24th Hour Research Articles

Efficacy of local infiltration analgesia on recovery after total hip arthroplasty using direct anterior approach under spinal anaesthesia: a randomized, double-blind, placebo-controlled trial.

The utilization of local infiltration analgesia (LIA) is a common practice in total hip arthroplasty (THA) procedures to mitigate postoperative pain and diminish the necessity for opioids. However, contemporary literature reports conflicting results. Our working hypothesis was that LIA renders better postoperative VAS-scores and reduces the need for oral analgetics. We performed a randomized, double-blind, placebo-controlled trial aimed at examining the effectiveness of LIA in THA. A total of 90 patients were included for statistical analysis. Our primary endpoint was the Visual Analogue Scale, VAS, (0: no pain, 10: unbearable pain) preoperatively, at the 1st, 2nd, 3rd, 4th and 12th hour postoperative intervals and at discharge. Our secondary endpoints included the postoperative opioid consumption, as well as patient satisfaction at 2 and 6 weeks postoperatively, measured using the Numeric Rating Scale, NRS. LIA has a tendency for superior results regarding VAS- Scores at 3 and 4 hours postoperatively. There were no notable statistical distinctions observed in terms of patients necessitating rescue opioid consumption. Patient satisfaction using the NRS at both the 2-week and 6-week postoperatively did not differ significantly between both groups. The administration of LIA could offer advantages during the initial stages of postoperative recovery, which could be particularly valuable in rapid recovery programs.

Anti-Inflammatory and Antipyretic Activity of Methanol Leaf Extract of Phoenix Reclinata, Jacq (Aracaceae)

Phoenix reclinata, Jacq (Arecaceae), known as the wild date palm, has garnered interest for its traditional applications in folk medicine, specifically for its anti inflammatory and antipyretic properties. Some local communities in Ethiopia traditionally use decoctions and remedies derived from Phoenix reclinata extracts to treat fever. This study was designed to evaluate the acute and chronic anti inflammatory activities, as well as antipyretic activity of the methanol leaf extract of P. reclinata Jacq (aracaceae). The acute anti inflammatory effect was evaluated in rats using egg albumin while the chronic anti inflammatory activity was studied in formaldehyde induced inflammation. The LD50 of the extract was more than 5000 mg/kg. Phytochemical screening revealed the presence of alkaloids, flavonoids, tannins, saponins, terpenoids, glycosides, sterols, phenolic compounds and terpenes. The antipyretic activity was evaluated by using the brewer’s yeast pyrexia induction method. Inr the egg albumin model, the methanol extract showed significant ( P 0.05) inhibition of up to 52% at 400 mg/kg on the 5th hour. In the chronic model, there was a significant P 0.05) inhibition of formaldehyde induced paw oedema over the period in groups treated with the methanol extract (100, 200, and 400 mg/kg) and ibuprofen (400mg/kg). The methanol extract of P. reclinata (400 mg/kg) produced the highest inhibition (46 %) on the 10th day (P<0.05). In the antipyretic studies, administration of the methanol extract of P. reclinata significantly P 0.05) decreased the rectal temperature at 200 mg/kg and 400 mg/kg. Therefore, the findings underscore the promising anti inflammatory and antipyretic properties of Phoenix reclinata methanol leaf extract and supports its potential as a natural therapeutic agent for managing inflammatory conditions and fever.

The role of proangiogenic cytokines in predicting sepsis in febrile neutropenic children with cancer.

We assessed the relationship between sepsis occurrence and the serum levels of angiopoietin (Ang-1, Ang-2), vascular endothelial growth factor (VEGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in pediatric patients with cancer-related febrile neutropenia. Fifty-two children with malignant tumors who experienced 86 episodes of febrile neutropenia (FN) were examined between June 2016 and June 2018. Each FN episode was considered a separate event and the total number of FNs were recorded (86 FN episodes = FN group). The control group consisted of 21 healthy children. Ang-1, Ang-2, VEGF-A and sFlt-1 were measured at the baseline and 48th hour of each FN episode -alongside routine characterization of inflammation (C-reactive protein; white blood cell and absolute neutrophil count). Among the episodes, 29 (34.5%) developed sepsis while 57 were classified as non-complicated FN. The baseline values of patients and controls were significantly different for Ang-1, Ang-2, VEGF and sFlt-1 values (all, p < 0.05). In the subgroup with sepsis, Ang-2 values were higher than in the subgroup without sepsis (p = 0.017). In predicting sepsis, Ang-2 had 60.7% sensitivity and 66.7% specificity at the 74.6 cut-off value (AUC: 0.662 [95%CI: 0.541 - 0.783], p = 0.022), Ang-2 / Ang-1 ratio had 65.5% sensitivity and 60.0% specificity at the 0.405 cut-off value (AUC: 0.633 [95%CI: 0.513 - 0.753], p = 0.046). Our results reveal that Ang-2 and Ang-2/Ang-1 were higher in the sepsis group and Ang-2 might be a biomarker to indicate the risk of sepsis in patients with FN and/or cancer.

