Research Article

Three year outcomes following positive cross match renal transplantation despite failure to convert to Negative Flow Cross Match after Desensitization

Shree Patel*, Jamie Benken, Patricia West Thielke, Sanjeev Akkina, Enrico Benedetti and James Thielke

Desensitization allows successful transplantation of patients with a positive crossmatch (PXM) against their live donor. We evaluated outcomes following PXM renal transplant despite failure to convert to negative flow cytometric crossmatch (FCXM) after desensitization. Patients that underwent desensitization before PXM transplant between 1/1/00 and 11/1/11 were identified for analysis. Patients who received a transplant despite failure to convert to negative FCXM were identified as the not converted group. Patients who converted to negative FCXM after desensitization comprised the converted group control arm. 108 patients were desensitized before PXM transplant, (not converted group=42; converted group=66). Mean eGFR was comparable between groups at all time points, and 3-year eGFR was 57.8 mL/min vs. 57.1 mL/min, p=0.91. Patients with eGFR < 30mL/min at 3 years did not differ significantly (28% vs. 14%, p=0.15). Biopsy-proven rejection rates were numerically higher within the not converted group for each type of rejection and time point, but the values did not differ significantly. Opportunistic infections rates were comparable. Patient survival (95% vs. 91%) and death-censored allograft survival (84% vs. 95%, p=0.07) were similar between arms at 3 years post-transplant.

Case Report

Congenital poisoning after maternal parenteral mercury administration

Benjamin Courchia*, Leventer Roberts Maya, Meyer John, Galvez Maida, Herrera Jaime and Rauch Daniel

This is the case of a full-term baby girl, born to a mother with a history of parenteral inorganic mercury administration. Thirteen years prior, this mother injected 1mL of inorganic mercury in her right forearm, was subsequently hospitalized, but never received chelation treatment. Her first trimester blood and urine mercury concentration were found to be elevated at 28μg/L (normal <10μg/L) and 162 μg/L (normal <20μg/L) respectively. Her chest x-ray also revealed multiple small punctate metallic densities within the lower lung fields. The remainder of the prenatal course was uneventful. The baby was born at 40 weeks of gestation via uncomplicated caesarian section, and on day of life 3, blood mercury concentrations were found to be 20μg/L (normal <20μg/L). The baby, however, remained asymptomatic throughout her hospital stay and on outpatient follow up. She is now two years old. Mercury poisoning in the pediatric population remains a concern, and knowledge of exposure and health effects continues to be relevant as newer uses and modes of exposure are discovered. This case report illustrates a rare perinatal exposure scenario, and, while the mother and child were essentially asymptomatic, the case serves to raise awareness of the many ways in which fetuses, infants, and children may still be exposed to the harmful effects of mercury. This case underscores the need for careful environmental history taking in pregnancy, after birth, and ideally in the pre-conception period as well.

Research Article

Histological clonal change - A feature for dysplasia diagnosis

Lewei Zhang*, Tarinee Lubpairee, Denise M Laronde, Martial Guillaud, Calum E MacAulay and Miriam P Rosin

Aims: Histological diagnostic criteria are used for the assessment of the degree of dysplasia and hence the risk of cancer progression for premalignant lesions. Clonal changes in the form of hyperorthokeratosis and hyperchromasia that are sharply demarcated from adjacent areas are not currently part of the criterion for dysplasia diagnosis. The objective of this study was to determine whether such clonal change should be regarded as a diagnostic feature for dysplasia. The following histological conditions were used to define such change: (1) hyperorthokeratosis; (2) hyperchromatism but no other features of dysplasia; (3) sharp margin demarcation from adjacent area by both the hyperorthokeratosis and hyperchromasia (clonal change), and (4) no prominent rete ridges, marked acanthosis or heavy inflammation. Lesions fitting these criteria were termed orthokeratotic lesions with no dysplasia.

Methods: Patients from a population-based longitudinal study with more than 10 years of follow up were analyzed. Of the 214 patients with primary oral premalignant lesions, 194 had mild or moderate dysplasia (dysplasia group) and 20 fit the criteria for orthokeratotic lesions without dysplasia (orthokeratotic with no dysplasia group). The two groups were compared for their cancer risks using clinical (site and toluidine blue), histological (nuclear phenotype score), and molecular criteria (loss of heterozygosity) and by outcome (progression).

