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Obesity is a known risk factor for surgical site infection (SSI). Recent studies have demonstrated that fat burden at the incisional site rather than body mass index (BMI) is a more precise and sensitive measure to predict the risk of SSI. The purpose of the study was to evaluate the correlation between subcutaneous fat thickness (SCFT) at the level of Mc Burney’s point and the occurrence of superficial incisional SSI among the patients undergoing open appendectomy. A total of 120 patients who underwent open appendectomy were included in the study. SCFT was measured preoperatively with ultrasonography (USG). The occurrence of superficial incisional SSI was evaluated in relation to SCFT. Previously identified well established risk factors for the development of SSI were also considered by the study. Statistical analysis was performed using SPSS version 17. Overall, superficial incisional SSI was observed in 27 (22.5%) participants. Mean SCFT at the level of Mc Burney’s point among male and female population was 2.26 cm ± 0.74 (SD) and 2.02 cm ± 0.83 (SD) respectively. Patients with superficial incisional SSI had a mean fat thickness of 2.80 cm and those without SSI had mean fat thickness of 1.97 cm. The difference in SCFT was statistically significant (p=.001). More interestingly, the area under the ROC curve was more for SCFT, in comparison to BMI among the patients who developed superficial incisional SSI (81% vs. 73%). Furthermore, we analysed the occurrence of superficial incisional SSI with SCFT cut off at 2.80 cm, which was statistically significant. As majority of the study population were young adults, risk factors like smoking, diabetes mellitus and nutritional status failed to demonstrate significant correlation with post appendectomy wound site complications. The study demonstrated that the thickness of subcutaneous fat at the site of inci sion is a good predictor of superficial incisional SSI following open appendectomy and the risk of superficial wound site infection increases as the thickness of subcutaneous fat at the site of incision increases.

Introduction: Several prognostic models have been implemented for risk assessment and mortality prediction in critically ill patients admitted in ICU. The availability of such sophisticated methods has facilitated in clinical decision making and comparison of outcomes. However, none are universally accepted as standard method to predict mortality. We have decided to use SAPS II score because of the simplicity and easy availability of its variables to analyse the outcomes of critically ill surgical patients admitted to ICU at our centre. Methods: The study was conducted between September 2016 and August 2018 at Nepal Medical College and Teaching Hospital, Kathmandu, Nepal. We prospectively collected data on surgical patients consecutively admitted to the ICU during the study period. The variables of SAPS II score were collected from the physiological, laboratory, and patient characteristics mentioned in the ICU scoring data sheet at 24 hours. The SAPS II score and predicted mortality was calculated using computer software programme. The predictive mortality based on the score was compared with the actual outcome to derive the standardized mortality ratio (SMR). Results: During the period of study, 64 patients met the inclusion criteria. The mean age of the patients was 54±17.9 (20-84) years and length of ICU stay was 5.3 ±3.5 (3-22) days. GI malignancy was most common pathology comprising 43.8% (n=28). The mean SAPS II score was 24.9±16.4 (3-68). There was no statistical difference in mean SAPS II score between patients with different gender, nature of disease and type of surgical intervention The mean predicted mortality was 13.4% and the observed ICU mortality was 15.6% (n=10). The calculated mean SAPS II score and predicted mortality was higher in nonsurvivors compared to survivors (p

Austenitic stainless steel is used as fuel cladding in advanced gas-cooled nuclear reactors (AGR). At elevated temperatures, when the steel is exposed to CO2 based environments filamentary carbon deposits form on the surface of the steel. This filamentary carbon deposition is known to be catalysed by metallic nickel-rich particles. Adding trace amount of carbonyl sulphide (COS) into the gas mixtures suppresses the carbon deposition. In this current work, it has been shown that at 600 °C, the formation of filamentary carbon was suppressed by the addition of 215 ppb COS to a depositing gas mixture (containing approximately 1000 vppm C2H4/1% CO/bal. CO2) which was known to provide the environment suitable for carbon deposition. Samples exposed to the gas mixtures with and without 215 ppb COS were characterised using electron microscopy techniques to understand the formation mechanism of the nickel-rich particles and the inhibition mechanism due to the addition of COS. Electron diffraction study shows that the nickel-rich particles in the oxide layers assume the same crystallography as that of the austenitic metal underneath, regardless of the COS addition. The current observations also show that the metal-oxide interfaces was nickel-rich and a simple model has been proposed to explain the formation of nickel-rich particles within the subsurface oxide. Furthermore, it was found that when COS was added the surface of the nickel-rich particles in the oxide layer was found to be sulphur-rich by energy dispersive spectroscopy (EDS) on a scanning transmission electron microscope (STEM). It is believed that the surface sulphur adsorption onto the nickel-rich particles, rather than bulk sulphide formation, resulted in the inhibition of carbon deformation on the steel.

The effect of microwave modulated with square waves of different pulse repetition frequencies was studied on the physiologic behavior of the cyanobacterium Anabaena doliolum. The organism was exposed either directly after inoculating the nutrient solution or indirectly by exposing the nutrient solution before inoculation with the cyanobacterium cells for 1 h to microwave (9.575 GHz) modulated with square wave pulse repetition frequencies of 1000, 700, 500, 200, 100, and 50 Hz at a fixed incident power density (0.658 mW/cm2). This study reveals that microwaves athermally induce different biologic effects, perhaps by changing the structures of water. Modulation frequency–dependent water structures appear to cause the biologic effects by differentially partitioning the ions, altering the rate and/or directions of biochemical reactions, or other mechanisms.