Comparison of the analgesic effects of different bupivacaine concentrations in continuous femoral block after total knee arthroplasty surgery

Aim: In regional anesthesia practice, anesthesists’ goal must be to use the lowest effective concentration of local anesthetics to provide sufficient pain relief while minimizing side effects and complications. This study was designed to compare the analgesic efficacy of two different concentrations of bupivacaine (0.125% and 0.1%) in continuous femoral block for postoperative analgesia.Method: In this study, fifty patients were enrolled, all of whom underwent femoral nerve block catheterization. The block procedure involved the administration of 30ml of bupivacaine solution at a concentration of 0.25%. Following a thirty-minute interval post-block application, patients underwent knee surgery under general anesthesia. During the closure of subcutaneous tissues, an additional 10ml of bupivacaine solution was injected through the catheter. Two groups were formed based on the concentration of the solution administered: Group(0.125%) received bupivacaine at a concentration of 0.125%, while Group(0.1%) received it at a concentration of 0.1%. Subsequently, upon arrival at the postoperative care unit, infusion through the catheter commenced at a rate of 10ml/h-1, maintaining the same concentrations for both groups. In addition to the nerve block, all patients were provided with intravenous Patient Controlled Analgesia (PCA) devices containing morphine for pain management. Throughout the postoperative period, sensory and motor block levels, Numerical Rating Scale (NRS) values for static and dynamic pain assessment, total morphine consumption, morphine demand, as well as any observed side effects and complications, were meticulously recorded for analysis.Results: Postoperatively the NRSstatic values at 24th and 48th hours and NRSdynamic values at the 24th hour were higher in Group(0.1%) and it was statistically significant(p&lt;0,007). And at 48th hour, morphine consumption was significantly higher in Group(0.1%) (p&lt;0,05).Conclusions: In our study, all patients across both experimental groups initially experienced satisfactory analgesia. However, within the 24-hour postoperative period, Group(0.1%) exhibited a decline in the quality of analgesia, necessitating increased utilization of rescue analgesics. This escalation in rescue analgesic use was associated with a higher incidence of adverse effects and reduced patient comfort levels within this group. Consequently, our findings indicate that the 0.125% concentration of bupivacaine yielded superior efficacy compared to the 0.1% concentration in the context of continuous femoral block administration.

Analgesic efficacy of Ultrasound-Guided Caudal Block versus Pudendal Nerve Block in BRAKA - I Repair for Paediatric Hypospadias

Objective: To compare the efficacy of ultrasound-guided caudal versus pudendal nerve block analgesia in paediatric patients undergoing hypospadias. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital Rawalpindi, Pakistan from Mar to Sep 2022. Methodology: Paediatric patients with ages ranging from 4-12 years with ASA Grade I/II planned for hypospadias repair were included. Sixty-eight patients were divided into Group-C (caudal block) and Group-P (pudendal nerve block), after randomization. Group-C patients received ultrasound-guided caudal block while pudendal nerve blockade was performed under ultrasound guidance in Group- P. Demographic variables, requirement of rescue analgesics, CHEOPS scoring at 0, 1, 2,6 and 12 hours, and complications in the intraoperative period were recorded. Results: Pain scores at the 6th and 12th hour were significantly reduced in Group-P compared to Group-C. Requirement of analgesia was lesser in Group P 01(2.9%) compared to 11(32.3%) in Group C with a p-value of 0.006. Out of 34 patients in Group-C 07(20.6%), patients encountered complications compared to Group-P, which had no complications. Conclusion: Ultrasound-guided pudendal nerve block is superior to caudal block in providing adequate perioperative analgesia with fewer complications and decreased requirement of additional analgesic supplements.

Effect of thymol on oxidative stress and reelin signaling pathway in Alzheimer's disease model.