Results and conclusions: The lesions from orthokeratotic with no dysplasia group showed a similar cancer risk (clinical, histological and molecular risk) and time to progression as the dysplastic lesions. We recommend that the clonal change should be included as a criterion for dysplasia diagnosis.

Research Article

Life history strategies of the armored scale, Aulacaspis alisiana (Hemiptera: Coccoidea: Diaspididae) on the Japanese silver tree Neolitsea sericea (Bl.) Koidz. (Lauraceae) in Fukuoka, Japan

Charles AO Midega* and Keiji Takasu

The armored scale Aulacaspis alisiana, is a serious invasive pest of the Japanese silver tree, Neolitsea sericea, causing serious damage to the tree in Japan. However there are currently no control approaches available for it, complicated by shortage of information on the pest.We studied life history strategies of A. alisiana on N. sericea in Fukuoka Prefecture with a view to providing a basis for formulating sustainable control based on an understanding of the behavior of the pest and potential role of its natural enemies. We established that A. alisiana had three overlapped generations in Fukuoka, with generation times ranging between 65 and 71 days. The adults were relatively fecund, with each female producing between 60 and 67 eggs, with high hatchability, >78%. The pest settled on the lower side of leaves, and although it generally preferred younger leaves, it did not attack newly emerged leaves. Natural enemy groups comprising ants, spiders and beetles (coccinelids) played an important role in regulation of the pest population, with natural mortality of about 30%. They could thus form a critical component of an integrated management approach for the pest in Fukuoka.

Research Article

Effect of diabetes mellitus on the Pulmonary Function Tests in Sudanese Diabetic Patients

Elmutaz H Taha, Ibrahim A Ali* and Omer A Musa

Background: Diabetes mellitus is a leading cause of illness and death. Pulmonary function test PFT has assumed a key role in epidemiological studies investigating the incidence, natural history and causality of lung disease.

Methods: A cross sectional study was conducted in The National Ribat Teaching Hospital and Jabir Abualiz Specialized Diabetes Center in Khartoum state to measure the respiratory muscle power in 31 diabetic patients (case group) and 30 non-diabetics patients (control groups). Pulmonary function tests were measured by using Digital Spirometer-Micro-Plus version.

Results: Lung function parameters between diabetic patients and their matched control group show no significant differences between the means of FVC, FEV1 and FEV1/FVC. However, diabetic patients showed significant reduction in PEFR.

Conclusions: Exercise and well control of diabetes helped in preserving normal respiratory muscle power. Continuous reasonable exercise with good control is highly recommended for all diabetics.


Research Article

Preliminary Report on the Effect of Mesenchymal Stem Cell Therapy in Patients with Chronic Lung Allograft Dysfunction

Cesar A Keller*, Thomas A Gonwa, Athena L Russell, David O Hodge, David B Erasmus and Abba C Zubair

Background: Mesenchymal stem cell (MSC) effects can shift immune responses toward anti-inflammatory and tolerogenic phenotypes, potentially helping patients with bronchiolitis obliterans syndrome (BOS).

Methods: We evaluated the effect of infusing allogeneic MSC intravenously in 9 patients with moderate BOS refractory to standard therapy who were not candidates for retransplant, dividing them into 3 dosing groups: Group 1, 1×106 MSC/kg (n=3); Group 2, 2×106 MSC/kg (n=3); and Group 3, 4×106 MSC/kg (n=3). We recorded pulmonary function tests, laboratory variables, and serum biomarkers pre- and post-MSC infusion.

Results: These patients had significant decline in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) over 1 year pre-MSC infusion (mean ± SD) FVC, 3.11±0.98 L, and FEV1 1.99+0.64 L versus FVC 2.58±1.03 and FEV1 1.61±0.52 just before infusion (P<0.05); representing a mean loss of 530 mL in FVC and 374 mL in FEV1 over 12 months. One year post-MSC infusion, mean FVC and FEV1 increased to 2.66±1.01 L and 1.63±0.55 L, respectively (changes no longer significant compared to before MSC infusion). Patients in Group 1 showed elevation of tolerance-inducing T regulatory cells and increased levels of epidermal growth factor. Tolerance-inducing Th-2 cytokines increased in Groups 1 and 2. These changes were not significantly different in these small sub-groups.

Conclusion: MSC infusion appears to slow down or reverse the progressive decline in lung function in some patients with moderate BOS, possibly by inducing anti-inflammatory effects and promoting cell proliferation and angiogenesis.


