p53 expression was significantly increased (p<0.001), confirming its role in doxorubicin-associated cardiotoxicity. Furthermore, doxorubicin was associated with increased DNA-damage as evidenced by increased expression and activation of DNA double-stranded breaks (DSBs) marker, y-H2A.X (p<0.001). Elevated levels of DNA-damage were further associated with significantly increased doxorubicin-induced apoptosis as measured by immunoblotting for cleaved-Caspase 3 (p<0.001). However, DNA-damage and apoptosis were attenuated by pre-treatment of cells with curcumin. Curcumin treatment led to a significant decrease in both y-H2A.X (p<0.01) and cleaved-Caspase 3 (p<0.01) expression compared to cells treated with only doxorubicin.

Conclusions

Our data provides the first evidence that curcumin protects against doxorubicin-induced apoptosis in rat cardiomyoblast cells in vitro. Further studies are warranted in vivo to confirm the potential of curcumin as a cardio-protective drug. Curcumin is a natural compound with little to no side-effects in humans, therefore our finding may provide a novel therapeutic target and treatment approach for doxorubicin-associated cardiotoxicity.

Acknowledgement/Funding

Heart & Stroke Foundation of Canada

Urban green space availability in Bathinda City, India

This paper aims to investigate and map the spatial distribution of urban green spaces (UGSs) in Bathinda City, India. Since urban green spaces affect the quality of life and provide various ecological, socio-cultural and economic benefits to a city, the spatial distribution of UGSs and per capita availability deserve greater consideration in urban planning and research. The UGSs are extracted from freely available Sentinel 2 image with spatial resolutions of 10 m (blue, green, red, and near infrared bands). The result indicates that the planned urban setups have higher area under UGSs as compared to the rest of the city. Analysis and intra-city comparison (ward wise) of distribution of green spaces and per capita availability indicate that there is an inequitable distribution of UGSs in Bathinda City. The study also attempts to accentuate the scope of green initiatives in the various wards of the city to ensure the well-being of people.

Application of hot melt extrusion for improving bioavailability of artemisinin a thermolabile drug

Hot melt extrusion has been used to produce a solid dispersion of the thermolabile drug artemisinin. Formulation and process conditions were optimized prior to evaluation of dissolution and biopharmaceutical performance. Soluplus^®, a low T_g amphiphilic polymer especially designed for solid dispersions enabled melt extrusion at 110 °C although some drug-polymer incompatibility was observed. Addition of 5% citric acid as a pH modifier was found to suppress the degradation. The area under plasma concentration time curve (AUC_0-24h) and peak plasma concentration (C_max) were four times higher for the modified solid dispersion compared to that of pure artemisinin.

Bulk synthesis of multi-walled carbon nanotubes by AC arc discharge method

This work proposes the production of multi-walled carbon nanotubes by AC arc discharging of spectroscopically pure graphite electrodes of different shapes, that is, movable cylindrical and stationary rectangular electrode by manual metal arc welding setup. Continuous arc was generated by maintaining the gap of about 3 mm between the electrodes which in turn formed the plasma zone. Vaporization of carbon cations followed by sudden quenching paved the way for formation of carbon nantotubes. Nanotubes produced were deposited on the stationary graphite electrode in the form of soot. Further extraction of the nanoparticles from the soot was performed by conducting series of purification processes which will be discussed in upcoming chapters. Morphology and purity of the extracted nanotubes were investigated by X-ray diffraction, scanning electron microscopy, field-emission scanning electron microscopy, transmission electron microscopy and Raman spectroscopy. Following the characterization process, it was observed that the so-produced nanotubes were of different shapes, that is, carbon cone nanotubes, nanocapsules, nanoparticles and branching type and randomly oriented. The length of the nanotubes varied from 231 to 561 nm, whereas diameter was found to be in the range of 14–55 nm.

Postharvest Processing and Benefits of Black Pepper, Coriander, Cinnamon, Fenugreek, and Turmeric Spices

Spices are prime source for flavor, aroma, and taste in cuisines and play an active role as medicines due to their high antioxidant properties. As medicine or food, the importance of spices cannot be overemphasized. The medicinal values of spices are very well established in treating various ailments like cancer, fever, malaria, stomach offset, nausea, and many more. A spice may be available in several forms: fresh, whole dried, or pre-ground dried which requires further processing to be utilized in the form of value-added product. This review paper deals with the cultivation, postharvesting, chemical composition, uses, health, and medicinal benefits of the selected spice viz., black pepper, coriander, cinnamon, fenugreek, turmeric, and technological advances in processing of spices viz., super critical fluid extraction, cryogenic grinding, and microencapsulation etc. This paper also focuses on issues related to utilization of spices toward its high end-product development and characterization in pharmaceuticals and other medicinal purposes. The availability of different spices and their varietal differences and location have their pertinent characters, which are much demanding to refine postharvest and processing to assure its quality in the international market.