The purpose of this study was to investigate how thymol affects cognitive functions and the levels of MDA, GSH, Aβ1-42, ApoE, reelin, and LRP8 in an AD model induced in male Wistar albino rats with the application of D-galactose (D-gal) and aluminum chloride (AlCl3). In this work, 3-month-old male Wistar albino rats were used. Group 1 served as the Control, Group 2 received 0.5 mL/day saline + 0.5 mL/day sunflower oil, Group 3 was administered 200 mg/kg/day AlCl3 + 60 mg/kg/day D-gal, Group 4 received 30 mg/kg/day thymol, and Group 5 was administered 200 mg/kg/day AlCl3 + 60 mg/kg/day D-gal + 30 mg/kg/day thymol. At the end of the 10-week experimental period, behavioral and memory tests were performed. GSH and MDA levels were measured in the obtained serum and brain tissue samples, while Aβ1-42, ApoE, reelin, and LRP8 levels were measured in brain tissue samples. Statistical analyses were performed using ANOVA test in Graphpad Prism V8.3 program. A p-value <0.05 was considered significant in intergroup analyses. When the novel object recognition test (NORT) results were evaluated, the Alzheimer + thymol (ALZ+TYM) group showed a significant increase in the recognition index (RI) and discrimination index (DI) compared to the Alzheimer (ALZ) group at the 24th hour. Thymol reduced working memory errors (WME), reference memory errors (RME), and maze completion time at 48, 72, and 96 hours when evaluated in terms of spatial memory in rats with Alzheimer's disease. Furthermore, Aβ1-42 and ApoE levels were increased in the ALZ group compared to the control (C), while reelin and LRP8 levels were decreased in the ALZ group compared to the C group. The data we obtained suggest that thymol may play an effective role in cognitive processes against AD and have an anti-Alzheimer's disease effect.

The investigation of cytotoxic and apoptotic activity of Cl-amidine on the human U-87 MG glioma cell line.

Peptidyl (protein) arginine deiminases (PADs) provide the transformation of peptidyl arginine to peptidyl citrulline in the presence of calcium with posttranslational modification. The dysregulated PAD activity plays an important role on too many diseases including also the cancer. In this study, it has been aimed to determine the potential cytotoxic and apoptotic activity of chlorine-amidine (Cl-amidine) which is a PAD inhibitor and whose effectiveness has been shown in vitro and in vivo studies recently on human glioblastoma cell line Uppsala 87 malignant glioma (U-87 MG) forming an in vitro model for the glioblastoma multiforme (GBM) which is the most aggressive and has the highest mortality among the brain tumors. In the study, the antiproliferative and apoptotic effects of Cl-amidine on GBM cancer model were investigated. The antiproliferative effects of Cl-amidine on U-87 MG cells were determined by 4-[3-(4-iodophenyl)-2-(4-nitrophenyl)-2H-5-tetrazolio]-1,3-benzene disulfonate method at the 24th and 48th hours. The apoptotic effects were analyzed by Annexin V and Propidium iodide staining, caspase-3 activation, and mitochondrial membrane polarization (5,5', 6,6'-tetrachloro-1,1', 3,3' tetraethyl benzimidazolyl carbocyanine iodide) methods in the flow cytometry. It has been determined that Cl-amidine exhibits notable antiproliferative properties on U-87 MG cell line in a time and concentration-dependent manner, as determined through the 4-[3-(4-iodophenyl)-2-(4-nitrophenyl)-2H-5-tetrazolio]-1,3-benzene disulfonate assay. Assessment of apoptotic effects via Annexin V and Propidium iodide staining and 5,5', 6,6'-tetrachloro-1,1', 3,3' tetraethyl benzimidazolyl carbocyanine iodide methods has revealed significant efficacy, particularly following a 24-hour exposure period. It has been observed that Cl-amidine induces apoptosis in cells by enhancing mitochondrial depolarization, independently of caspase-3 activation. Furthermore, regarding its impact on healthy cells, it has been demonstrated that Cl-amidine shows lower cytotoxic effects when compared to carmustine, an important therapeutic agent for glioblastoma. The findings of this study have shown that Cl-amidine exhibits significant potential as an anticancer agent in the treatment of GBM. This conclusion is based on its noteworthy antiproliferative and apoptotic effects observed in U-87 MG cells, as well as its reduced cytotoxicity toward healthy cells in comparison to existing treatments. We propose that the antineoplastic properties of Cl-amidine should be further investigated through a broader spectrum of cancer cell types. Moreover, we believe that investigating the synergistic interactions of Cl-amidine with single or combination therapies holds promise for the discovery of novel anticancer agents.