Research Article

Expression of C-type Natriuretic Peptide and its Specific Guanylyl Cyclase-Coupled Receptor in Pig Ovarian Granulosa Cells

Soo Mi Kim, Suhn Hee Kim, Kyung Woo Cho, Sun Young Kim and Sung Zoo Kim*

Background: C-type natriuretic peptide (CNP) was isolated from porcine brain and is a 22-amino acid peptide which belongs to the natriuretic peptide (NP) family. Even though this peptide shares structural similarity to other endogenous NPs including atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) its receptor selectivity is different from other NPs. The present study was undertaken to investigate the expression of C-type natriuretic peptide (CNP) and its specific guanylyl cyclase (GC)-coupled receptor in the granulosa cells of the pig ovarian follicle.

Results: Specific 125I-[Tyr0]-CNP(1-22) binding sites were localized in the granulosa cell layer of the ovarian follicle with an apparent dissociation constant (Kd>) and a maximal binding capacity (Bmax) of 1.41±0.39 nM and 2.75±0.65 fmol/mm2 respectively. Binding of 125I-[Tyr0]-CNP(1-22) to these sites was also prevented by atrial natriuretic peptide (ANP(1-28)), brain natriuretic peptide (BNP(1-26)) and des[Gln18,Ser19,Gly20, Leu21,Gly22] ANP(4-23) (C-ANP). Production of 3’,5’-cyclic guanosine monophosphate (cGMP) by particulate GC in the granulosa cell membranes was stimulated by natriuretic peptides (NPs) with a rank order of potency of CNP(1-22)>>BNP(1-26)>ANP(1-28). HS-142-1, a selective antagonist of the two recognized GC-coupled NPRs, inhibited CNP(1-22)-stimulated cGMP production in granulosa cell membranes in a dose-dependent manner. Also mRNAs for all three recognized NPRs were detected in granulosa cells using reverse transcriptase-polymerase chain reaction (RT-PCR). Serial dilution curves of granulosa cell extracts were parallel to the standard curve of synthetic CNP.

Conclusion: These results indicate that CNP and its specific receptor are expressed in the granulosa cells of the pig ovary, and suggest that CNP may be a local autocrine and/or paracrine regulator via activation of its specific GC-coupled receptor, NPR-B.

Review Article

Cyberbullying: A narrative review

Tiffany Field*

A literature search was conducted using PubMed and PsycINFO to locate cyberbullying research that was published during the last 4 years. In this narrative review, cyberbullying research is briefly summarized and critiqued. The review is focused on the varying definitions and characteristics of cyberbullies, victims and bystanders. Highly variable prevalence rates have been reported for cyberbullies, victims and bystanders as a function of age, gender, country, size of the social network and socioeconomic factors. In addition, the effects of cyberbullying are reviewed including the frequent suicide attempts along with risk factors/predictors of cyberbullying which include previous cyberbullying, excessive internet use and lack of empathy, anger, narcissism and authoritarian/permissive parenting. To reflect the recent literature, special attention is given to the studies on victims of bullying. Research on cyberbullies and on prevention/intervention programs for bullying is extremely limited despite the increasing prevalence of bullying and the rapidly accumulating literature. Methodological limitations include the primary focus on the prevalence of bullying and on the victims of bullying. Longitudinal, multivariate studies are needed to identify profiles on risk factors for bullying that can inform prevention programs.

Case Report

A Case-Study of the Anatomy of a Miscommunication: Why colleagues as patients develop complications?

Colin Pritchard* and Jeremy Latham

This is an anatomy of a miscommunication, written by the patient, a medical school professor and his orthopaedic consultant, who was also a colleague leading to a series of misunderstandings. This raises the practical question of who is responsible for effective communication with the patient who is also a colleague. At the pre-operative assessment a combination of the diffidence of an inexperienced nurse and the patient’s wrong assumptions about his post-operative mobility and his keenness to maintain his independence and identity nearly led to a delayed discharge. The miscommunication was due to the patient’s assumptions about previous orthopaedic and recent cardiac surgery hospital experience. Neither he nor the nurse checked these assumptions and we speculate might this possibly account for why senior colleagues who become patients sometimes have unexpected complications. There are lessons to be learned from this frank exploration of the colleague patient’s experience of a miscommunication.

