2nd Hour Research Articles

Malign asitli over kanserinde sitoredüktif cerrahide perioperatif hemodinamik optimizasyon

Purpose: In this study, we aimed to evaluate the effects of norepinephrine and albumin use in patients with epithelial ovarian cancer with malignant ascite in order to maintain plasma oncotic pressure and intravascular volume, to provide perioperative hemodynamic stabilization and tissue perfusion. In addition, it was aimed to compare in terms of postoperative intensive care admission, hospital stay and complications.
 Materials and Methods: A total of 66 patients, 38 with ascites and 28 without ascites, who underwent cytoreductive surgery for ovarian cancer were included in this study. PVI and invasive arterial monitoring of the patients were performed after hemodynamic stabilization (after the start of surgery) (T0). T0, 1st hour (T1) and 2nd hour (T2) and postoperative (Tpostop.) Ascites patients were composed of 3 subgroups which the ones received norepinephrine (NE) infusion, norepinephrine + albumin (NEA) infusion or only fluid therapy (FT). From the perioperative hemodynamic and laboratory data of the patients, tissue perfusion was evaluated with lactate, and hemodynamic status was evaluated with pleth variability index (PVI), perfusion index (PI) and mean arterial pressure (MAP).
 Results: Demographic and clinical findings did not differ significantly between patients with and without ascites. Lactate level in NEA / NE group in Tpostop, PVI level in T1h, T2h and Tpostop time frames were determined higher than the FT group. PI was found to be significantly lower in the T2 time frame. The postoperative ICU admission rate was higher in the NEA and NE groups. The duration of ICU stay in group NEA was shorter than in group NE.
 Conclusion: We recommend the use of low-dose NE with albumin to provide perioperative hemodynamic optimization, tissue perfusion and plasma oncotic pressure in surgery of ovarian cancer with malignant ascites. Despite high fluid replacement in these patients, the use of norepinephrine and albumin together may have an important role in preventing / reducing major complications in the perioperative period.

Fermente edilmiş pseudo-tahılların glutensiz ekmek üretiminde kullanımı: Fiziksel ve tekstürel özellikler üzerine etkileri

Bu çalışmada karabuğday, kinoa ve amarant 2 farklı yöntemle (spontan ve maya kullanılarak) fermente edilmiş ve hazırlanan hamurlar, mısır nişastası ile pirinç unu kombinasyonunu içeren glutensiz ekmek formülasyonunda farklı oranlarda (%0, 15, 30 ve 45) kullanılmıştır. Fermente edilmiş pseudo-tahılların, glutensiz ekmeklerin fiziksel ve tekstürel özellikleri üzerindeki etkileri değerlendirilmiştir. Karabuğday fermente hamuru içeren ekmeklerde kabuk ve iç parlaklık (L*) değeri, kinoa ve amarant katkılı ekmeklerden daha düşük bulunmuştur. Formülasyonda pseudo-tahıl fermente hamuru (PFH) oranının artması ekmeklerde kabuk parlaklık değerinin azalmasına, kırmızılık (a*) değerinin ise artmasına neden olmuştur. Ekmeklerde en yüksek hacim değeri kinoa katkılı örneklerde belirlenmiştir. Maya kullanılarak fermente edilen pseudo-tahılları içeren ekmeklerde, spontan fermentasyona kıyasla daha yüksek hacim, spesifik hacim ve daha düşük sertlik değerleri elde edilmiştir. Artan PFH oranı ile 2. 24. 48. ve 72. saat sertlik değerleri önemli artış göstermiştir (p<0.05). Karabuğday katkılı ekmekler 72. saatte en yüksek ekmek içi sertlik değerini verirken, en düşük sertlik değeri ise kinoa içeren ekmeklerde belirlenmiştir.

Új illat allergén a nemzetközi epicutan sorokban: Evernia furfuracea Ajánlás a magyar standard epicutan tesztsorba való beemelésre

Evernia furfuracea (tree moss), is a moss occurring in various pine trees, its extract is widely used in the perfume industry. It can be found in cosmetics (perfumes, lotions, shower gels, deodorants, facial cleansers, make-up products, and shaving products). According to international literature, the prevalence of allergic contact dermatitis caused by Evernia furfuracea is estimated to be between 2.1 and 6.37%. The present article describes the frequency and the characteristics (age, gender, distribution by localization) of Evernia furfuracea sensitization in patients patch tested between 2018 and 2021 at the Department of Dermatology, Venereology, and Dermatooncology of the Semmelweis University. The incidence of sensitization increased over the years. 75% of the sensitized patients were female, with an average age of 46.82 years, 25-25% of them belonged to the age group of 30-39 years and 50-59 years. Patients sensitized with Evernia furfuracea mostly developed allergic contact dermatitis symptoms on their hands and faces. The positive patch test reactions occurred mainly in the 72nd hour. The most common co-sensitizations were Pix, colophonium, methylisothiazolinone, and fragrance mix I. 17.86% of the Evernia furfuracea sensitized patients had a history of atopic dermatitis. According to our results, we recommend the inclusion of Evernia furfuracea in the Hungarian standard patch test series.