Development of cross‐linked polyvinyl alcohol/sodium caseinate/silver nanoparticle electrospun mats for antibacterial wound dressing

AbstractIn this study, nanofibers were produced by the electrospinning method by adding 1%, 3%, 5%, and 7% silver nanoparticles (Ag NPs) into the polyvinyl alcohol/sodium caseinate (60/40, w/w) mixture. Electrospun materials were cross‐linked by immersion in a glutaraldehyde bath. Thus, antibacterial wound dressings that could be used on exuding wounds were developed. According to the scanning electron microscopy images of nanofibers, the cross‐linking process by immersion method did not cause negative effects such as breakage or adhesion on the surface of fibers. The cross‐linking of nanofibers was demonstrated by the presence of acetal linkages by Fourier‐transform infrared spectroscopy analysis. The cross‐linking process significantly improved the thermal properties of the nanofibers. The lowest crystallinity calculated in the differential scanning calorimeter was observed in the 3% Ag NP‐added nanofiber with a value of 1.83%. It exhibited the lowest total soluble matter content with a value of 11.98% owing to its high cross‐linking density. In addition, the 3% Ag NP‐added nanofiber, which had the highest toughness and ductility, displayed the highest tensile stress with 3.5 MPa and the highest tensile strain with 7.53%. Moreover, it showed 78.11% cell viability on the L929 fibroblast cell line at the end of the 24th hour. It was indicated that although the electrospun mats maintained 100% antibacterial effectiveness, they could not be used as a wound dressing for 48 h. It was reported that only 3% Ag NP‐added nanofiber could be used as a 100% effective antibacterial wound dressing for both Escherichia coli and Staphylococcus aureus provided that it was renewed every 24 h. Consequently, it was notified that cross‐linking by the immersion method can be used in biomedical applications.Highlights The antibacterial effects of Ag NP‐doped PVA/NaCAS electrospun mats were significant. The cross‐linking process did not induce toxic effects some of the nanofibers. High cross‐linking density was observed in the nanofibers. The swelling property of nanofibers is a good feature required in an ideal wound dressing.

Design of Hydrogel for the Drug Delivery of Less Permeable Ursolic Acid Isolated from Rhododendron arboreum Flower in Animal Skin Membrane

Ursolic acid (UA) is a pentacyclic triterpene that has antioxidant, anticancer, and anti-inflammatory properties. As it belongs to the biopharmaceutical classification system IV due to its poor water solubility and permeability restricts its use in clinical application. So, the research is focused on the development of hydrogel containing encapsulated liposomes of ursolic acid to increase its permeability. The ursolic acid liposomal gel was prepared with a 0.5%, 1%, and 1.5% mixture of carbopol 934P and HPMC K4M as gelling agents. The pH and spreadability of liposomal gel were found to be in the range of (6.93±0.035 to 7.12±0.03) and (15.41±0.36 to 24.47±0.90) g.cm/sec respectively. The drug content was found to be in (19.77±0.02 to 20.11±0.02)%. The study of drug release kinetics showed Higuchi release followed by a non-Fickian diffusion mechanism. The result of the permeation study by Franz diffusion cell showed 1.55 times higher compared to the plain gel at the 5th hour of the study with a flux value of 0.455(mg/cm2/hr). It resolved the fast and enhanced delivery of liposomal ursolic acid through the skin membrane.

The Application Research of FCN Algorithm in Different Severe Convection Short-Time Nowcasting Technology in China, Gansu Province

This study explores the application of the fully convolutional network (FCN) algorithm to the field of meteorology, specifically for the short-term nowcasting of severe convective weather events such as hail, convective wind gust (CG), thunderstorms, and short-term heavy rain (STHR) in Gansu. The training data come from the European Center for Medium-Range Weather Forecasts (ECMWF) and real-time ground observations. The performance of the proposed FCN model, based on 2017 to 2021 training datasets, demonstrated a high prediction accuracy, with an overall error rate of 16.6%. Furthermore, the model exhibited an error rate of 18.6% across both severe and non-severe weather conditions when tested against the 2022 dataset. Operational deployment in 2023 yielded an average critical success index (CSI) of 24.3%, a probability of detection (POD) of 62.6%, and a false alarm ratio (FAR) of 71.2% for these convective events. It is noteworthy that the predicting performance for STHR was particularly effective with the highest POD and CSI, as well as the lowest FAR. CG and hail predictions had comparable CSI and FAR scores, although the POD for CG surpassed that for hail. The FCN model’s optimal performances in terms of hail prediction occurred at the 4th, 8th, and 10th forecast hours, while for CG, the 6th hour was most accurate, and for STHR, the 2nd and 4th hours were most effective. These findings underscore the FCN model’s ideal suitability for short-term forecasting of severe convective weather, presenting extensive prospects for the automation of meteorological operations in the future.