Research Article

The influence of physical activities on biological age parameters of females from 17 to 18 years old

Dao Chanh Thuc*

The effect of weekly physical activity on biological age (BA) parameters, we have conducted a study 215 females from 17 to 18 years old who were divided into the experimental (EG, n=105) and control (CG, n=110) groups. It was established that if at the end of the experiment the BA parameters of the females CG weren’t a significantly different from the average data (p>0.05), then there was a statistically significant decrease in the BA parameters of the females EG. This was confirmed by statistical probability (p<0.01), which suggests the dependence of biological age parameters on the extent of weekly physical activity.

Research Article

Successful treatment of late-onset pulmonary hypertension after atrial septal defect operation with macitentan: Our center experience

Tarik Kivrak*, Zeynep Ulutas, Sena Sert and Bulent Mutlu

Background: Macitentan signifi cantly improves pulmonary hemodynamics and survival in patients with primary pulmonary hypertension (PPH). Its beneficial effect, however, may be blunted due to the adverse impacts such as anemia and peripheral edema.Pulmonary arterial hypertension (PAH) is a significant consequence of congenital heart disease (CHD). Its presence and severity are associated with increased morbidity and mortality. We tried to evaluate that the effectiveness of the macitentan in patients with late-onset pulmonary hypertension after atrial septal defect operation in our center.

Methods: The effect of a single dose of macitentan (10 mg) on pulmonary hemodynamics, functional capacity was examined in four patients with late-onset pulmonary hypertension after atrial septal defect operation.

Results: The macitentan significantly improved mean pulmonary artery pressure (MPAP), cardiac output (CO), tricuspid annular plane systolic excursion (TAPSE), right ventricle systolic wave(RVS’), 6-minute walking test and NT-proBNP levels compared with before treatment.

Conclusions: Macitentan can be used in patients with late-onset pulmonary hypertension after shunt operation especially atrial septal defect.


Review Article

Neurobiology of Common Sleep Disorders

Zhao Liu*, Abdullah Tolaymat and Sreenivas K Avula

Sleep disorders in human are common and detrimental to general health of all age groups. While the neurobiological mechanisms of sleep disorders are not yet fully understood, recent advances in research on the sleep-wake regulation mechanism, genetic and epigenetic factors, cognitive,emotional and physiological changes related to sleep have shed light on the mechanistic basis of sleep disorders. Over the past two decades, studies in Drosophila have yielded new insights into basic questions regarding sleep function and regulation. More recently, powerful genetic approaches in the fly have been applied toward studying primary human sleep disorders and other disorders associated with dysregulated sleep. In this review, we discussed recent advances in neurobiology of sleep-wave cycle and common sleep disorders. Understanding these mechanisms are important in the diagnosis, treatment and prevention of these common disorders.

Case Report

A Pancreatic Neuroendocrine Tumor with an Unusual Flush

Nathania Sutandi* and Steven White

A 60-year-old man presented with an unusual history of lower limb flushing. A CT scan suggested a pancreatic neuroendocrine tumor. After a robotic distal pancreatectomy, his symptoms completely resolved. The tumor was positive for synaptophysin and chromogranin. This case emphasizes the importance of recognizing atypical features in patients, especially with an unusual skin presentation that might indicate rare tumor types.

Review Article

Effect of cement solidification on strength and leaching properties of Heavy Metals Contaminated Soil

Syed Taseer Abbas Jaffar*, Sajjad Yousefi Oderji, Si-an Zhang and Long-zhu Chen

This study investigated the effect of Portland cement on stabilization of heavy metal contaminated clayey soils that may give range of geo environemntal benefits. The absolute concentration of heavy metals: Lead (Pb), Zinc (Zn), Chromium (Cr), Cadmium (Cd) and Copper (Cu) were measured using an inductively coupled plasma atomic emission spectroscopy (ICP-AES). A series of laboratory scale experiments such as unconfined compression test (UCT), pH test and synthetic precipitation leaching procedure (SPLP) were performed to study the effects of curing time and cement content on the unconfined compressive strength (UCS) and leaching characteristics of heavy metals. According to results, excessive concentration of heavy metals are present in the topsoil of Shanghai Jiao Tong University (SJTU) among which Pb, Zn and Cd were most prominent. Other test results showed that the dry density of both C4 and C8 soil samples increases with curing time. Similarly the compressive strength (qu)of C4 and C8 samples at 21 d of curing increases by 40% (113 kPa-288 kPa) and 15% (745kPa-864 kPa) respectively, as compared to the 7 d of curing. Besides, the test results showed a prominent decrease in the leached concentration of heavy metals with increasing curing time.