Effect of Fermentation on Bacteriological and Physicochemical Properties of ‘Ofada” Rice

Rice (Oryza sativa) is an important annual crop in Nigeria. It is one of the major staples, which can provide a nation’s population with the required food security of 2,400 calories per person per day. In Nigeria rice is one of the few food items whose consumption has no cultural, religious, ethnic or geographical boundary. Fermented rice is used to produce rice wine, spaghetti and noodles. Work was then carried out on the Nigerian rice var. ITA 150 (ofada) to determine the bacteriological and physicochemical activities during fermentation. Standard microbiological and chemical methods were used. Six microorganisms were isolated which include; Bacillus cereus, Micrococcus luteus Lactobacillus plantarum, Staphylococcus aureus, Leuconcostoc mesenteroides, and Bacillus licheniformis. It was observed that the microbial loads increased till the 72nd hours of fermentation except Staphylococcus aureus and Micrococcus luteus that their loads decreased after the 72nd hours. There was an increase in the moisture, fibre, fat and protein contents, while carbohydrate, ash and anti-nutrients contents decreased. It was evident that fermentation process contributes to the bacteriological and physicochemical properties of the fermented rice in the production of another consumable product like rice wine, kunnu –zaki, spaghetti and the noodles.

Melatonin in preservation solutions prevents ischemic injury in rat kidneys.

Transplantation is lifesaving and the most effective treatment for end-stage organ failure. The transplantation success depends on the functional preservation of organs prior to transplantation. Currently, the University of Wisconsin (UW) and histidine-tryptophan-ketoglutarate (HTK) are the most commonly used preservation solutions. Despite intensive efforts, the functional preservation of solid organs prior to transplantation is limited to hours. In this study, we modified the UW solution containing components from both the UW and HTK solutions and analyzed their tissue-protective effect against ischemic injury. The composition of the UW solution was changed by reducing hydroxyethyl starch concentration and adding Histidine/Histidine-HCl which is the main component of HTK solution. Additionally, the preservation solutions were supplemented with melatonin and glucosamine. The protective effects of the preservation solutions were assessed by biochemical and microscopical analysis at 2, 10, 24, and 72 h after preserving the rat kidneys with static cold storage. Lactate dehydrogenase (LDH) activity in preservation solutions was measured at 2, 10, 24, and 72. It was not detectable at 2 h of preservation in all groups and 10 h of preservation in modified UW+melatonin (mUW-m) and modified UW+glucosamine (mUW-g) groups. At the 72nd hour, the lowest LDH activity (0.91 IU/g (0.63–1.17)) was measured in the mUW-m group. In comparison to the UW group, histopathological damage score was low in modified UW (mUW), mUW-m, and mUW-g groups at 10, 24, and 72 hours. The mUW-m solution at low temperature was an effective and suitable solution to protect renal tissue for up to 72 h.

Comparitive study of 0.1% ropivacaine with fentanyl versus 0.125% bupivacaine with fentanyl in epidural labour analgesia

Background: Analgesic adequacy during labor along with the avoidance of adverse effects is vital for obstetric conditions. Painful labor can have negative impacts on maternal and fetal physiology. Aim: The aim of the study was to compare the efficacy of ropivacaine with fentanyl and bupivacaine with fentanyl in epidural labour analgesia. Methodology: Seventy ASA I&II parturients with singleton pregnancies who presented in active labour with cervical dilatation of 3-5cm were studied in a prospective, randomized control manner. Patients were randomized into Group A (ropivacaine)-35 patients and Group B (bupivacaine) - 35 patients. Epidural analgesia was performed and various parameters (heart rate, blood pressure, respiratory rate, oxygen saturation, pain score) and complications if any were recorded every 15 minutes in the 1st hour, every 30 minutes in the 2nd hour and every hour later on. Results: The fluctuations in pain were not clinically or statistically significant between the two study groups. The number of patients who required bolus were 7(20%) in both the groups. The spontaneous deliveries were more, 62.9% in Group-A as compared to 54.3% in Group-B. The instrumental delivery rates were less, 25.7% in Group-A as compared to 37.1% in Group-B.

