Objective Mitral valve repair (MVR) is the definitive therapy for mitral myxomatous degeneration. Median sternotomy has been the traditional approach to repair until the advent of the da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA). Minimally invasive surgical approaches for mitral repair have been slow to gain acceptance in cardiac surgery. We review the MVR results from our single-institution academic robotic program. Methods From August 2004 through April 2008, patients who underwent a robotic-assisted (RA) MVR were identified. RA technique included a 4-cm right minithoracotomy, femoral cardiopulmonary bypass with transthoracic aortic occlusion, and RA-MVR. Repair types were combinations of quadrangular/triangular leaflet resection, sliding plasty, chordal transfer/replacement, and edge-to-edge approximation, with band annuloplasty in all cases. Postrepair echocardiography and morbidity follow-ups were completed in all patients. Our primary outcome was adequacy of repair, and secondary outcome was major complications. Results There were 43 patients (29 male and 14 female) who underwent RA-MVR for severe (4 +) mitral regurgitation during the 4-year review. Average operative time was 272.26 minutes. Only one patient had mild postoperative mitral regurgitation, whereas 20 had trace and 22 had no regurgitation after repair. Mean ventilator time was 32.1 hours, and length of stay was 5.7 days. One third of the patients (33%) received postoperative-packed red blood cell transfusions (average: 2.4 units per patient). Twenty-eight percent of patients developed atrial fibrillation after repair. Most of the patients (95.3%) were discharged home. There were no 30-day mortalities. Conclusions Based on our small single-institution experience, RA-MVR provides an effective treatment for severe mitral valve regurgitation. Although procedure durability is slowly being established, preliminary results are promising. Careful programmatic advances with an integrated team approach can facilitate acceptable postoperative outcomes and excellent MVR.
During the mite sampling of the genus Caloglyphus, the taxonomical analysis of diagnostic features of the hypopial stage confirmed two new taxa named as C. agrios and C. hadros. When compared with the already known worldwide species within this genus, these species showed sufficient dissimilarity to be classified as separate taxa. The characteristic features differentiating these new species from the other Caloglyphus species are the shapes ofgnathosoma, propodosoma, hysterosoma, apodemes, coxal fields, suctorial shield, and chaetotaxy and solenidiotaxy of legs. The present study reports the historical review of the genus, completed with the information on already known species, their description, illustration of main characters, geographical distribution, host range, remarks on the new species, matrixes showing comparisons, and the percentage of similarity along with a key for their identification based on hypopial characters for the species known from Pakistan.
The peer review process not only confirms the quality and integrity of research work, but also reinforces the legitimacy of academic journals, and as such, is a valuable process underpinning the scholarly publishing industry.Peer Review Week (PRW) 1 is an initiative between members of the academic community to acknowledge the importance of peer review to scholarly research and publishing.The fifth Peer Review Week was celebrated all around the world during 16-20th September 2019.The week saw a diverse range of engaging presentations, panel sessions and innovations focused on the theme of "Quality in Peer Review", discussing many different aspects of 'Quality' , and the ways in which it manifests through various stages of the peer review process, as different forms of peer review, through the technical infrastructure, or being enhanced through the progressive actions of organisations and individuals.
Objectives: To access the Homocystein and Antioxidant Status in Patient withVariation in Duration of Type 2 Diabetes Mellitus. Data source: 90 selected patients sufferingfrom Diabetes Mellitus Type 2 (DMT2) and 30 subjects as control group. Design of study: CaseControl Study. Setting: Rawal Institute of Health Sciences, Islamabad. Period: July 2013 –March 2014. Materials & methods: Out of 120 selected subjects, 30 were assigned as control,(group 1) and 90 of DMT2. Based on duration, patients of DMT2 were divided into; group 2(DMT2 <5 years), 3 (DMT2 = 5-10 years) and group 4 (DMT2 >10 years). Smokers, renalfailure, coronary artery disease, thyroid disease and patients on antioxidant treatment wereexcluded from the study. DMT2 was diagnosed according to American Diabetes Associationstandards. The fasting plasma glucose levels were measured by glucose oxidase method;HbA1c by automated kit, TAC by calorimetric TAC Assay Kit (BioVision), Vitamin C and E byELISA Kit (HUMAN) while homocysteine measured by AXSYM HCY assay kit (ABBOTT). Cut offvalues for HbA1c was taken as ≤6%; FBS ≤110 mg/dl; TAC ≥1.16 mmol/L; Vitamin C ≥2 mg/dl;Vitamin E ≥ 9.5nmol/ml and homocysteine was < 6.3 μmol/L. Results: As the duration of DMT2increases, levels of vitamin C and TAC fall significantly (p <0.05) in all groups except betweengroups 1 & 2; however, vitamin E, decreased significantly in all the groups with increased DMT2duration. A significantly increased level of HbA1c was noticed in groups 2, 3 and 4 comparedto group 1 with increased DMT2 duration. The fasting blood sugar increased significantly in allthe groups except between group 3 and 4. ANOVA showed significant differences (p <0.05)between each group and within the groups when Hb1Ac, vitamin E, vitamin C, & TAC werecompared. A positive significant correlation was observed when HbA1c was correlated withFBS; TAC correlated with vitamin C and E and between vitamin C and vitamin E. Conclusions:The levels of TAC, vitamin C and E gradually decrease with increased DMT2 duration; so shouldbe supplemented in diabetics. TAC status can be taken as early marker to detect complicationswhile homocysteine levels to prevent diabetic complications.
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