Research Article

Evaluation of novel culture media prepared from plant substrates for isolation and identification of Cryptococcus Neoformans Species Complex

Krema ZA, Mokthar ES, El Magrahi HS, Eshwika A, Ellabib MS, Cogliati M

Background: Melanin production due to phenoloxidase activity is a distinctive property of Cryptococcus neoformans and Cryptococcus gattii species complex yeasts. Therefore, an agar medium containing a precursor of melanin pigment is potentially useful to identify and differentiate cryptococcal colonies from other yeasts.

Background: This study aimed to evaluate and compare the ability of Cryptococcus neoformans species complex isolates to produce brown-pigmented colonies when grown on media prepared from various plant leaves or seeds extracts.

Material and Methods: Forty-six C. neoformans species complex isolates which were obtained from various environmental and clinical samples were inoculated on different media containing coriander, cumin, soybean, lupine, flax, pumpkin, basil, peppermint, and marjoram, were observed for the rate of growth and pigment production during a five-day period.

Results: All isolates were pigmented on all media within 24-48 hours, and brown or dark brown colonies were observed in less than five days, while C. albicans grew but did not produce any pigment.

Conclusion: The differential media tested in the present study are simple and inexpensive, and represent alternative valid tools for presumptive identification of C. neoformans species complex from clinical and environmental samples.

Research Article

Oral Candida colonization in HIV infected patients: Species and antifungal susceptibility in Tripoli/Libya

Mohamed H, Krema Z, Mokthar E, Ellabib M, El Magrahi H, Eshwika A

Introduction: Candidiasis is more frequent in human immunodeficiency virus (HIV)-infected patients and knowledge about the distribution and antifungal susceptibility of oral Candida species is important for effective management of candidiasis.

Material and Methods: An oral rinses sample collected from hundred HIV-infected patients with and without clinical evidence of oral candidiasis in this study at the Infectious Department/Tripoli Medical Center, Libya. Species identified by standard phenotypic and conventional methods and in vitro susceptibility testing of the yeast isolates to antifungals were performed using the Disc diffusion method protocol as recommended by the Clinical Laboratory Scientific Institute.

Results: Oral Candida colonization is detected in all patients with and without clinical syndromes, and Candida albicans were accounted for (74%), C. dubliniensis (11%) and C. glabrata (6%). A high proportion of Candida species (42%) showed decreased susceptibility to fluconazole. Among C., albicans more than 30% of isolate were resistant to most new azole antifungal including fluconazole, itraconazole, posoconazole and voriconazole.

Conclusions: A significant number of oral Candida species particular Candida albicans exhibiting decreased susceptibility to fluconazole were isolated from colonized HIV-infected individual, given the high incidence and severity of fungal infections in HIV-infected individuals. The results of this study reinforce the importance of antifungal susceptibility testing, which contributes to the therapeutic strategies and highlights the need for continuous surveillance of Candida colonization in this population.

Review Article

Investigation of radiation attenuation parameters of some drugs used in Chemotherapy in Wide Energy Region

Ferdi Akman* and Mustafa Recep Kacal

Objectives: The aim of this study is to compute the radiation attenuation parameters such as mass attenuation coeffi cient, linear attenuation coefficient, half value layer, mean free path, and effective atomic number for some selected chemotherapy drugs such as Lomustine, Cisplatin, Carmustine, and Chlorambucil in the energy range from 1 keV to 100 GeV.

Materials and Methods: The mass attenuation coefficients were calculated with the help of WinXCOM program. Using the obtained mass attenuation coefficients, other parameters such as linear attenuation coefficient, half value layer, mean free path, and effective atomic number were derived.

Results: It is observed that the variations of these parameters with respect to the photon energy show changes in different energy regions. According to the obtained results, Cisplatin has the highest mass attenuation coefficient, linear attenuation coefficient and effective atomic number results among the selected chemotherapy drugs. Moreover, Chlorambucil has the highest half value layer and mean free path results among the selected chemotherapy drugs.

Conclusion: The results of this study are useful for applied science fields such as radiation physics, pharmacology, and medical physics. These results may be useful when the selected chemotherapy drugs are used together with radiology.

