Analysis of Advantages of Single Layer Vs Double Layer Anastomosis of Bowel

INTRODUCTION: In the modern day surgical practice, we come across situations in abdominal surgery, where we require resection and anastomosis of bowel. In small bowel resection and anastomosis, conventionally, two layer suturing technique i.e., inner layer with absorbable suture material in continuous fashion and outer layer with non absorbable suture material in a continuous or interrupted fashion, was considered secure. Recently, it has been advocated that anastomosis of small bowel with a single layer suturing using a non absorbable monofilament suture material in a continuous fashion has the same outcome when compared to double layer suturing technique. AIMS AND OBJECTIVES: 1. Complications of Single layer technique and the Double layer technique in emergency and elective surgeries. 2. Time consumption for performing single layer anastomosis as well as double layer anastomosis. 3. Cost effectiveness of single layer anastomosis. MATERIALS & METHODS: All adult patients requiring intestinal anastomosis at Govt. Rajaji Hospital from July 2008 to June 2010 were considered eligible. Totally 60 patients were included in our study. 30 patients under went single layer anastomosis and 30 patients underwent double layer anastomosis. Patients who underwent elective or emergency surgery were included in our study. Based on a careful history and meticulous physical examination, combined with adjunctive investigations, a decision to operate urgently or electively was taken. Baseline laboratory parameters like blood urea, blood sugar, serum creatinine, serum electrolytes, blood grouping and typing were done in all the cases, to rule out co morbid conditions. Evaluation of patients with Acute abdomen: Immediately after receiving the patient, primary survey was done, which included resuscitation secondary survey included definitive management. DISCUSSION: Our study assessed the efficacy and safety of single and double layer anastomosis after intestinal resection, in emergency and elective situations. Generally, conventional two layered technique is being practised. But this causes excessive mucosal inversion, causing narrowing of lumen and may lead to ischaemia of anastomotic site. To overcome this problem little mucosal and complete serosal continuous suturing technique was tried. It has the advantage of good opposition of serosal surfaces, no luminal narrowing and less damage to submucosal vascular plexus. In our study, anastomotic leakage in single layer group was 3.3% which is consistent with the other studies which showed leakage in the range of 1.3 to 7.7%. In emergency situations the anastomotic leak rate in single layer group is 5% The double layer group shows anastomotic leakage around 3.3% again which is consistent with the other studies. In emergency situations the anastomotic leak rate in double layer group 5%. CONCLUSION: Among the two methods of small intestinal bowel anastomosis which we have studied, our observations are ; 1. There is no much difference in the development of the complication in both the methods. However the development of complications in emergency situation is more marked in both the methods. 2. The time required to construct a single layer anastomosis is lesser than that of the double layer anastomosis. 3. Narrowing of the lumen of the bowel is lesser in single layer anastomosis when compared to double layer anastomosis. 4. Bowel movements recovered early in single layer anastomosis when compared to double layer anastomosis. 5. Finally, construction of single layer anastomosis of small bowel is cost effective when compared to that of double layer anastomosis

Comparative Studies on Application of Various Adsorbents in Textile Waste Water

This thesis aims to explore the potential of employing natural adsorbents, such as cashew nut shells, date seeds, orange peels, and coir pith, to mitigate COD levels in textile wastewater. The wastewater used for the study was sourced from a textile industry located in Salem. The investigation involved batch studies, wherein the effectiveness of each selected absorbent in reducing COD was assessed to determine the most efficient among the four sorbents. The initial concentration from the batch research served as a basis for identifying the optimal adsorbent, with the COD of the textile wastewater maintained consistently along with the initial dye concentration. To conduct the study, the adsorbent was incrementally introduced in 10 g portions into conical flasks. Over a10-minute period following a 20-minute contact time, the supernatant liquid from each conical flask was collected using syringes. The COD concentration in the obtained samples was determined using a standard methodology. Results revealed that date seeds exhibited the highest percentage of COD removal at 67%, followed by cashew nut shells at 45%, coir pith at 33%, and orange peels at 23%. The data obtained indicated that cashew nut shells and date seeds achieved the highest percentages of COD reduction, respectively. On the other hand, the Orange Peel Adsorbent displayed the least reduction in COD. Based on the collected findings, date seeds emerge as a promising adsorbent for effectively lowering COD in the treatment of textile wastewater

b-Coloring of the Mycielskian of Some Classes of Graphs

The b-chromatic number b(G) of a graph G is the maximum k for which G has a proper vertex coloring using k colors such that each color class contains at least one vertex adjacent to a vertex of every other color class. In this paper, we have mainly investigated on the b-chromatic number of the Mycielskian of regular graphs. In particular, we have obtained the exact value of the b-chromatic number of the Mycielskian of some classes of graphs. This includes a few families of regular graphs, graphs with b(G) = 2 and split graphs. In addition, we have found bounds for the b-chromatic number of the Mycielskian of some more families of regular graphs in terms of the bchromatic number of their original graphs. Also we have found b-chromatic number of the generalized Mycielskian of some regular graphs