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Even regression of Barrett's metaplasia after surgery has become the interest for physicians to advocate the procedure .
Few papers have been published regarding the feasibility of laparoscopic Nissen fundoplication in day care setting and fewer are double cohort studies in this regard [11—13].
Thus highlighting that an approach towards day care fundoplication had begun whilst the possibility of day care cholecystectomy had already become evident and been brought into practice.
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Simple acceptances of a procedure to be performed as day care needs to have no increased morbidity and mortality compared to inpatient procedure, high success rate of same-day discharge and satisfied patients. Good pain relief can be brought in by local infiltration of the diaphragm as well as port site wounds supplemented by NSAIDs or likewise .
Recently new interventions to treat GERD have been developed like the magnetic sphincter positioned around the distal esophagus laparoscopically .
Here post operative pain is almost negligible since the dissection is minimal.
'Maha Bharatam : Draupadi Vyaktitvam' In Telugu By Sri Devisetty Chalapathirao
Thus pain relief becomes a major criterion for deciding the feasibility of the surgical procedure to be considered as a day care procedure. The Nissen Rossetti fundoplication differs from the usual Nissen fundoplication in not having the divide the short gastric vessels during the fundic wrap creation. All the other operative steps are similar.
This reduces the operative time and also decreases the blood loss in the surgery.
In normal individuals this would even add to decreased post operative pain since the dissection is less than the nissen fundoplication procedure. The De Meester score post operatively for the result of the procedure can assess the efficacy of the procedure. Symptomatic relief does remain the single best criteria for the outcome analysis of the procedure .
Cost factor analysis also highlights the importance of choosing to perform the procedure in day care setting. Older concepts have changed when now the nasogastric tube is avoided in post operative setting and early alimentation is also initiated for the patients.
In elective setting of a clean surgery even prophylactic antibiotics are enough not necessitating long hospitalizations in view of medication administration or for parenteral alimentation.
Received Jun 8; Accepted Jul This article has been cited by other articles in PMC. Abstract Screening of ligand molecules to target proteins using computer-aided docking is a critical step in rational drug discovery.
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Based on this circumstance, we attempted to develop a virtual screening application system, named VSDK Virtual Screening by Docking, which can function under the Windows platform.
This is a user-friendly, flexible, and versatile tool which can be used by users who are familiar with Windows OS. It took 90 minutes for molecules for this virtual screening.
This tool will have a more challenging scope and achievement as the computer speed and accuracy are increased and secured in the future.
At the same time, structure databases in which numerous numbers of small molecules are stored and supplemented by physico-chemical properties, have been made available.
On the other hand, docking application tools, in which the ligand-macromolecule interaction conformation is predicted and scored in terms of binding free energy between the ligand and macromolecule, have made a remarkable progress in their accuracy and speed, although molecular docking is an extremely demanding task for computer resources.
There is no question about the fact that the CAMD computer-aided molecular design approach is becoming a common practice in drug discovery and development [ 1 ].
Owing to all these advancements in structure data bases and application software, a highthrough- put virtual screening technology, in which one can screen thousands of compounds for their binding affinity against a target macromolecule, has been developed and utilized to aid in the drug discovery.Included in the process are preparations of acceptable ligands and a receptor macromolecule, calculation of maps, creation of folders for each ligand, and so on.
More studies can be done prospectively and with appropriate blinding to prove the efficacy of this procedure as a day care option for anti-reflux surgery. Author contribution Dr Kaundinya Kiran Bharatam — primary surgeon involved in treatment of the patients and primary and corresponding author for the article. Simple acceptances of a procedure to be performed as day care needs to have no increased morbidity and mortality compared to inpatient procedure, high success rate of same-day discharge and satisfied patients.
Besides, a mixture of difluorinated pyran scaffolds and are isolated, the gem-diol derivate being the major product when using propargyl ethers as starting reactants and 2-MeTHF as solvent McCarter et al.
It is worth to note that the usual initial carboxy rearrangement determines the fate and further transformations that encompass this chemistry.
Cost factor analysis also highlights the importance of choosing to perform the procedure in day care setting. AutoDock Vina is a new program for molecular docking and virtual screening and achieved an approximately two orders of magnitude speed up compared to AutoDock4 [ 5 ].
However the dysphagia after the procedure did not differ in the choice of procedure and thus there was no harm done to the patient in choosing the Nissen Rossetti procedure for the treatment of GERD for the patient.