Review Article

Microdialysis technique for in-vivo monitoring of •OH generation on myocardial injury in the rat

Toshio Obata*

The micro dialysis procedure is a technique that has been established for some years. Although free radical reaction is a part of normal metabolism, sustained elevation of noradrenaline (NA) in the extracellular fluid can be autoxidized, which in turn leads (possibly by an in direct mechanism) to the formation of cytotoxic free radicals. Reactive oxygen causes excessive Na+ entry through the fast Ca2+ channel, leading to intracellular Ca2+ overload through the Na+-Ca2+ exchange system. However, the interaction between intracellular Ca2+ overload and oxygen free radicals in myocardium is not clear. Angiotensin converting enzyme (ACE) inhibitor is associated with cardioprotective effect due to suppression of NA-induced hydroxyl radical (•OH) generation in the heart. Low-density lipoprotein (LDL) oxidation may be related to NA induced •OH generation. Although the neuroprotective effects of nitric oxide (NO) is discussed, NO contributes to the extracellular potassium concentration ([K+]o)-induced •OH generation via NO synthase (NOS) activation. Opening of ATP sensitive K+ channel (KATP) channel may cause •OH generation. These finding may be useful in elucidating the actual mechanism of free radical formation in the pathogenesis of heart disorders.

Research Article

Laparoscopic Cholecystectomy: Challenges faced by beginners our perspective

Kunal Chowdhary, Gurinder Kaur, Kapil Sindhu, Muzzafar Zaman*, Aliya Shah, Rohit Dang, Ashish Kumar, Jose John Maiakal and Ashutosh Bawa

Background: Laparoscopic cholecystectomy is gold standard and most widely performed surgery for gallstone disease all over the world. Surgeons entering into the field of laparoscopic surgery for the first time faces challenges that are different from those with experienced hands. We in this study tried to enumerate the various such challenges and also recommend few steps to counter them.

Aims & Objectives: To study the challenges faced by new surgeons in laparoscopic cholecystectomy and recommendations to reduce them.

Material & Methods: This study was carried out in a medical college in the department of General and Minimal Access surgery. In this retrospective study, ten general surgeons working as senior residents in in this medical college over a period of 3 years having never performed laparoscopic surgery in past were included.

Results: A total of 50 cases, five operated by each surgeon with minimal assistance by senior surgeon in few cases. Operative time varied from 90 to 120 minutes. The various technical challenges faced by the new surgeon were in the Creation of Pneumoperitoneum, Creation of second port (epigastric port 10mm), Gallbladder Retraction and Dissection at calot’s triangle, Dissection at gallbladder bed and Removal of the gallbladder from epigastric port.it has been observed that following various simple steps will abate these technical difficulties for these beginners while doing laparoscopic cholecystectomy.

Conclusion: Laparoscopic cholecystectomy is the most commonly performed minimal access surgical procedure nowadays and almost all the new surgeons enter the world of laparoscopic surgery via this surgery. Knowing and following the above recommendations will help them abate the technical challenges generally faced during the initial phase in the laparoscopic field.

Case Report

Gossypiboma due to a retained surgical sponge following abdominal hysterectomy, complicated by intestinal migration and small bowel obstruction- A Case Report

Vivek Agrawal and Praroop Gupta*

A gossypiboma is a mass of cotton material from any source, left in a body cavity after a surgical procedure. This enhances the morbidity, cost of treatment and potential mortality to the patient with the addition of medicolegal issues. We report a case of a 32 year old lady who presented with complaints of central abdominal pain and vomiting for 1 month, fever for 20 days and non-passage of flatus and faeces for 5 days. She had undergone a total abdominal hysterectomy 4 months prior. On clinical examination, adhesive small intestinal obstruction was suspected. On CECT evaluation, a gossypiboma was suggested to have possibly migrated into the small bowel. Laparotomy revealed the presence of clumped bowel loops, which on dissection got torn and showed a gauze like material within the bowel lumen. A diagnosis of gossypiboma with intestinal migration of a retained surgical sponge was ascertained. The possibility of a gossypiboma, particularly in previously operated cases, must be kept in mind and measures must be taken to prevent such incidences.