A multicenter prospective cohort study of cardiac ultrasound phenotypes in patients with sepsis: Study protocol for a multicenter prospective cohort trial.

BackgroundSepsis-induced cardiomyopathy significantly increased the mortality of patients with sepsis. The diagnostic criteria for septic cardiomyopathy has not been unified, which brings serious difficulties to clinical treatment. This study aimed to provide evidence for the early identification and intervention in patients with sepsis by clarifying the relationship between the ultrasound phenotype of septic cardiomyopathy and the prognosis of patients with sepsis.MethodsThis was a multicenter, prospective cohort study. The study population will consist of all eligible consecutive patients with sepsis or septic shock who meet the Sepsis 3.0 diagnostic criteria and were aged ≥18 years. Clinical data and echocardiographic measurements will be recorded within 2 h, at the 24th hour, at the 72nd hour, and on the 7th day after admission. The prevalence of each phenotype will be described as well, and their association with prognosis will be analyzed statistically.DiscussionTo achieve early recognition, prevent reinjury, achieve precise treatment, and reduce mortality in patients with sepsis, it is important to identify septic cardiac alterations and classify the phenotypes at all stages of sepsis. First, there is a lack of studies on the prevalence of each phenotype in Chinese populations. Second, each phenotype and its corresponding prognosis are not clear. In addition, the prognosis of patients with normal cardiac ultrasound phenotypes vs. those with suppressed or hyperdynamic cardiac phenotypes is unclear. Finally, this study was designed to collect data at four specific timing, then the timing of occurrence, duration, changes over time, impact to outcomes of each phenotype will probably be found. This study is expected to establish a standard and objective method to assess the ultrasound phenotype of septic cardiomyopathy due to its advantages of visualization, non-invasiveness and reproducibility, and to provide more precise information for the hemodynamic management of septic patients. In addition, this research will promote the clinical application of critical care ultrasound, which will play an important role in medical education and make ultrasound the best method to assess cardiac changes in sepsis.Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT05161104, identifier NCT05161104.

INVESTIGATION OF NEUROPROTECTIVE EFFECT OF SHILAGITE EXTRACT IN EXPERIMENTAL HEAD TRAUMA MODEL CREATED IN RATS.

In this study, it was aimed to investigate the neuroprotective effect of shilajit extract in experimental head trauma. Three groups of 33 Sprague Dawley Albino strain male rats were included in the study. Group 1 (n: 11): trauma but not treated. Group 2 (n: 11): trauma and treated with 0.5 mL / rat saline Group 3 (n: 11): 150 mg / kg shilajit extract was administered intraperitoneally in the treatment of trauma. Following the head trauma, the indicated treatments were applied to the 2nd and 3rd groups at the first, twenty-four and forty-eighth hours. Brain tissues and blood samples were taken after the control animals were sacrificed at the 72nd hour in all groups after trauma. Sections prepared from cerebral cortex and ca1 region were examined with hemotoxylin eosin and luxol fast blue staining. Total antioxidant capacity, total oxidant capacity and oxidative stress index were measured from blood samples taken after routine procedures. The number of red neurons and the severity of edema were significantly higher in both the cerebral cortex and the ca1 region in the group treated with trauma only and in the group administered saline after trauma compared to the group that received shilajit extract after trauma. The total antioxidant capacity increased significantly in blood samples taken only from the group treated with trauma and saline in post-trauma treatment compared to the group given post-traumatic shilajit extract, while shilajit extract given due to traumatic brain injury significantly decreased the total oxidant capacity and oxidative stress index values compared to the other groups. . As a result; Shilajit extract has been shown to have a neuroprotective effect in the treatment of acute traumatic brain injury. Our study showed that shilajit may be a useful option in the treatment of secondary brain injury, in humans.

Design and Optimization of Floating Microspheres Using Abelmoschus esculentus Natural Polymer

