Roles of host mitochondria in the development of COVID-19 pathology: Could mitochondria be a potential therapeutic target?

The recent emergence of severe acute respiratory syndrome-Corona Virus 2 (SARS-CoV-2) in late 2019 and its spread worldwide caused an acute pandemic of Coronavirus disease 19 (COVID-19). Since then, COVID-19 has been under intense scrutiny as its outbreak led to significant changes in healthcare, social activities, and economic settings worldwide. Although angiotensin-converting enzyme-2 (ACE-2) receptor is shown to be the primary port of SARS-CoV-2 entry in cells, the mechanisms behind the establishment and pathologies of COVID-19 are poorly understood. As recent studies have shown that host mitochondria play an essential role in virus-mediated innate immune response, pathologies, and infection, in this review, we will discuss in detail the entry and progression of SARS-CoV-2 and how mitochondria could play roles in COVID-19 disease. We will also review the potential interactions between SARS-CoV-2 and mitochondria and discuss possible treatments, including whether mitochondria as a potential therapeutic target in COVID-19. Understanding SARS-CoV-2 and mitochondrial interactions mediated virus establishment, inflammation, and other consequences may provide a unique mechanism and conceptual advancement in finding a novel treatment for COVID-19.

Open Technique Versus Blind Technique in Placement of Primary Ports in Laparoscopic Procedures- A Prospective Cohort Study

Introduction: Laparoscopic access has always been a challenge because it has been associated with severe complications and sometimes fatal also. Aim:Tocompareopentechniqueversusblindtechniqueinplacement of primary port in various laparoscopic procedures in terms of operative time, complications, ease of use and acceptability. Materials and Methods: This prospective cohort study was conducted at Government Medical College, Patiala, Punjab, India, between June 2014 to August 2016. The study included 100 patients, which were divided into two groups. Group A (n=50) received placement of primary port by open technique and Group B (n=50) received placement of primary port by blind technique. The time taken for access into peritoneal cavity and duration of surgery was noted. Multivariate analysis done using Chi-square test, p-value of less than 0.05 was considered significant. Results: Mean age of patients in group A and group B was 42.66±12.37 years and 43.06±14.67 years, respectively. Majority of patients were females in both groups (n=45 in group A and n=39 in group B). There was no significant difference in time taken for access into peritoneal cavity (p-value>0.05). The duration of hospital stay (in hours) of the patients was 36.96 in Group A and 34.42 in Group B which was not statistically significant. The incidence of intraoperative and postoperative complications was not significant. Most common complication port site infections 3 (6%) in Group A. Conclusion: There was no significant difference between the two techniques with respect to time taken for peritoneal access and complications. In expert hands, both methods are comparable.

Laparoscopic Gynecological Surgery in Bharatpur Hospital: An Experience from a Government Tertiary Care Center of Central Nepal

Background: The aim of the study was to share the experience of laparoscopic gynecologic surgery in a government hospital outside Kathmandu valley Method: A descriptive cross-sectional study was carried out in Bharatpur Hospital from 15 Dec, 2018 to 15 June, 2019. Fifty consecutive patients who underwent laparoscopic gynecological procedures were included in the study and analyzed demographics, indication, hospital stay and complications. Results: The mean age of the patients (n = 50) was 34.6 ± 12.5 years (Range: 17 – 66 years). More than athird of the total patients (n = 18, 36.0%) were between 26 – 35 years. Majority (n = 26, 56.0 %) of the patients were multipara (≥ 2 child). Hasson type was more frequently utilized type of primary port incision in the surgeries performed (52.0%, n = 26). The median duration of surgery was 2.08 hours (Range: 0.83 – 3.25 hours). The commonest post-operative diagnosis was dermoid cyst (n = 14, 28.0%). Complications were observed in eight patients (16.0 %). The median duration of post-operative hospital stay was 3 days. Conclusions: LGS has evolved greatly advantageous as it reduces hospital stay, surgical site infection, and better aesthetic results. It is essential to extend services outside the Kathmandu Valley

Trans-Umbilical Open Port Placement During Laparoscopic Access: A Safe Technique

Introduction: Intra-peritoneal access and creation of pneumoperitoneum through a quick, safe and reliable technique is important for Laparoscopic Surgery. Specially in an resource constrained setting where there is paucity of needed equipment and cost is prohibitive, utilization of the fewer instruments available and accompanid by excellent functional and cosmetic outcomes should be the aim of a laparoscopic surgeon. Objectives: To describe a modified method of primary trocar introduction that utelizes fewer available instruments. Materials and Methods: A vertical incision is made in the trans-umblical region at the base of to an everted umblicul scar. The linea alba is incised and the resultant opening bluntly developed after which the 1st port is inserted using tocar as an guide. The trocar is withdrawn while the canula is pushed in. Results: We included total 124 patient (Male-44, Female-80) in the study period, from Jan 2017 to December 2018. In one single surgical unit, with the age limit 18-75 years, With no significant complications. Conclusion: This modified open trans-umblical approach is a simple, quick, and reliable way to primary port insertion. Access is gained easily in different age groups and umblicus types, through a small congenital umblical defect that is almost universally present. It is associated with minimum morbidity and has excellent outcome. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 67-70

Transumblical versus Infraumblical pneumoperitoneum: A comparative study.