Sustained Early Disruption of Mitochondrial Function Contributes to Arsenic-Induced Prostate Tumorigenesis

Arsenic is a well-known human carcinogen that affects millions of people worldwide, but the underlying mechanisms of carcinogenesis are unclear. Several epidemiological studies have suggested increased prostate cancer incidence and mortality due to exposure to arsenic. Due to lack of an animal model of arsenic-induced carcinogenesis, we used a prostate epithelial cell culture model to identify a role for mitochondria in arsenic-induced prostate cancer. Mitochondrial morphology and membrane potential was impacted within a few hours of arsenic exposure of non-neoplastic prostate epithelial cells. Chronic arsenic treatment induced mutations in mitochondrial genes and altered mitochondrial functions. Human non-neoplastic prostate epithelial cells continuously cultured for seven months in the presence of 5 µM arsenite showed tumorigenic properties in vitro and induced tumors in SCID mice, which indicated transformation of these cells. Protein and mRNA expression of subunits of mtOXPHOS complex I were decreased in arsenic-transformed cells. Alterations in complex I, a main site for reactive oxygen species (ROS) production as well as increased expression of ROS-producing NOX4 in arsenic-transformed cells suggested a role of oxidative stress in tumorigenic transformation of prostate epithelial cells. Whole genome cGH array analyses of arsenic-transformed prostate cells identified extensive genomic instability. Our study revealed mitochondrial dysfunction induced oxidative stress and decreased expression of p53 in arsenic-transformed cells as an underlying mechanism of the mitochondrial and nuclear genomic instability. These studies suggest that early changes in mitochondrial functions are sustained during prolong arsenic exposure. Overall, our study provides evidence that arsenic disruption of mitochondrial function is an early and key step in tumorigenic transformation of prostate epithelial cells.

Clinico-anesthetic changes following administration of propofol alone and in combination of meperidine and pentazocine lactate in dogs

Aim:

The aim of this study is to find out the effect of propofol and its combination with meperidine and pentazocine lactate on certain clinico-anesthetic profiles in dogs.

Materials and Methods:

15 apparently healthy mongrel dogs of either sex of about 1 year of age were randomly divided into three groups of five dogs each. The animals of Group I were administered propofol intravenously alone “to effect,” whereas meperidine at 2 mg/kgb.wt. and pentazocine lactate at 2 mg/kg b.wt. were injected intramuscularly 15 min before propofol “to effect” in Groups II and III, respectively. Atropine sulfate at 0.04 mg/kgb.wt. was injected intramuscularly 20 min before each treatment. Rectal temperature, heart rate, respiration rate, and anesthetic indices were recorded before and at 5, 10, 20, 30, and 60 min of induction.

Results:

As compared to Group I, the animals of Groups II and III exhibited a significant decrease (p<0.05) in the level of rectal temperature, respiration rate, and heart rate. Duration of recumbency, time of standing, time of recovery as well as the duration of analgesia were longer in pentazocine lactate (Group III) followed by meperidine (Group II) as compared to propofol alone (Group I). Meperidine treated dogs showed defecation and muscle twitching during anesthesia.

Conclusion:

Meperidine and pentazocine are suitable opioids used in combination with propofol for achieving surgical anesthesia and helpful in reduction of propofol dose.

Knowledge, attitude and practice GAP in family planning usage: an analysis of selected cities of Uttar Pradesh

Background

The GAP between the knowledge of contraception and its actual practice is well recognized in the literature of family welfare studies. The present study assessed the relation between the level of knowledge and practice of contraception among the women and sought to explore the reasons behind the Knowledge, Attitude, and Practice - GAP (KAP GAP) regarding contraceptive users in six cities of Uttar Pradesh.

Method

Present analysis based on 17,643 currently married women aged 15 to 49. A Bivariate analysis (χ2 test) and a multivariable logistic regression were performed for the study.

Result

The highest percentages of respondents (women) were in the age group 35-49 (40-45 %) in all the districts considered. Knowledge of contraceptives was almost universal; tubal ligation and pill were the commonly known methods. Information about the contraceptive methods was mostly obtained through the husband. In the present study, there was a highly significant association (p < 0.01) of age group, educational status of respondents, the number of living children, the wealth of the respondent, media exposure and husband's education with the variable KAP GAP for all six cities. Health concern issues in all the districts were the most prominent reason for not using contraception.

Conclusion

There differences in the socioeconomic and demographic factors exist, which lead to KAP GAP in the family planning (FP) usages. Therefore, in designing effective family planning programme, there is a need to understand the various factors which influence the practice of contraception.

Antioxidant, antimicrobial activity and bioactive compounds of Bergenia ciliata Sternb.: A valuable medicinal herb of Sikkim Himalaya

Bergenia ciliata Sternb., commonly known as Paashaanbhed, is a well known herb of Sikkim Himalaya with various pharmaceutical properties. However, scientific exploration of B. ciliata, growing in the Sikkim Himalaya, for phytochemicals and pharmacological properties is in infancy. With this view, the present study was undertaken to investigate B. ciliata leaf extracts for antioxidant, antimicrobial activity and bioactive compounds. Three solvents viz., methanol, ethyl acetate and hexane were used for extraction and the respective leaf extracts were analyzed for total phenolic and flavonoid contents along with the antioxidant and antimicrobial activities. Amongst the tested solvents, methanol was found to be the best solvent for extraction with highest total phenolic contents and the lowest IC₅₀ values for the 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays. Methanol extract also exhibited effective antimicrobial activity, particularly against bacteria and actinomycetes. Further, high performance liquid chromatography (HPLC) analysis revealed that methanolic extract contains the highest amount of all the three analyzed bioactive compounds viz. bergenin, catechin and gallic acid. The current study suggests that the methanol extract of B. ciliata is a potential source of natural antioxidant and antimicrobial compounds that can be used in food and drug industries.