Evaluation of whether there is residual polyp tissue after hysteroscopic morcellation at Cam and Sakura City Hospital: a retrospective cohort study

BackgroundIn polypectomy with mechanical hysteroscopic morcellators, the tissue removal procedure continues until no polyp tissue remains. The decision that the polypoid tissues were removed completely is made based on visual evaluation. In a situation where the polyp tissue was visually completely removed and no doubt that the polyp has been completely removed, short spindle-like tissue fragments on the polyp floor continue in most patients. There are no studies in the literature on whether visual evaluation provides adequate information at the cellular level in many patients in whom polypoid tissues have been determined to be completely removed. The aim of the present study was to analyze the pathological results of the curettage procedure, which was applied following the completion of polyp removal with operative hysteroscopy, and to evaluate whether there was residual polyp tissue in the short spindle-like tissue fragments that the mechanical hysteroscopic morcellator could not remove. The secondary aims of this study were to compare conventional loop resection hysteroscopy with hysteroscopic morcellation for the removal of endometrial polyps in terms of hemoglobin/hematocrit changes, polypectomy time and the amount of medium deficit.MethodsA total of 70 patients with a single pedunculate polypoid image of 1.5-2 cm, which was primarily visualized by office hysteroscopy, were included in the study. Patients who had undergone hysteroscopic polypectomy were divided into two groups according to the surgical device used: the morcellator group (n = 35, Group M) and the resectoscope group (n = 35, Group R). The histopathological results of hysteroscopic specimens and curettage materials of patients who had undergone curettage at the end of operative hysteroscopy were evaluated. In addition, the postoperative 24th hour Hb/HCT decrease amounts in percentage, the polypectomy time which was measured from the start of morcellation, and deficit differences were compared between groups.ResultsIn total, 7 patients in the morcellator group had residual polyp tissue detected in the full curettage material. The blood loss was lower in the morcellator group than in the resectoscope group (M, R; (-0.07 ± 0.08), (-0,11 ± 0.06), (p < 0.05), respectively). The deficit value of the morcellator group were higher (M, R; (500 ml), (300 ml), (p < 0.05), respectively). The polypectomy time was shorter in the morcellator group (M, R; mean (2.30 min), (4.6 min), (p < 0.05)).ConclusionsEven if the lesion is completely visibly removed during hysteroscopic morcellation, extra caution should be taken regarding the possibility of residual tissue. There is a need for new studies investigating the presence of residual polyp tissue.

Gastrointestinal Tonometry in the Perioperative Period of Liver Transplantation: An Integrative Review

Introduction: Gastric tonometry is a useful tool for examining regional splanchnic perfusion as it provides an indirect assessment of the state of the liver graft. This is because splanchnic hypoperfusion is a critical parameter in the context of liver transplantation, being associated with the development of problems such as acute liver failure and multiple organ failure. Objective: To analyze the effects of gastrointestinal tonometry in the perioperative period of patients undergoing liver transplantation. Methodology: This is an Integrative Review using the PubMed and VHL databases. The following descriptors were used: “Tonometry”, “Splanchnic circulation” and “Liver transplantation” with the Boolean operator “AND”, and articles of relevance to the topic were selected. Initially, 24 articles were selected, all published in the last 20 years, in Portuguese and/or English. After analysis, 6 articles matched the proposed objective. Results:It was observed that the difference between PraCO2 at the end of surgery and in the anepathic phase was greater in patients without liver graft dysfunction. A positive correlation was found between ǻpraCO2 and peak ALT after liver transplantation. In another study, it was found that the relationship between poor graft function was the presence of elevated liver enzymes, worsening synthetic liver function, coagulopathy and encephalopathy. It has also been shown that intramucosal gastric pH can predict early graft function. In a group with liver dysfunction, patients had an intramucosal gastric pH of less than 7.3 in the perioperative period, which remained low until the 24th hour postoperatively, while the group without dysfunction had an intramucosal gastric pH of more than 7.3, except in the anepathic phase when it was below this value. Conclusion: The usefulness of gastrointestinal tonometry to monitor splanchnic circulation and liver graft function during liver transplantation has been described and although support for this statement was found in some studies, this review had limitations due to the small number of articles available, which prevents it from covering a wide range of scientific evidence

Ameliorative effects of Atriplex crassifolia (C.A.Mey) on pain and inflammation through modulation of inflammatory biomarkers and GC-MS-based metabolite profiling.