Objectives: In Laparoscopic surgery placement of primary port is an important step and is often associated with complications. Our objective is to compare the merits and demerits like safety, efficacy of the site, time of entry of the port, per-operative and post-operative complications of infrumbilical (IU) with transumbilical (TU) approach for placement of this port. So on the basis of best clinical evidence get a clinical direction for a better site for placement of primary port. Study Design: A prospective randomized controlled trial of 238 patients. Setting: Surgical unit II of DHQ Hospital/ Sargodha Medical College (University of Sargodha) Sargodha. Period: June 2015 to December 2017. Material & Methods: Patients aged 16-70 years, fit for surgery, under general anesthesia were included in this study after informed consent. Patients who were unfit for general anaesthesia, who were Imuno-compromised, diabetics, CLD, with ascites, patients with suspected malignancy, with previous surgery in the umbilical region like midline laparotomy scar, previous hernia repair in this region were excluded from this study. Permission was sought from and granted by institutional ethical committee. Results: A total number of 238 patients were included. Group A (Trans-Umbilical) and Group B (Infra-Umbilical) contained 119 cases each. There were 147 female and 91 male. (M: F ratio of 1: 1.615). Conclusion: Based on results from this study and previous literature, it may be concluded that Transumbilical (TU) placement of primary port for creation of pneumoperitoneum is superior to infrumbilical (IU) approach.

Multiport Isolated link with Current-Fed Z-Source Converters to Manage Power Imbalance in PV Applications

In order to address power imbalance in large-scale PV systems, this paper presents a multiport isolated medium-frequency (MF) link to process different power levels from PV arrays, using current-fed Z-source inverters (CZSI) modules to drive the energy from the PV array to the MF link in a single power stage. The MF link provides the galvanic isolation required by many codes and standards to integrate a system to the grid. The multiport configuration of the MF link allows the system to process different power levels on each primary port and, being all ports magnetically coupled, provide balanced power levels on secondary ports which can be used for multilevel converters applications. Additionally, the current-fed version of the Z-source topology offers natural protection against short-circuit damage enhancing reliability of the system. The analysis of CZSI cells and the study of asymmetrical power levels transference, as well as simulation and experimental results are presented.

Identifikasi struktur dan perubahan lanskap Kota Banjarmasin di masa kesultanan (1526-1860)

Identifying the structure and transformation of Banjarmasin townscape during the Sultanate period(1526-1860): Banjarmasin city in the past was widely known as one of the main pepper producers in theArchipelago that turned the town to becoming one of the port cities in the Southeast Asia maritime tradenetwork. As a port city, Banjarmasin showed a typical landscape character similar to other port cities inSoutheast Asia. The physical landscape feature of this city inevitably was influenced by the economic factoron which trade was the primary income of the sultanate and its people. During the Sultanate period (15261860),the landscape of Banjarmasin was transformed as an impact of the political influence that related to the pepper trade, which involved foreign traders. The main objective of this study is to analyse the landscape changing of Banjarmasin during the Sultanate period by applying the historical method and spatial approach. In the spatial analysis, the landscape component of processes, space, material, and form was used to identifythe landscape structure and its transformation. The result of the study shows that the landscape of Banjarmasinevolved in the following stages: (1) port-polity of Banjar sultanate (1526-1612); (2) secondary port-city of thesultanate (1612-1663); (3) primary port of the sultanate (1663-1787); (4) primary port of the Dutch in SoutheastKalimantan (1787-1860). With regard to the research process, the spatial dimension was not only obtainedfrom the historical maps but also from written sources that indicated the location of activities or events.

Normal laparoscopic anatomy of the caprine pelvic cavity

Due to the several advantages over conventional procedures, the laparoscopic disease diagnosis and surgery has now started receiving attention in small ruminants. The normal laparoscopic anatomy needs to be described for comparison with the findings in animals with various diseases. The objective of the present study was therefore to describe the laparoscopic anatomy of the caprine pelvic cavity. Adult Bakerwal and Pashmina goats (n=25) of both the sexes were included in this laparoscopy study. All the animals were restrained in dorsal recumbency and Trendelenburg position under lumbosacral epidural anesthesia and sedation. After creating the pneumoperitoneum, the primary port for 5 mm laparoscope was placed at linea alba (3.0 cm cranial to mammary glands in does), and at right paramedian (3.0 cm cranial to the rudimentary teat in the bucks) site. Secondary port was placed under direct laparoscopic observation 5-6 cm away from the primary port in horizontal plane, to allow insertion of the grasping forceps. Scan was performed first at the primary port and subsequently through the secondary port for orientation and exploration of the pelvic cavity. The ventral laparoscopic approach provided satisfactory exposure of the pelvic cavity in goats. Comprehensive description of the pelvic organs could be obtained. However, dorsal aspect of the urinary bladder neck and accessory genital organs of male animals could not be visualized. Major complications were not encountered during or after laparoscopy. Laparoscopy a minimally invasive procedure has several advantages over alternate methods of understanding anatomy, physiology and pathology of most of the intraperitoneal pelvic structures in goats. The technique has high pedagogic value. The procedure is safe in experienced hands.

Detention at Angel Island

Between 1910 and 1940 the Angel Island Immigration Station was the primary port of entry for Asians into the United States, the place of enforcement of the Chinese Exclusion Act and other anti-Asian immigration policies. Even in the absence of substantiating data, it is frequently asserted that almost all entering Chinese were detained at Angel Island and that they were detained for weeks, months, even years. This article presents the first empirical evidence on how long people arriving at San Francisco were detained at the Angel Island Immigration Station. The use of newly discovered data on passengers of the Pacific Mail Steamship Company (PMSS) for the period 1913-19 adds an empirical basis to our understanding of how immigration laws were administered in classifying and detaining aliens seeking to enter the United States, which arrivals were detained at Angel Island, and for how long. Results show that many Chinese were not detained at all; there was great variation in length of detention for Chinese who were detained; only some of this variation can be explained by the type of “exempt” status claimed for admission under the Chinese exclusion laws; Japanese arrivals had an even higher incidence of detention; and many detainees were either non-Asian, had come on ships from Central or South America, or were not “immigrants” at all.