Contraceptive use before first pregnancy by women in India (2005-2006): determinants and differentials

Background

There exist ample of research literature investigating the various facet of contraceptive use behaviors in India but the use of contraception by married Indian women, prior to having their first pregnancy has been neglected so far. This study attempts to identify the socio demographic determinants and differentials of contraceptive use or non use by a woman in India, before she proceeds to have her first child. The analysis was done using data from the third National Family Health Survey (2005–2006), India.

Methods

This study utilized information from 54,918 women who ever have been married and whose current age at the time of NFHS-3 survey was 15–34 years. To identify the crucial socio-demographic determinants governing this pioneering behavior, logistic regression technique has been used. Hosmer Lemeshow test and ROC curve analysis was also performed in order to check the fitting of logistic regression model to the data under consideration.

Results

Of all the considered explanatory variables religion, caste, education, current age, age at marriage, media exposure and zonal classifications were found to be significantly affecting the study behavior. Place of residence i.e. urban - rural locality came to be insignificant in multivariable logistic regression.

Conclusions

In the light of sufficient evidences confirming the presence of early marriages and child bearing practices in India, conjunct efforts are required to address the socio demographic differentials in contraceptive use by the young married women prior to their first pregnancy. Encouraging women to opt for higher education, ensuring marriages only after legal minimum age at marriage and promoting the family planning programs via print and electronic media may address the existing socio economic barriers. Also, the family planning programs should be oriented to take care of the geographical variations in the study behavior.

Influence of pin and hammer mill on grinding characteristics, thermal and antioxidant properties of coriander powder

In present study, influence of grinding (hammer and pin mills) and moisture content (range: 6.4-13.6 % dry basis) on the quality traits of coriander powder were investigated. These include grinding parameters, colour parameters, specific heat, thermal conductivity, thermal diffusivity, glass transition temperature, essential oil, total phenolic content, total flavonoid content and DPPH scavenging (%) of coriander powder. For coriander seed, the geometric properties such as major, medium, minor dimensions, geometric mean diameter, arithmetic mean diameter, sphericity, surface area and volume of coriander seeds increased significantly with increasing moisture (6.4-13.6 % db). For coriander powder, the grinding parameters such as average particle size, volume surface mean diameter and volume mean diameter increased significantly with increasing moisture (6.4-13.6 % db). With the grinding method, the colour attributes of coriander powder such as L-value, a-value, b-value, hue angle and browning index varied significantly. It was observed that the specific heat followed second order polynomial relationship with temperature and moisture whereas thermal conductivity varied linearly with temperature and moisture content. The variation of glass transition temperature with moisture can be best represented in quadratic manner. Total flavonoid content (mg QE/g crude seed extract) and DPPH scavenging % activity of coriander powder is significantly affected by grinding methods. A lower value of specific heat was observed for hammer ground coriander powder as compared to pin mill ground coriander powder. The thermal conductivity of hammer mill ground coriander powder was higher as compared to pin mill ground coriander. It was observed that hammer mill yields more fine coriander powder in comparison to pin mill. The browning index was more in hammer mill ground coriander powder.

Evaluation of multiplex polymerase chain reaction utilising multiple targets in Mycobacterium tuberculosis direct test negative but culture positive cases: a potential method for enhancing the diagnosis of tuberculosis

PURPOSE

To evaluate multiplex Polymerase Chain Reaction (MPCR) utilising multiple targets (IS6110, Protein b [Pab] and MPB64 genes) in Mycobacterium tuberculosis Direct Test (MTD) negative but culture positive cases and comparison of MPCR with Real-Time polymerase chain reaction (RT-PCR) for diagnosis of tuberculosis.

MATERIALS AND METHODS

MPCR was carried out on 28 culture positive sputum samples. Out of 28 culture positive samples, 17 were originally reported, as MTD test negative and 11 were MTD test positive, respectively. The results of MPCR were compared with RT-PCR. To check the specificity of the tests, MPCR and RT-PCR were also evaluated with 16 non-tuberculous mycobacterial (NTM) isolates.

RESULTS

Out of 28 culture positive sputum samples, MPCR was positive in all 28/28 samples, whereas RT-PCR was positive in 27/28 samples and MTD test was originally tested positive in six sputum samples and on repeating MTD testing, five more sputum samples were positive and thus total number of MTD positive were 11/28 sputum samples, respectively. All the tests were negative on evaluation with all the 16 NTMs, thus giving specificity of 100% to all the tests; sensitivity of MPCR, RT-PCR and MTD tests were 100%, 96.42% and 39.28%, respectively, in these specifically selected samples.

CONCLUSIONS

MPCR may be an important tool in the rapid diagnosis of tuberculosis especially in disease endemic, resource limited countries.

Bardet-Biedl syndrome presenting with steroid sensitive nephrotic syndrome

Bardet-Biedl syndrome (BBS) is a rare autosomal recessive disorder characterized by postaxial polydactyly, retinitis pigmentosa, central obesity, mental retardation, hypogonadism, and renal involvement. Renal involvement in various forms has been seen in BBS. Cases with nephrotic range proteinuria not responding to steroid have been described in this syndrome. Here we report a case of BBS who presented with nephrotic range proteinuria. The biopsy findings were suggestive of minimal change disease. The child responded well to steroid therapy and remains in remission.

