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Introduction: Laparoscopic approach is emerging as a standard of care approach for management of masses amenable to partial nephrectomy. Laparoscopic partial nephrectomy is a challenging surgery and its successful performance depends on various factors. We aim to evaluate the influence of tumor characterestics on the operative performance for laparoscopic partial nephrectomy. Methods: Patients undergoing laparoscopic partial nephrectomy in our institution were recruited for this study. The tumor profile was evaluated by a senior radiologist from cross sectional imaging (computed tomography or magnetic resonance imaging). Tumor characerestics was defined by assessing tumor size, tumor location and RENAL score. The operative performance was evaluated in terms of warm ischemia time, blood loss, operation duration and any significant operative complications. Statistical inference was drawn. Results: 37 patients who underwent laparoscopic partial nephrectomy between January 2010 and June 2012 were included in this study. The mean tumor dimension was 3.81 cms. 21 tumors involved left kidney and 16 involved right kidney. 12 were located in upper pole, 8 were located in midpole and 17 were located in lower pole. The average RENAL score was 6.56. The mean warm ischemia time, blood loss and operation duration was 26.29 minutes (min), 256.76 millilitres (ml) and 208.11 min respectively. Statistically significant correlation was appreciated between tumor location (polar location, side, anterior/ posterior location) and RENAL score and operative parameters (warm ischemia time and operation duration). Tumor size did not have any correlation with the operative parameters. Conclusion: The operative performance of laparoscopic partial nephrectomy is significantly influenced by the tumor location and RENAL score.

Solar lentigo is defined as an alteration in cutaneous pigment deposition on account of exposure to ultraviolet radiation. Solar lentigo is a benign, pigmented lesion with a characteristic increment in the quantification of pigmented keratinocytes. It can manifest as a dark brown spot on the skin. The benign, pigmented spot or solar lentigo or multiple solar lentigines are preponderantly delineated in the sun exposed skin in a majority (> 90%) of Caucasians above 60 years of age although younger individuals and Asians can be implicated. Solar lentigines are induced by repetitive exposure to ultraviolet light with constituent mutagenic potential. Ultraviolet radiation can induce a localized proliferation of melanocytes with a subsequent accumulation of melanin within the keratinocytes. Individuals who are genetic carriers of one or two melanocortin-1- receptor (MC1R) gene or cogent variants demonstrate a 1.5 to twice the probability of developing solar lentigines [1,2].

Broad-spectrum sunscreens are now widely used worldwide as an adjunct to help prevent sunburn, skin cancers and premature skin aging. In the United States, all persons older than 6 months are recommended to apply sunscreen to all sun-exposed skin from toes to head except eyes and mouth even on cloudy days. Such a recommendation is apparently based on concepts that exposure to sunlight damages the skin, the damage is cumulative and hence any sun exposure should be minimized or prevented. This communication raises several questions suggesting that the above recommendation may need to be reconsidered. For example, numerous previous studies have indicated many potential health benefits from non-burning sun exposure including protection against sunburn, melanoma, colorectal cancer, breast cancer and prostate cancer, increasing vitamin D synthesis, helping sleep, reducing blood pressure, heart attack and stroke. Recent studies suggested that regular lifetime non-burning sun exposure may not result in premature skin aging and the skin aging is mainly caused by the intrinsic factor. Skin aging or whole-body aging has been recently postulated to be mainly attributed to a gradual reduction in cardiac output/index with age and a new anti-aging or age-reversing nutritional theory has been proposed. An apparent lack of long-term cumulative sunray damage was also supported by reported age independence in incidences of sunburn and skin cancers. It is of interest that the current US policy is different from that of World Health Organization and Australia recommending the need of sun protection only when UV Index is 3 or greater. In view of the above, some general guidelines regarding when to best apply sunscreen are proposed.

Excessive ankle stiffness can greatly impact mobility, leading to discomfort, difficulty in walking, and limited Range of Motion (ROM). We aimed to identify and address the symmetry of shank muscle strength, ankle passive stiffness, and plantar pressure distribution, in a patient with unilateral excessive ankle stiffness, utilizing Instrument-Assisted Soft Tissue Mobilization (IASTM) accompanied by Faradic Electrical Stimulation (FES).The patient’s muscle strength and ROM which had diminished due to 3.5 years of ankle immobilization post-rescue from amputation, underwent a 12-week program involving IASTM and FES. The plantar and dorsiflexion muscles’ torque, ROM, and plantar pressure were measured using an isokinetic and plantar distribution system before and after the intervention. Symmetry of muscle torque, ROM, and plantar pressure between two limbs were calculated for pre and post-test.Results indicated improvement in the ratio index of the concentric/eccentric dorsi- and plantar-flexion peak torque and dorsi- and plantar-flexion work, ROM, gait line length, and contact time after a 12-week intervention.The study suggests that IASTM and FES are effective interventions for restoring symmetry in a patient with post-operation complications, highlighting the need for further research on similar cases.

A Gamma Ionization Chamber was developed for the purpose of high gamma radiation detection during accident conditions in a Light Water reactor. The pre-eminence of the detector is that it was designed and developed to monitor gamma exposure rates in the wide range of 100 mR/hr to 107 R/hr. The detector has an overall diameter of 90 mm with a length of 400 mm. The response of the detector is accurate and the sensitivity is within ± 6% over gamma energies ranging from 660 KeV to 1.25 MeV. The detector operates with a DC voltage of 500V. The V0.9 voltage is about 250V for 107 R/hr. The estimated operation life of the detector is about 20 years. 