Review Article

Magnetohydrodynamic CNTs Casson Nanofluid and Radiative heat transfer in a Rotating Channels

Abdullah Dawar, Zahir Shah*, Saeed Islam, Muhammad Idress and Waris Khan

The main purpose of this investigation is to inspect the innovative conception of the magneto hydrodynamic (MHD) nanoparticles of single wall carbon nanotubes base on the fluids (water, engine oil, and ethylene, glycol and kerosene oil) between two rotating parallel plates. Carbon nanotubes (CNTs) parade sole assets due to their rare structure. Such structure has significant optical and electronics features, wonderful strength and elasticity, and high thermal and chemical permanence. The heat exchange phenomena is deliberated subject to thermal radiation. Kerosene oil is taken as based nano fluids because of its unique attention due to their advanced thermal conductivities, exclusive features, and applications. The fluid flow is presumed in steady state. With the help of suitable resemblance variables, the fundamental leading equations have been converted to a set of differential equations. To obtain the solution of the modeled problem, the homotopic approach has been used. The influence of imbedded physical variables upon the velocities and temperature profiles are defined and deliberated through graphs. Moreover, for the several values of relevant variables, the skin fraction coefficient and local Nusselt number are tabulated. Plots have been presented in order to examine how the velocities and temperature profile get affected by various flow parameters.

Review Article

High energy HF (DF) lasers

Victor V Apollonov*

Non-chain HF (DF) lasers are the most suitable and ecologically safe source of powerful and energetic coherent radiation in the 2.6-3.1 cm (HF laser) and 3.5-4.1 cm (DF laser) spectral regions. Among the different methods of HF (DF) pulse and pulseperiodic laser creation suggested by our team under the guidance of Academician A.M. Prokhorov was self-sustained volume discharge (SSVD).It is well known that a SSVD can be established in a gas by creating a primary electron density that exceeds a certain minimum value nmin throughout the dis­charge gap. Various methods for the preionization of the gas in the discharge gap have been developed for this purpose. Using these methods, primary electrons can usually be created directly in the discharge gas, which sometimes causes difficul­ties in the establishment of the conditions necessary for the formation of SSVD. For example, high voltages are needed for the formation of an initial plasma when the preionization source and active medium are combined in the same volume, whereas preionization with ultraviolet radiation may be inef­fective because of the strong absorption of such radiation in a medium. In the case where soft x-rays are used, it is necessary to ensure rigid synchronization of the x-ray and pump sources. In the mixtures of gases typical of CO2 lasers, electron losses due to the trapping process are relatively small at low values of E/p. The trapping coefficient is considerably smaller than the absorption coefficient of ultraviolet radiation for the same mixtures. In principle, it should be possible to create primary electrons at the density needed for the formation of a SSVD at a considerable distance from an ionization source, and then to transport the electrons to the gap by drift in an electric field. We have investigated and confirmed this physi­cal matter experimentally [1]. A SSVD formation method that works by filling the discharge gap with a flux of electrons drifting in an electric field, without preliminary ionization of the whole discharge volume, was proposed and implemented by our team. The electron source was a plasma formed in an auxiliary discharge initiated under a grid cathode. This method also made it possible to establish a SSVD in a system with a strongly inhomogeneous electric field in the discharge gap [1].

Review Article

Parental Role in Adolescent Substance Abuse Prevention

Shelby Miller*

Background: There is a huge gap in the U.S. health care system when it comes to the prevention of substance abuse and addiction, specifically involving adolescents. It has been determined through literature review that parents in Utah are not informed about/knowledgeable of/aware of the current usage of alcohol/drugs in the adolescent population in this area or the inherent risks involved with consumption/use/misuse/abuse/addiction.

Aim: The overarching aim of the doctoral project was to prevent Utah County middle school students from harmful alcohol and drug consumption by involving parents in prevention efforts. The prevention goals of this project included: increased parental knowledge of the brain disease of addiction, warning signs of adolescent drug use, what to do if their child is already using, and increased parental self-efficacy on communicating with teens on this subject.

Design: For parents to be productively involved, barriers were broken down through education. The DNP student completed a 15-minute presentation at five separate parent meetings that took place annually during middle school registration at Lehi Jr High.

Population: The education was for parents, foster parents, guardians, etc. of first-year middle school students only; an estimated 420 participants were in attendance.

Data collection and analysis: A pre-and post- combined self-efficacy and knowledge test was given to the attendees. Data was gathered from 117 appropriately completed tests and analyzed using a paired t-test. The results were studied to evaluate effectiveness of the program relating to parental self-efficacy and knowledge.

Findings: The presentation ultimately increased parental self-efficacy and knowledge (p-value <0.01) which in turn increases protective factors and decreases risk factors associated with adolescent substance abuse.

Conclusions: The DNP project was successful, and the results assisted in the refinement of the presentation for sharing on a mass level to all Jr. High schools in Utah County, Utah.