Removal of americium from aqueous nitrate solutions by sorption onto PC88A-impregnated macroporous polymeric beads

The removal of Am (III) ions from aqueous solutions was studied by solid-liquid extraction using indigenously synthesized Extractant Impregnated Macroporous Polymeric Beads (EIMPBs). These beads were prepared by an in situ phase inversion method using polyethersulfone (PES) as base polymer and 2-ethylhexyl phosphonic acid mono-2-ethylhexyl ester (PC88A) as an extractant. The synthesized EIMPBs were characterized by FTIR, TGA and SEM techniques. The batch equilibration study using these beads for the uptake of Am (III) was carried out as a function of parameters, like pH, equilibration time, Am (III) concentration, etc. The blank polymeric beads, without PC88A, have shown negligible sorption of Am (III) under the experimental conditions. The experimental data on the sorption behavior of Am (III) on the polymeric beads fitted well in the pseudo-second-order kinetics model. The synthesized polymeric beads exhibited very good sorption capacity for Am (III) at pH 3. The reusability of the beads was also ascertained by repetitive sorption/desorption of Am (III) up to 10 cycles of operation, without any significant change in their sorption characteristics.

Intracellular mannose binding lectin mediates subcellular trafficking of HIV-1 gp120 in neurons

Human immunodeficiency virus-1 (HIV-1) enters the brain early during infection and leads to severe neuronal damage and central nervous system impairment. HIV-1 envelope glycoprotein 120 (gp120), a neurotoxin, undergoes intracellular trafficking and transport across neurons; however mechanisms of gp120 trafficking in neurons are unclear. Our results show that mannose binding lectin (MBL) that binds to the N-linked mannose residues on gp120, participates in intravesicular packaging of gp120 in neuronal subcellular organelles and also in subcellular trafficking of these vesicles in neuronal cells. Perinuclear MBL:gp120 vesicular complexes were observed and MBL facilitated the subcellular trafficking of gp120 via the endoplasmic reticulum (ER) and Golgi vesicles. The functional carbohydrate recognition domain of MBL was required for perinuclear organization, distribution and subcellular trafficking of MBL:gp120 vesicular complexes. Nocodazole, an agent that depolymerizes the microtubule network, abolished the trafficking of MBL:gp120 vesicles, suggesting that these vesicular complexes were transported along the microtubule network. Live cell imaging confirmed the association of the MBL:gp120 complexes with dynamic subcellular vesicles that underwent trafficking in neuronal soma and along the neurites. Thus, our findings suggest that intracellular MBL mediates subcellular trafficking and transport of viral glycoproteins in a microtubule-dependent mechanism in the neurons.

Low dose methylprednisolone induced bradycardia

Methylprednisolone induced arrhythmias, especially bradycardia, are well known. Most of the available reports suggest the occurrence of these arrhythmias with high dose intravenous therapy. We, hereby report a case of low dose methylprednisolone induced bradycardia.

Quality evaluation of millet-soy blended extrudates formulated through linear programming

Whole pearl millet, finger millet and decorticated soy bean blended (millet soy) extrudates formulations were designed using a linear programming (LP) model to minimize the total cost of the finished product. LP formulated composite flour was extruded through twin screw food extruder at different feed rate (6.5-13.5 kg/h), screw speed (200-350 rpm, constant feed moisture (14% wb), barrel temperature (120 °C) and cutter speed (15 rpm). The physical, functional, textural and pasting characteristics of extrudates were examined and their responses were studied. Expansion index (2.31) and sectional expansion index (5.39) was found to be was found maximum for feed rate and screw speed combination 9.5 kg/h and 250 rpm. However, density (0.25 × 10(-3) g/mm(3)) was maximum for 9.5 kg/h and 300 rpm combination. Maximum color change (10.32) was found for 9.5 kg/h feed rate and 200 rpm screw speed. The lower hardness was obtained for the samples extruded at lowest feed rate (6.5 kg/h) for all screw speed and feed rate at 9.5 kg/h for 300-350 rpm screw speed. Peak viscosity decreases with all screw speed of 9.5 kg/h feed rate.

Open transinguinal preperitoneal mesh repair of inguinal hernia: a targeted systematic review and meta-analysis of published randomized controlled trials

OBJECTIVE

The objective of this article is to systematically analyse the randomized, controlled trials comparing transinguinal preperitoneal (TIPP) and Lichtenstein repair (LR) for inguinal hernia.

METHODS

Randomized, controlled trials comparing TIPP vs LR were analysed systematically using RevMan® and combined outcomes were expressed as risk ratio (RR) and standardized mean difference.

RESULTS

Twelve randomized trials evaluating 1437 patients were retrieved from the electronic databases. There were 714 patients in the TIPP repair group and 723 patients in the LR group. There was significant heterogeneity among trials (P < 0.0001). Therefore, in the random effects model, TIPP repair was associated with a reduced risk of developing chronic groin pain (RR, 0.48; 95% CI, 0.26, 0.89; z = 2.33; P < 0.02) without influencing the incidence of inguinal hernia recurrence (RR, 0.18; 95% CI, 0.36, 1.83; z = 0.51; P = 0.61). Risk of developing postoperative complications and moderate-to-severe postoperative pain was similar following TIPP repair and LR. In addition, duration of operation was statistically similar in both groups.