Atriplex crassifolia (A. crassifolia) is a locally occurring member of Chenopodiaceae family that has been used in folk medicine for the treatment of joint pain and inflammation. The present study was focused to determine the analgesic and anti-inflammatory potential of the plant. n-hexane (ACNH) and methanol (ACM) extracts of A. crassifolia were evaluated for in vitro anti-inflammatory potential using protein denaturation inhibition assay. In vivo anti-inflammatory potential was determined by oral administration of 250, 500, and 1000mg/kg/day of extracts against carrageenan and formalin-induced paw edema models. Inflammatory mediators such as TNF-α, IL-10, IL-1β, NF-kB, IL-4, and IL-6 were estimated in blood samples of animals subjected to formalin model of inflammation. Analgesic activity was determined using acetic acid-induced writhing and tail flick assay model. Phytochemical profiling was done by GC-mass spectrophotometer. The results of in vitro anti-inflammatory activity revealed that both ACNH and ACM displayed eminent inhibition of protein denaturation in concentration-dependent manner. In acute in vivo carrageenan-induced paw edema model, both extracts reduced inflammation at 5th and 6th hour of study (p < 0.05). A. crassifolia extracts exhibited significant inhibition against formalin-induced inflammation with maximum effect at 1000mg/kg. ACNH and ACM significantly augmented the inflammatory mediators (p < 0.05). Levels of TNF-α, IL-6, IL-1β, and NF-kB were reduced, while those of IL-4 and IL-10 were upregulated. ACNH displayed maximum analgesic effect at 1000mg/kg, while ACM showed potent activity at 500 and 1000mg/kg. The extracts restored the CBC, TLC and CRP toward normal. GC-MS analysis revealed the presence of compounds like n-hexadecanoic acid, Phytol, (9E,11E)-octadecadienoic acid, 2-hydroxy-1-(hydroxymethyl) ethyl ester, 1-hexacosene, vitamin E, campesterol, stigmasterol, gamma sitosterol in both extracts. These compounds have been reported to suppress inflammation by inhibiting inflammatory cytokines. The current study concludes that A. crassifolia possesses significant anti-nociceptive and anti-inflammatory potential owing to the presence of phytochemicals.

Effect of peritoneal closure versus non closure after open hysterectomy on postoperative pain

Background: Hysterectomy is one of the widely performed gynecological surgeries. During closure of the abdomen, parietal peritoneum could be closed or not .Whether the parietal peritoneum should be closed at hysterectomy or not is an argumental topic. Aim: To assess the level of postoperative pain in women undergoing hysterectomy with closure of peritoneum versus non- closure of peritoneum. Patients and methods: A prospective observational study was conducted on women undergoing abdominal hysterectomy. Results: There was a statistically significant difference between the closures and non- closure groups during hysterectomy regarding VAS after 2 hours, 3 hours and 6 hours, 12 hours and 24 hours with p value &gt; 0.001. Conclusion: Non closure of the peritoneum during abdominal hysterectomy was associated with less operative time and less pain during the 2nd, 3rd, 6th, 12th and 24th hours after hysterectomy.

Designing, Optimising, and Assessing a Novel Emulgel Containing Minoxidil for Controlled Drug Release, Incorporating Marine-based Polymers.

This study aimed to develop an emulgel containing minoxidil as a drug for hair growth promotion in diseases, such as androgenetic alopecia, using gelling agents, such as chitosan and fucoidan. In this study, gelling agents were selected for the emulgel formulation. By various evaluation tests and through optimization, the chitosan-fucoidan combination was selected as the gelling agent for the preparation of emulgel using various evaluation parameters. X2, the best emulgel formulation, contained 2.54 % chitosan and 0.896 % fucoidan. Chitosan prolonged the duration of drug release, and controlled release was obtained. Fucoidan increased the gelling activity, water absorption rate, and stability of the formulation. In this study, the X2 formulation showed the highest percentage of drug release at the 12th hour. It was found to be 99.7%, which followed the zero-order release model. Owing to the wide range of biological activities of fucoidan, the loaded active substance can be protected, and at the same time, its potency can be improved, resulting in effective treatment. Because fucoidan has diverse properties and potential, it will be widely used in the biomedical and pharmaceutical industries in the future.