Renal lymphangiectasia, a rare lymphatic disorder, manifests as cystic infiltration in the perirenal and para-pyelic space due to lymphatic drainage defects. Diagnosis hinges on imaging modalities like ultrasound, CT, and MRI. However, lack of awareness can lead to confusion with other renal cystic pathologies. Here, we present a case of renal lymphangiectasia in a child, detailing diagnostic and therapeutic strategies. The patient, a 2-year-old and 2-month-old girl from a consanguineous marriage, presented with persistent abdominal distension. Clinical examination revealed growth retardation and normal blood pressure but abdominal distension with dullness. Lab investigations indicated acute renal failure with non-nephrotic proteinuria. Radiologically, renal lymphangiectasia was confirmed by ultrasound showing microcysts and perirenal cystic lesions with ascites, corroborated by MRI and CT scans. Treatment involved nephroprotective therapy and diuretics for ascites. Surgical intervention was necessitated due to cyst size and compressive nature, involving iterative punctures, marsupialization, and percutaneous drainage. Postoperatively, recurrent ascites temporarily worsened renal function but returned to baseline afterward. renal lymphangiectasia necessitates careful management due to its potential to progress to chronic renal failure. The prognosis depends on factors like initial proteinuria severity, treatment response, and complication management. Personalized approaches are pivotal in its diagnosis and management.

A study was undertaken the effect of pretreatments and drying methods on quality parameters of tomato slices with respect to storage using two factors as treatments i.e. 5 pre-treatment levels (P1-Peeled by hot water dip blanching, P2-Peeled by hot brine dip blanching, P3-Unpeeled by hot water blanching, P4-Unpeeled by hot brine blanching, P5-Control- No peeled and no blanched) and 2 drying methods i.e. (D1-Tray drying, D2-Sun drying) with completely randomized design of factorial concept with three repetitions at Post Graduate Laboratory of Horticulture Department, College of Agriculture, Junagadh Agricultural University, Junagadh. The quality was evaluated on the basis of physicochemical (i.e. drying time (h) and moisture content (%) at 1, 20, 40, 60 and 80th day of storage. Result of study depicts that the pretreatment P2 i.e. peeling of tomato by hot brine dip blanching followed by tray drying (D2) recorded minimum (14.50 h) drying time and the minimum changes in moisture content (4.00%-6.54%) observed in treatment P1 at 1st to 80th day of storage, respectively.

Chondromyxoid fibroma (CMF) is a very rare benign cartilaginous tumor representing less than 0.5% of all bone tumors while also being the rarest cartilaginous bone tumor. Common locations of occurrence include the metaphysial region of the proximal tibia and distal femur. We report a case of a 10-year-old female affected by a CMF of the left lower tibia. The radiological features demonstrated by X-ray and magnetic resonance imaging (MRI) are discussed.

Introduction: Necrotizing Fasciitis (NF) is a rapidly progressing, severe suppurative infection of the superficial fascia and the sorrounding tissues that may lead to necrosis, septic shock and death if left untreated. Facial NF is rarely seen and symptoms may be non-specific at the onset and depend on the origin site and the stage of the disease, making it difficult for diagnosis. Materials and Methods: A systematic review was done following the PRISMA guidance. PubMed database was searched for case reports published between January 2007 and March 2017. Full text articles were obtained and assesed for relevance. Data extraction was performed as an iterative process. Results: A total of 24 articles, describing 29 adult patients with facial NF were included. Facial NF was more common in males. Skin trauma was the most frequent mechanism of lesion and diabetes mellitus was the most common associated systemic disorder. Periorbital area was the most affected area. In order of appereance, swelling and pain were the most common initial clinical manifestations. Group A Streptococcus was the most frequent microorganism isolated. Advanced airway management was needed in more than 50% of the cases and surgical management was done in 90% of the cases. Conclusions: Practitioners should be aware of its existance, epidemiology, etiology, risk factors and initial clinical manifestations to develop a high index of suspicion, to order studies that may discard or confirm the diagnosis, and to offer prompt treatment to preserve patient’s life and reduce the disfigurement and disability that it may cause.

Prostate specific membrane antigen, a type II transmembrane protein is an excellent target for the radionuclide therapy in advanced prostate cancer patients due to its high expression in the prostate cancer cells. We present the case of a 69-year old man with advanced metastatic castration resistant prostate cancer. In view of rising serum PSA levels despite hormonal and chemotherapy, we decided to perform a 68Ga-PSMA-HBED-CC PET/CT scan (prostate specific membrane antigen). It revealed intense radiotracer uptake in the prostate, lymph nodes and multiple skeletal sites. Five cycles of 177Lu-PSMA-DKFZ-617 radioligand therapy were administered in the patient followed by an intrim 68Ga-PSMA-HBED-CC PET/CT. Intrim 68Ga-PSMA-HBED-CC PET/CT scan demonstrated a near complete remission of disease with a corresponding decrease in the sPSA levels. During the follow-up duration of 12 months, the patient did not develop haematological, kidney and liver toxicity during the course of treatment and follow-up. 177Lu-PSMA-DKFZ-617 is a promising therapeutic option in metastatic castration resistant prostate cancer (mCRPC) patients.