CONCLUSION

TIPP repair for inguinal hernia is associated with lower risk of developing chronic groin pain. It is comparable with LR in terms of risk of hernia recurrence, postoperative complications, duration of operation and intensity of postoperative pain.

An emerging role for Wnt and GSK3 signaling pathways in schizophrenia

Schizophrenia is a disabling illness with limited treatment options. The underlying pathophysiology remains unknown, partially due to its heterogeneous nature, and a lack of understanding of the biological functions of genetic risk factors. Several signaling pathways have been implicated, however, with the varying degrees of support. In this article, I will focus on the converging evidence supporting a prominent role for Wnt and glycogen synthase kinase 3 (GSK3) signaling in the biological bases of schizophrenia. This includes current pharmacological therapies that target GSK3, animal model and cell-based studies, and recent human genetic findings that implicate Wnt and GSK3 signaling.

Use of antibacterial sutures for skin closure in controlling surgical site infections: a systematic review of published randomized, controlled trials

Objective: The objective of this article is to systematically analyse the randomized, controlled trials that compare the use of antibacterial sutures (ABS) for skin closure in controlling surgical site infections.

Methods: Randomized, controlled trials on surgical patients comparing the use of ABS for skin closure in controlling the surgical site infections were analysed systematically using RevMan® and combined outcomes were expressed as odds ratios (OR) and standardized mean differences (SMD).

Results: Seven randomized, controlled trials evaluating 1631 patients were retrieved from electronic databases. There were 760 patients in the ABS group and 871 patients in the simple suture group. There was moderate heterogeneity among trials (Tau² = 0.12; chi² = 8.40, df = 6 [P < 0.01]; I² = 29%). Therefore in the random-effects model, the use of ABS for skin closure in surgical patients was associated with a reduced risk of developing surgical site infections (OR, 0.16; 95% CI, 0.37, 0.99; z = 2.02; P < 0.04) and postoperative complications (OR, 0.56; 95% CI, 0.32, 0.98 z = 2.04; P = 0.04). The durations of operation and lengths of hospital stay were similar following the use of ABS and SS for skin closure in patients undergoing various surgical procedures.

Conclusion: Use of ABS for skin closure in surgical patients is effective in reducing the risk of surgical site infection and postoperative complications. ABS is comparable with SS in terms of length of hospital stay and duration of operation.

Cryogenics and its application with reference to spice grinding: a review

Cryogenics is the study of very low temperature and its application on different materials including biological products. Cryogenics has numerous applications in space science, electronics, automobiles, the manufacturing industry, sports and musical instruments, biological science and agriculture, etc. Cryogenic freezing finds pivotal application in food, that is, spices and condiments. Although there is a wide range of cryogens to produce the desired low temperature, generally liquid nitrogen (LN₂) is used in food grinding. The application of low temperature shows a promising pathway to produce higher quality end product with higher flavor and volatile oil retention. Cryogenic grinders generally consist of precoolers and grinder with the cryogen distribution system. In such grinding systems, cryogens subject the raw material up to or lower than glass transition temperature before it is ground, thus eliminating much of the material and quality hassles of traditional grinding. At present, the capital investment including cryogen and handling costs escalate the final cost of the product. Thus, for large-scale production, a proper design to optimize and make it feasible is the need of the hour and understanding the behavior of different food materials at these low temperature conditions. This article reviews the scenario and application of cryogenics in different sectors, especially to spice grinding.

Routine on-table cholangiography during cholecystectomy: a systematic review

INTRODUCTION

The aim of this review was to systemically analyse trials evaluating the efficacy of routine on-table cholangiography (R-OTC) versus no on-table cholangiography (N-OTC) in patients undergoing cholecystectomy.

METHODS

Randomised trials evaluating R-OTC versus N-OTC in patients undergoing cholecystectomy were selected and analysed.

RESULTS

Four trials (1 randomised controlled trial on open cholecystectomy and 3 on laparoscopic cholecystectomy) encompassing 860 patients undergoing cholecystectomy with and without R-OTC were retrieved. There were 427 patients in the R-OTC group and 433 patients in the N-OTC group. There was no significant heterogeneity among trials. Therefore, in the fixed effects model, N-OTC did not increase the risk (p=0.53) of common bile duct (CBD) injury, and it was associated with shorter operative time (p<0.00001) and fewer peri-operative complications (p<0.04). R-OTC was superior in terms of peri-operative CBD stone detection (p<0.006) and it reduced readmission (p<0.03) for retained CBD stones.

CONCLUSIONS

N-OTC is associated with shorter operative time and fewer peri-operative complications, and it is comparable to R-OTC in terms of CBD injury risk during cholecystectomy. R-OTC is helpful for peri-operative CBD stone detection and there is therefore reduced readmission for retained CBD stones. The N-OTC approach may be adopted routinely for patients undergoing laparoscopic cholecystectomy providing there are no clinical, biochemical or radiological features suggestive of CBD stones. However, a major multicentre randomised controlled trial is required to validate this conclusion.