Postoperative Pain in the General Surgery Department of Fousseyni Daou Hospital in Kayes

Goal: To study the management of postoperative pain in the general surgery department of the Fousseyni DAOU hospital in Kayes. Patients and Method: We conducted a prospective 6-month study from November 2022 to May 2023, involving 107 surgical patients, aged 15 to 81 years, who met the inclusion criteria. We assessed pain using the Visual Analogue Scale (VAS) at patient admission, at the second hour, and then every eight hours until seventy- second hours after analgesic use. Multimodal analgesia was the most widely used in the study. Administration of paracetamol alone and/or in combination with nefopam and/or ketoprofen and/or morphine. The evolution of pain as well as adverse effects after administration of analgesics were investigated. Results: The mean age of our patients was 35.9 years with extremes of 15 and 81 years. Male sex was the most represented at 64.5% with a sex ratio of 1.82 and the majority of patients were classified as ASA 1 (82.2%). VAS less than 3 (VAS≤ 4) was most observed during the first 2 hours postoperatively, i.e. 41.1% for VAS 0-2 and 28.9% VAS 3-4 at rest, respectively, and respectively 33.6% and 30.8% for no pain and mild pain. At 24 hours postoperatively, 87.2% of patients did not feel pain after the resting assessment, this figure increased from 89.8% at the 48th postoperative hour at rest, still after the use of analgesics. At the 72nd hour, we observed cases of pain, i.e. 0.9% of patients, which was related to a postoperative complication. The average cost of pain management was estimated at 23580 FCFA. Side effects observed were vomiting in 3 patients and drowsiness in one patient. Conclusion: Postoperative pain is still understudied, the evaluation with the visual analogue scale of patients before and after the use of analgesics has allowed us to better understand patients' pain and to improve pain management in the surgical department.

Epidural versus intravenous analgesia for pain control in kidney donors, a retrospective cohort study. Is there a kinship relationship?

Aims: Best care must be provided for live kidney donors, including postoperative pain control. Treatment options include iv intermittent analgesics, iv or epidural patient-controlled analgesia (PCA). In this study we aimed to compare these modalities with respect to their analgesic efficacy. Methods: A retrospective analysis of fifty-eight live donor nephrectomy patients operated in a 7-year-period in a university hospital performed. Investigational Review Board approval has been obtained. Data of the patients’ postoperative analgesia methods, degree of kinship with the recipient, postoperative pain scores, and rescue analgesic and antiemetic use were obtained. Correlation of postoperative pain scores with the analgesia technique was investigated, as well as with the degree of kinship of the donor and recipient. Results: Patient-controlled analgesia provided better postoperative pain control, with the epidural PCA being the best. Moderate to severe pain at 6th postoperative hour in the iv intermittent, iv PCA, and epidural PCA groups was 76, 37, and 14%, respectively. Rescue analgesic use on the day of operation was 32% and 5% in the iv intermittent and iv PCA groups respectively, with no rescue analgesic use in the epidural PCA group. Postoperative antiemetic consumption was also less with the epidural PCA (P=0.024 and P=0.027 for postoperative days 1 and 2, respectively). No correlation was detected between the pain and the degree of kinship. Conclusion: Epidural patient-controlled analgesia provides better postoperative pain control after live donor nephrectomy, compared with intravenous intermittent or patient-controlled analgesia. Postoperative pain scores were not related to the degree of kinship.

Effectiveness of port site bupivacaine infiltration in postoperative pain reduction after laparoscopic cholecystectomy: A randomized controlled trial from a tertiary care hospital.

Objective: To determine the effectiveness of port site bupivacaine infiltration in postoperative pain reduction among patients undergoing LC in a tertiary care hospital in Karachi, Pakistan. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesia, Hamdard Hospital, Karachi, Pakistan. Period: April 2022 to September 2022. Material &amp; Methods: Patients of either gender aged between 18-45 years, undergoing elective laparoscopic cholecystectomy were included. Twenty ml of 0.25% bupivacaine solution were locally injected into the intervention group at the port locations. Treatment for the control group was consistent with standard of care. Post-surgery, to measure the severity of the pain, a visual analogue scale (VAS) was utilized and compared. Results: In a total of 170 patients, age, weight, systolic and diastolic blood pressure, ASA grade, SPO2, and the duration of the surgery were not substantially different between the two study groups at baseline (p&gt;0.05). Post-operatively, from third hour till ninth hour pain score, abdominal pain, incisional pain and shoulder pain were significantly lower among the group received local infiltration of bupivacaine. No significant differences were seen at 12th hour. Median time to rescue analgesia was 12 (IQR=6-12) hours and 6 (IQR=6-9) hours among the intervention and control group (p&lt;0.001). Conclusion: This study found lower pain intensity and higher time of rescue analgesia to be associated with local infiltration of bupivacaine at port as compared to control group in the early post-operative period among patients underwent laparoscopic cholecystectomy.

