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The objective of this study is to assess the role of intrathecal and topical vancomycin in the prevention of ventriculoperitoneal shunt infection. Infections of the ventriculoperitoneal (VP) shunt are a frequent consequence of shunt surgery. Different strategies, and protocols in addition to prophylactic intravenous antibiotic administration have been described to limit the infection rate, but the burden still remains high. The use of intrathecal Vancomycin along with topical application can be implemented as an additional measure to limit shunt-related infections. The study includes 105 patients who underwent ventriculoperitoneal shunt insertions for different reasons. Apart from the standard operative protocols used for shunt surgeries, intraoperatively intrathecal and topical vancomycin were administered to all the patients. Postoperatively, all the patients were followed for three months to assess shunt-related infections The study showed that the infection rate after administration of intrathecal and topical Vancomycin was found to be low, which is 4.7%, which shows a reduction of 5.8% from our baseline infection rate of 10.5%. We also found that patients having tuberculous meningitis were more at risk of developing shunt-related infections, the p-value being significant (0.001*). Therefore, we conclude that as part of a standardized shunt operation routine, Intrathecal and topical vancomycin treatment may be an appropriate option for preventing pediatric shunt infections. [ABSTRACT FROM AUTHOR]

Atomically-abrupt interfaces in transition metal oxide (TMO) heterostructures could host a variety of exotic condensed matter phases that may not be found in the bulk materials at equilibrium. A critical step in the development of such atomically-sharp interfaces is the deposition of atomically-smooth TMO thin films. Optimized deposition conditions exist for the growth of perovskite oxides. However, the deposition of rutile oxides, such as VO 2 , with atomic-layer precision has been challenging. In this work, we used pulsed laser deposition to grow atomically-smooth VO 2 thin films on rutile TiO 2 (101) substrates. We show that an optimal substrate preparation procedure followed by the deposition of VO 2 films at a temperature conducive for step-flow growth mode is essential for achieving atomically-smooth VO 2 films. The films deposited at optimal substrate temperatures show a step and terrace structure of the underlying TiO 2 substrate. At lower deposition temperatures, there is a transition to a mixed growth mode comprised of island growth and layer-by-layer growth modes. VO 2 films deposited at optimal substrate temperatures undergo a sharp metal to insulator transition, similar to that observed in bulk VO 2 , but at a transition temperature of ∼ 325 K with ∼ 10 3 times increase in resistance. [ABSTRACT FROM AUTHOR]

Objective: To compare the marginal integrity of Class-I amalgam and bonded amalgam restorations in maxillary and mandibular molars at seven days, three, six and twelve-months intervals. Study Design: Comparative prospective study. Place and Duration of Study: Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Jul 2017 to Jul 2018. Methodology: A total number of 114 patients of either gender with an age range of 14-45 years having Class-I cavities in first and second maxillary and mandibular molars on both sides were equally distributed in two groups. Group-A received conventional Amalgam, and Group-B received bonded amalgam restorations. All the fillings were placed and carved using routine instruments used for amalgam restorations, and the restorations were polished after 24 hours. The patients were initially evaluated for marginal ditching around restorations with the help of a dental mirror and explorer at seven days, followed by inspection at 3, 6 and 12 months. Results: Of the 114 participants, all showed excellent marginal integrity at seven-days intervals regardless of the restorative material used. However, marginal integrity deteriorated swiftly with time among those 57(50%) participants who acquired conventional Amalgam. Marginal integrity at 3, 6 and 12-months period was 51(89.5%), 35(61.4%) and 17(29.8%), respectively. Bonded amalgam restorations performed superiorly with 100%, 56(98.2%) and 43(75.4%) successful marginal integrity at 3, 6 and 12-months, respectively. Conclusion: Bonded amalgams can be a better substitute than non-bonded amalgam restorations with superior longevity in marginal integrity. [ABSTRACT FROM AUTHOR]

Background: Acute pancreatitis (AP) has been defined as an "acute inflammatory process of the pancreas with variable involvement of other regional tissues or remote organ systems". Increasing incidence of AP worldwide with 33.74 cases per 100,000 persons per year reported globally over the last few years has landed it amongst the most common gastrointestinal disorders requiring hospitalization. Objective: To determine the efficacy of C Reactive Protein (CRP), in predicting severity and outcome of Acute Pancreatitis (AP), taking CT scan findings as gold standard. Study type, settings & duration: This cross-sectional research was conducted at the Department of General Surgery (Unit III), Jinnah Postgraduate Medical Center, Karachi, from January to March 2021. Methodology: A sample of 186 patients (obtained via non-probability - consecutive sampling), presenting with acute pancreatitis (based on Revised Atlanta Classification - RAC). After taking written informed consent, patient data was recorded on a structured questionnaire (containing inquiries pertaining to basic biodata, sociodemographic details, presenting complaints, inferences obtained from disease history and clinical examination, laboratory investigation (CRP values and variations - at scheduled intervals), CT findings, and patient outcome. The data obtained was analyzed using SPSS. v. 21.0. Results: The mean age of the sample was 39 (SD ± 4) years and 119 (63.9%) were males, while the remaining 67 (36.1%) were females. A raised CRP (= 150 mg/dL) was present among 163 (87.6%) of the patients. CRP changes at 24, 48 and 72 h were synonymous with disease severity and a positive association between CRP level / CRP change (rise) and disease severity was noted (p value 0.035). Recovery was achieved during the study period among majority of the patients, however complaints such as pancreatic necrosis were reported in 24 (12.9%), abscesses in 32 (17.2%), and pseudocysts in 25 (13.4) patients. Mortality was reported in 2 cases. Conclusion: CRP has a high efficacy at predicting disease severity of acute pancreatitis. The evidence yielded has offer much needed solace from AP, which is a pressing situation, both for the patient and healthcare provider. The resources (infrastructural and financial) for CT evaluation of AP patients are often not available and thus, CRP may offer help for the much needed insight into the disease severity quickly, easily and at a lower cost. [ABSTRACT FROM AUTHOR]

Objective: To carry out preoperative assessment of scoring system designed for prediction of difficult cholecystectomy in patients with symptomatic gall stones. Study Design: Prospective observational study. Place and Duration of Study: The study was conducted in General Surgery Unit 1, ward 3, JPMC, from Jun 2017 to Aug 2018. Methodology: During the study, 208 patients were enrolled who presented for the elective cholecystectomy. Personal data, comorbid illness, sonographic, clinical and biochemical parameters were assessed. Based on the preoperative scoring, outcome measure was easy, difficult or very difficult cholecystectomy. Results: On the basis of preoperative assessment and scoring, 157 (75.5%) patients were preoperatively predicted for easy cholecystectomy whereas 51 (24.5%) patients were predicted for difficult cholecystectomy. Sensitivity and specificity of this scoring method were 96.5% and 68.5% respectively. Positive predictive value of this scoring method was 89.1% and 72.5% for easy and difficult cases, respectively. Conclusion: The scoring system proposed in our study incorporating all the known factors for difficult cholecystectomy does provide a definite, objective and reliable prediction of difficult case pre operatively. [ABSTRACT FROM AUTHOR]