Adverse drug reaction reporting in a pharmacovigilance centre of Nepal

BACKGROUND

Pharmacovigilance is the "science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug related problems". Nepal joined the international pharmacovigilance programme as a full member in 2007. KIST Medical College, Lalitpur, Nepal joined the national programme as a regional centre from mid-July 2008. Currently, the pattern and scope of adverse drug reactions (ADRs) in Nepal remains unexplored.

AIMS

To observe and analyse the pattern of ADRs at KIST Medical College, Lalitpur, Nepal.

METHOD

A retrospective analysis of all ADRs reported to the centre from mid July 2008 to July 2011 was performed. Data was analysed for ADR severity, causality, and preventability.

RESULTS

A total of 113 ADR reports were obtained from various clinical departments. The maximum number of reactions was due to antimicrobials, followed by anti-hypertensives and NSAIDs.

CONCLUSION

Antimicrobials were the commonest group of drugs causing ADRs and the most commonly seen ADR was maculopapular rash followed by diarrhea and vomiting.

Adverse drug reaction reporting in a pharmacovigilance centre of Nepal

BACKGROUND

Pharmacovigilance is the "science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug related problems". Nepal joined the international pharmacovigilance programme as a full member in 2007. KIST Medical College, Lalitpur, Nepal joined the national programme as a regional centre from mid-July 2008. Currently, the pattern and scope of adverse drug reactions (ADRs) in Nepal remains unexplored.

AIMS

To observe and analyse the pattern of ADRs at KIST Medical College, Lalitpur, Nepal.

METHOD

A retrospective analysis of all ADRs reported to the centre from mid July 2008 to July 2011 was performed. Data was analysed for ADR severity, causality, and preventability.

RESULTS

A total of 113 ADR reports were obtained from various clinical departments. The maximum number of reactions was due to antimicrobials, followed by anti-hypertensives and NSAIDs.

CONCLUSION

Antimicrobials were the commonest group of drugs causing ADRs and the most commonly seen ADR was maculopapular rash followed by diarrhea and vomiting.

Comparative therapeutic evaluation of different topicals and narrow band ultraviolet B therapy combined with systemic methotrexate in the treatment of palmoplantar psoriasis

Background:

The incidence of uncomplicated psoriasis is 1–3% in the general population. The involvement of palm and sole is seen in 7–14.5% of cases. There are different topicals and systemic therapies available for treating the case of psoriasis but none is satisfactory for longer duration.

Aim:

The study involved the comparative therapeutic evaluation of the different topical regimens and narrow band ultraviolet B (NB-UVB) therapy in combination with systemic methotrexate.

Materials and Methods:

The study was held in out-patient department of Skin, VD and Leprosy of B.R.D. Medical College, Gorakhpur, from July 2007 to December 2008. The group included 98 new cases of palmoplantar psoriasis. These cases were divided into eight groups according to the eight regimens involved in the study. The severity of psoriasis was assessed by the ESIF (erythema, scaling, induration and fissuring) score.

Results:

The study showed that all the regimens had significant response rates. The combination of NB-UVB with systemic methotrexate had maximum response rate (64.85±4.52%) that was statistically significant (paired “t” at 16d.f. = 33.329, P<0.001) with minimum number of recurrences after stopping the treatment. The combination of halobetasol ointment with systemic methotrexate also had significant response rate (paired “t” at 19d.f. = 13.5183, P<0.001) but had maximum number of cases with recurrence (70%) after stopping the treatment.

Conclusion:

These results suggest that the combination of every regimen with systemic methotrexate resulted in an early and a good improvement in the quality of life of patients suffering from psoriasis. It also shows that NB-UVB in combination with systemic methotrexate is more efficacious and has minimum recurrence rate and side effects in the treatment of palmoplantar psoriasis.

Nevirapine nanosuspensions for HIV reservoir targeting

In this paper we discuss, production, characterization and in-vivo evaluation of nevirapine nanosuspensions. Laser diffraction showed that the average particles size was 457 nm. Following single-dose administration, the plasma gamma concentration profiles showed fast release. Macrophage uptake studies confirmed enhanced cellular uptake for nanonized nevirapine with no added cytotoxicity. Gamma scintigraphy showed that the nanosuspension prepared can be used to target spleen, thymus and lungs, which represent anatomical viral reservoirs. Thus nevirapine nanosuspensions with targeting potential have been prepared successfully.

Flaxseed: a potential source of food, feed and fiber

Flaxseed is one of the most important oilseed crops for industrial as well as food, feed, and fiber purposes. Almost every part of the flaxseed plant is utilized commercially, either directly or after processing. The stem yields good quality fiber having high strength and durability. The seed provides oil rich in omega-3, digestible proteins, and lignans. In addition to being one of the richest sources of α-linolenic acid oil and lignans, flaxseed is an essential source of high quality protein and soluble fiber and has considerable potential as a source of phenolic compounds. Flaxseed is emerging as an important functional food ingredient because of its rich contents of α-linolenic acid (ALA), lignans, and fiber. Lignans appear to be anti-carcinogenic compounds. The omega-3s and lignan phytoestrogens of flaxseed are in focus for their benefits for a wide range of health conditions and may possess chemo-protective properties in animals and humans. This paper presents a review of literature on the nutritional composition of flaxseed, its health benefits, and disease-prevention qualities, utilization of flaxseed for food, feed, and fiber, and processing of flaxseed.