The Supression of Migration and Metastasis via Inhibition of Vascular Endothelial Growth Factor in Pancreatic Adenocarcinoma Cells Applied Danusertib.

Pancreatic ductal adenocarcinoma is an extremely deadly type of cancer with a high metastatic potential. Genetic factors in cellular events play an important role in the emergence of this situation. One of these factors is Aurora kinase family members, which play a role in migration, invasion, and cell cycle. In this study, the expression of vascular endothelial growth factor gene, which plays a role in migration, metastasis, and angiogenesis, on cystic fibrosis human pancreatic ductal adenocarcinoma 1 cells of danusertib, a pan-Aurora kinase inhibitor, was examined. The half maximal inhibitory concentration (IC50) value (400 nM) of danusertib in cystic fibrosis human pancreatic ductal adenocarcinoma 1 cells was determined by the wound-healing test depending on the dose and time and migration with CIM-Plate 16 in the xCELLingence system. In addition, the effect of danusertib on migration was determined by quantitative reverse transcription polymerase chain reaction (qRT-PCR) method and vascular endothelial growth factor gene expression. When the dose- and time-dependent danusertib-applied cystic fibrosis human pancreatic ductal adenocarcinoma 1 cells were compared with the control group, it was observed that the wound formed did not close. In the xCELLigence system CIM-Plate 16 migration analysis, it was observed that migration was inhibited in the group administered danusertib in parallel with the wound dehiscence experiment. The gene expressions of vascular endothelial growth factor decreased 0.5-fold at the 24th hour and 0.3-fold at the 48th hour in the Danusertib-administered groups. Danusertib, a pan-Aurora kinase inhibitor, is predicted to be used as a potential agent in pancreatic cancers due to its antitumor and anti-metastatic effect.

Mechanistic Insights into Nitrite Degradation by Metabolites of L. plantarum A50: An LC-MS-Based Untargeted Metabolomics Analysis

Nitrites are universally acknowledged natural toxic substances that frequently lead to poisoning in humans and animals. During fermentation, certain microorganisms utilize a portion of the nitrogen element and reduce nitrates to nitrites through specific metabolic pathways. In this study, a highly effective lactic acid bacterial strain, Lactiplantibacillus plantarum A50, was isolated and screened from alfalfa silage for its remarkable ability to degrade nitrites. L. plantarum A50 exhibits exceptional nitrite removal capacity, with a degradation rate of 99.06% within 24 h. Furthermore, L. plantarum A50 demonstrates normal growth under pH values ranging from 4 to 9 and salt concentrations of 5%, displaying excellent tolerance to acidity, alkalinity, and salinity. Additionally, it undergoes fermentation using various carbon sources. Within the first 6–12 h of culture, L. plantarum A50 primarily achieves nitrite degradation through non-acidic processes, resulting in a degradation rate of 82.67% by the 12th hour. Moreover, the metabolites produced by L. plantarum A50 exhibit a synergistic interaction with acidity, leading to a nitrite degradation rate of 98.48% within 24 h. Notably, both L. plantarum A50 and MRS broth were found to degrade nitrites. Consequently, a non-targeted metabolomic analysis using LC-MS was conducted to identify 342 significantly different metabolites between L. plantarum A50 and MRS broth. Among these, lipids and lipid-like molecules, organic acids and derivatives, organic oxygen compounds, and organoheterocyclic compounds emerged as the main constituents. Lipids and lipid-like molecules, derivatives of glucose and galactose, amino acids and their derivatives, as well as organoheterocyclic compounds, are likely to play a role in nitrite elimination. Through the enrichment analysis of differential metabolic pathways using KEGG, nine distinct pathways were identified. These pathways provide essential nutrients, maintain cellular structure and function, participate in substance transport, regulate metabolic activities, and enhance resistance against pathogenic microorganisms in L. plantarum A50.