Ectopic liver tissue (ELT) is a rare clinical entity that any surgeon faces in their career. Due to the association or propensity to develop hepatocellular carcinoma, this disease has gained clinical importance, and surgeons ought to be aware of the possible intervention and complications that can be associated with it. Incidence has been reported to be 0.24%-0.47%, with the gall bladder being the most common site. Anatomically, ELT in the gall bladder derives its blood supply either from the vascular pedicle arising with or without its own vein from the liver parenchyma or from branches of the cystic artery and, sometimes, through vascular structures embedded within the mesentery lying adjacent to the liver parenchyma. Surgically, it becomes important to delineate the blood supply because, often, the operating surgeon might encounter uncontrollable bleeding if the blood supply has been derived from the liver parenchyma itself. Complications that can be associated with ectopic liver are torsion, bleeding into the peritoneum, cirrhosis, and, sometimes, lead to malignant degeneration to hepatocellular carcinoma. It can be due to metabolic inactivity owing to less efficient vascular and biliary ductal systems, which sometimes might be confused for occult metastases from a primary hepatoma. Gall bladder-associated ELT is best managed by en bloc resection via laparoscopic cholecystectomy, which suffices if the biopsy comes out to be negative. However, as the risk of malignant degeneration still exists in about 3% of cases, some patients might need to undergo a second surgery for a negative resection margin and regional lymphadenectomy.
Background: A manifold cause of global disparity in medical and surgical care exists, among which lack of access to proper biomedical equipment including surgical tools are a recurrent theme. Use and reuse of such donated tools are common in low resource settings including countries like Nepal; however, there is a lack of adequate data and less has been explored. Through this nationwide study, we aimed to discover the knowledge of donated medical and surgical devices and the practice of reusing single-use equipment by Nepalese medical practitioners and surgeons. Methods: An online, questionnaire-based cross-sectional study was conducted using SurveyMonkey from October 2020 through January 2021. The link was sent to target respondents via email and social media and responses were recorded. Data processing and analysis were done using the same platform. Results: Among 466 respondents, 349 completed the survey. Around 81.5% recorded that their institute has never received medical devices or donations in the past, while 18.34% believed they had received such commodities. Most of the donations were received from countries like the United States, China, Japan, and India. Around 24% of the respondents reused the tools meant for single-use and only 5% communicated with the donors. Commodities like laparoscopic sets, sutures, dialysis machines, magnetic resonance imaging machines, surgical retractors, face masks, sanitizers, personal protective equipment, endoscopy apparatus, etc., were received. The majority of them were concerned about national guidelines regarding donating reusable tools which might not be acceptable through custom rules of the country, although the facilitation of functional yet unused tools is always welcome in the underserved regions of Nepal. Conclusion: Nepalese medical professionals had adequate knowledge about the donated medical devices and only a few of them had practiced reusing single-use equipment. Mutual cooperation between donors and recipients is one of the most important aspects of safe medical/surgical tools delivery.
Sunscreens protect the skin from the harmful effects of Ultraviolet radiation in the sunlight. However, most commercial sunscreens pose health and environmental hazards, lose effectivity over time, or are simply unpleasant to use, making it imperative to search for greener, safer, and efficacious alternatives. Plant-based oil extractions are promising given their hydrophobicity, nontoxicity, and availability. This paper aims to determine the absorptive capabilities of five common cooking (vegetable) oils using UVA spectrophotometry and analyze the properties of the oils that relate to their efficacy. Oils high in tocols, such as Rice Bran Oil, had the highest extinction coefficient. The analysis suggests that plant-based oil extractions high in phytonutrients with aromatic rings and pi-systems, such as tocols and carotenoids, present the greatest potential to serve as UV chemical filters.
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