Stavudine entrapped lipid nanoparticles for targeting lymphatic HIV reservoirs

The main objective of present research study was to evaluate the potential of lipid nanoparticles for active delivery of an antiretroviral drug to lymphatic tissues. Stavudine entrapped drug loaded solid lipid nanoparticles (SLNs) were prepared and characterized for a variety of physicochemical parameters such as appearance, particle size, polydispersity index and zeta potential. The targeting potential of the prepared nanoparticles was investigated by carrying out ex vivo cellular uptake studies in macrophages which depicted several times enhanced uptake as compared to pure drug solution. Further, the lymphatic drug levels and organ distribution studies demonstrated efficiency of the developed nanoparticles for prolonged residence in spleenic tissues. Thus it was concluded that stavudine entrapped lipid carriers can be exploited for effective and targeted delivery to cellular and anatomical HIV reservoirs and may ultimately increase the therapeutic safety and reduce side effects.

Study on disinfestation of pulses using microwave technique

Mortality of the pulse beetle (Callosobruchus chinensis L.) exposed, continuously, to microwave radiation (2450 MHz) was evaluated as a function of exposure time and percent power level, at adult stages. The microwave exposure time to attain 100% insect mortality at 100 %, 80%, 60%, 40%, and 20% power levels for Chickpea, Pigeon Pea and Green Gram was optimized. Effect of optimized microwave exposure time on viability, germination, cooking and milling characteristics of Chickpea, Pigeon Pea and Green Gram was also evaluated. Adult stage study was characterized by a distinct dose-exposure curve. The mortality curve was following third degree polynomial equation. The seed viability and germination of Chickpea, Pigeon Pea and Green Gram was affected by microwave exposure time and power level. It was observed that as the power level is decreasing the germination and viability of all the pulses are increasing. The effect on cooking and milling characteristics are not affected by microwave exposure time and power level. The insects in the mobile state were observed to move towards the surface from inside the nutrient medium during microwave exposure. They also curled up and in some cases aggregation was observed.

Effect of moisture content and residence time on dehulling of flaxseed

Effects of moisture content and residence time on various dehulling parameters of flaxseed including yield, hull, hullability, extraction rate and embryo (dehulled flaxseed) recovery were studied. A laboratory model rice polisher/ dehulling machine and a laboratory model aspirator were used for dehulling and aspiration (hull separation), respectively. The dehulling experiments were carried out for moisture contents ranging from 1.9 to 7.8% wb and residence times from 20 to 50 sec in dehulling machine at 2000 rpm of abrasive disc (rotor) of the polisher. Both moisture content and residence time played an important role in dehulling of flaxseed. The optimum moisture range and residence time for dehulling of flaxseed were 1.9 to 4.5% wb and 40 sec, respectively.

Rectal dosimetry in intracavitary brachytherapy by HDR at rural center of Maharashtra: Comparison of two methods

The purpose of this study was to calculate the radiation dose at the anterior rectal wall as per the International Commission on Radiation Units and Measurements (ICRU 38) recommendations and compare it with the dose calculated by the commonly used intrarectal catheter. Dose delivery by brachytherapy to the cervix is limited by the critical structure of the bladder and rectum. In this study the ICRU-38 rectal point was derived by using a radio-opaque gauze piece on the posterior vaginal wall, and the intrarectal point was derived by inserting a rubber catheter with a wire, inside the rectum. A total of 146 applications were performed in 81 patients. Rectal doses were compared for complementary rectal points R1 and R5, R2 and R6, R3 and R7, and R4 and R8, obtained by both methods. The rectal doses at each complementary pair were compared with each other. The average dose at R1 was 5% higher than at R5 (60.57% vs. 55.57%). The average dose at R2 was 1% higher than at R6 (58% vs. 57%). The average dose at R3 was 1.29% higher than at R7 (52.71% vs. 51.42%), and the average dose at R4 was 1.15% higher than at R8 (43% vs. 41.85%). There were many instances where the rectal dose exceeded by more than 15%, from the R1 to R4 points (43, 22, 21, and 11 times, respectively, for R1-R5, R2-R6, R3-R7, and R4-R8 pairs). The difference in dose between R1 and R5 was significant as seen on the statistical tests, i.e., Pair T test, Wilcoxan Signed Ranks test, and Sign test (p value 0.002). The rectal dose obtained by the intrarectal wire method underestimates the actual dose to the rectum when compared to the ICRU-38 method. Thus ICRU-38 recommendations should be strictly adhered to, to reduce late complications.

Prevalence of dural ectasia in 63 gene-mutation-positive patients with features of Marfan syndrome type 1 and Loeys-Dietz syndrome and report of 22 novel FBN1 mutations

Marfan syndrome is an autosomal dominant disorder involving different organ systems. Marfan syndrome type 1 (MFS1) is caused by mutations in the FBN1 gene. Heterozygosity for mutations in the TGFBR1 or TGFBR2 genes cause Loeys-Dietz syndrome (LDS) types 2A and 2B that overlap with MFS1 in their clinical features. The phenotype of MFS1 is defined by the Ghent nosology, which classifies the clinical manifestations in major and minor criteria. Dural ectasia is one of the major criteria for Marfan syndrome but it is rarely tested for. We here report 22 novel and 9 recurrent mutations in the FBN1 gene in 36 patients with clinical features of Marfan syndrome. Sixty patients with identified mutations in the FBN1 gene and three patients with mutations in the TGFBR1 or TGFBR2 genes were examined for dural ectasia. Forty-seven of the 60 patients (78%) with MFS1 showed the dural ectasia criterion and 13 (22%) did not. Thirty-three (55%) patients were suspected of having Marfan syndrome and 24 (73%) of them had dural ectasia. Two of the three patients with LDS had dural ectasia.

Chemical warfare agents

Chemical warfare agents (CWA's) are defined as any chemical substance whose toxic properties are utilised to kill, injure or incapacitate an enemy in warfare and associated military operations. Chemical agents have been used in war since times immemorial, but their use reached a peak during World War I. During World War II only the Germans used them in the infamous gas chambers. Since then these have been intermittently used both in war and acts of terrorisms. Many countries have stockpiles of these agents. There has been a legislative effort worldwide to ban the use of CWA's under the chemical weapons convention which came into force in 1997. However the manufacture of these agents cannot be completely prohibited as some of them have potential industrial uses. Moreover despite the remedial measures taken so far and worldwide condemnation, the ease of manufacturing these agents and effectiveness during combat or small scale terrorist operations still make them a powerful weapon to reckon with. These agents are classified according to mechanism of toxicity in humans into blister agents, nerve agents, asphyxiants, choking agents and incapacitating/behavior altering agents. Some of these agents can be as devastating as a nuclear bomb. In addition to immediate injuries caused by chemical agents, some of them are associated with long term morbidities and psychological problems. In this review we will discuss briefly about the historical background, properties, manufacture techniques and industrial uses, mechanism of toxicity, clinical features of exposure and pharmacological management of casualties caused by chemical agents.

Spermicidal agents

In recent years, there is a development of vaginal contraceptives incorporating potent spermicides. Many compounds with different pharmacological activity have been evaluated in vitro for their spermicidal activity. Drugs such as surfaceactive agents (synthetic and natural), ionophores, antiliquefying agents, antimicrobial agents and miscellaneous agents such as gossypol, Azadirachta indica, vanadocenes have all been demonstrated to possess good spermicidal activity. Nonoxynol is the only spermicidal agent currently marketed and widely used. But there is still a need to develop alternative compounds for future use as safe spermicide.

Removal of Cr(VI) from aqueous solutions using agricultural waste 'maize bran'

Novel biosorbent 'maize bran' has been successfully utilized for the removal of Cr(VI) from aqueous solution. The effect of different parameters such as contact time, sorbate concentration, pH of the medium and temperature were investigated and maximum uptake of Cr(VI) was 312.52 (mgg(-1)) at pH 2.0, initial Cr(VI) concentration of 200mgL(-1) and temperature of 40 degrees C. Effect of pH showed that maize bran was not only removing Cr(VI) from aqueous solution but also reducing toxic Cr(VI) into less toxic Cr(III). The sorption kinetics was tested with first order reversible, pseudo-first order and pseudo-second order reaction and it was found that Cr(VI) uptake process followed the pseudo-second order rate expression. Mass transfer of Cr(VI) from bulk to the solid phase (maize bran) was studied at different temperatures. Different thermodynamic parameters, viz., DeltaG degrees , DeltaH degrees and DeltaS degrees have also been evaluated and it has been found that the sorption was feasible, spontaneous and endothermic in nature. The Langmuir and Freundlich equations for describing sorption equilibrium were applied and it was found that the process was well described by Langmuir isotherm. Desorption studies was also carried out and found that complete desorption of Cr(VI) took place at pH of 9.5.

Ex-Servicemen Medical Aid Group (ESMAG) : The Hidden Force

Natural calamities such as cyclones, floods and earthquakes are common occurrences in the Indian sub continent which require super human effort to contain damage to men and material. Such events put the dedication, endurance capabilities and organizational skills available in the country to a litmus test. It is not surprising therefore, that the Armed Forces are often asked to spearhead the relief work in such disaster situations. So far, the potential for utilization of disciplined and trained ex-servicemen population for such situations has remained untapped due to the lack of an organizational framework. A concept of tapping this large pool of trained manpower is presented.

Laparoscopic gastrectomy for gastric cancer: early experience among the elderly

BACKGROUND

The data are scarce on the outcome for elderly patients presenting with resectable gastric cancer in the West who have been treated with minimally invasive surgery. This report presents the authors' early experience with totally laparoscopic gastric resections for cancer in elderly patients.

METHODS

A total of 20 patients underwent laparoscopic gastrectomy procedures: 14 distal, 5 subtotal, and 1 total gastrectomy. The male-to-female ratio was 15 to 5. The ages ranged from 75 to 88 years (mean, 80 years).

RESULTS

All cases were managed laparoscopically with R0 resection. Four patients needed high-dependency unit care postoperatively. There were no perioperative deaths. The median time required for the procedure was 212 min, and time to diet was 4 days. The hospital stay was 8 days. Four patients experienced significant complications, with two patients requiring reoperation. The pathology was adenocarcinoma for 17 patients and high-grade dysplasia for 3 patients.

CONCLUSION

Among elderly patients for whom conventional gastric surgery carries a high morbidity and mortality risk, minimal access surgery may offer equivalent oncologic integrity but with superior safety and economy. The primary aim is to remove the tumor with at least a D1 lymphadenectomy.