The main objective of the present research study was to fabricate Vildagliptin floating microspheres by ionotropic gelation using natural polymer, Abelmoschus esculentus obtained from the fruits of Abelmoschus esculentus in combination with sodium alginate. Microspheres were prepared and optimized using central composite rotatable design model using design expert software version 12 .The study is focussed on the interaction effects of the three independent variables, natural polymer concentration, sodium alginate concentration and crosslinker concentration, optimization of formulations response surface methodology was used . drug –excipient compatibility studies were carried out by infrared spectroscopic studies. Infrared spectroscopic studies clearly shown that drug and excipients were compatible. Totally 15 formulations were generated taking 8 factorial points, 6 axial points and 1 centre point. Response surface methodology was used to optimize the formulations. To investigate the responses %cumulative drug release, floating time and floating lag time Response surface methodology was used Polynomial equations and model plots of 3 dimensional model surface plots were generated. Vildagliptin optimized microspheres were formulated and a second order, model quadratic model was used to study influence of formulation factors on response variables. Experimental data of Statistical analysis exhibited good coefficient of regression for cumulative in vitro drug release Regression F –ratios for the experimental variables were significant. The experimental values and predicted values are agreed. All fifteen formulations exhibited % yield of 94.35-99.99%, particle size of 124-441µm, %swelling index 64.52-89.65%, floating time of 10.16 to 13.16 and floating lag time of 30.31 to 46.98 sec. F4 formulation is optimized based on cumulative % in-vitro drug release at 2nd hour, 12th hour, floating lag time and floating time values. Predicted and observed results are in agreement 95% confidence intervals. Based on investigation, RSM is the good tool for optimization of formulations.

Value of Auricular Point Pressing in Postoperative Pain Nursing Care of Laparoscopic Cholecystectomy Under the Guidance of Nano-Probe

This work aimed to investigate and analyse the application value of auricular point pressing (APP) in pain nursing care after laparoscopic cholecystectomy guided by nano-probe. In this study, 100 patients who underwent laparoscopic cholecystectomy guided by nanoprobes were selected. According to the difference in admission time and intervention measures, 100 patients meeting the inclusion criteria were enrolled into an observation group (n = 50) and a control group (n = 50). Then, patients as controls after surgery were treated with routine preventive nursing intervention measures, and patients for observation received APP on the basis of routine nursing. Anal exhaust time (AET), bowel sound recovery time (BSRT), incidence of abdominal distension, and clinical efficacy were compared. In addition, the degree of abdominal pain was evaluated at the 24th hour, 48th hour, and 72nd hour after surgery, as well as the degree of gastrointestinal reaction. There was no marked difference in the general data of patients from the two groups. The time of first exhaust defecation in the observation group was shorter (P <0.05), indicating that the exhaust effect was better. The differences in degree of abdominal pain in patients were statistically marked between the 24th and 48th hours and the 48th and 72nd hours (P <0.05), indicating that postoperative abdominal pain symptoms of both groups could be effectively improved. The degree of gastrointestinal reaction of patients showed obvious difference between the 24th and 48th hour and the 24th and 72nd hour (P <0.05). However, there was no huge difference in the degree of gastrointestinal reaction between 72 hours and 48 hours (P >0.05), suggesting that the gastrointestinal symptoms were improved after 48 hours. In conclusion, postoperative APP could effectively alleviate postoperative pain in patients.

Comparison of full-face and oronasal mask effectiveness in hypercapnic respiratory failure patients with non-invasive mechanical ventilation.

Non-invasive mechanical ventilation (NIMV) is a successful treatment modality in hypercapnic respiratory failure. Patient compliance and mask selection are the most important factors in the success of NIMV. In our prospective randomized study, we aimed to investigate the efficacy of full-face and oronasal masks in the treatment of patients with hypercapnic respiratory failure who underwent NIMV and to investigate the mask compliance of the patients. In this prospective randomized study, 60 patients with hypercapnic respiratory failure were divided into two groups; the full face mask group (n= 30) and the oronasal mask group (n= 30). Arterial blood gas values and respiratory rates were measured before the treatment and at the 1st, 6th, 24th, and 72nd hours of the treatment. The compliance of the patients with the treatment was evaluated with the patient compliance scale (PCS) at the 1st, 6th, and 24th hours of the treatment. Eight patients from the full-face mask group were excluded because of mask-face mismatch and claustrophobia, and two patients from the oronasal mask group due to persistent hypercapnia. In the full face mask group, improvement in pH was observed at the 1st and 24th hours of treatment (p= 0.042, p= 0.033), and PCO2 decreased at the 72nd hour of treatment (p= 0.024). There was no difference in patient compliance and respiratory rate between groups. The complaints of burning sensation and pressure in the eyes were higher in the full face mask group (p= 0.025), and pressure ulcers were more common in the oronasal mask group (p= 0.025). The reduction in PCO2 and improvement in pH were greater with a full face mask. Pressure sores were less common with a full face mask. In our study, no difference was found in terms of patient compliance between groups. It should be noted that choosing a full face mask in patients with high compliance will increase the success in the treatment of hypercapnic respiratory failure.

Anti-Inflammatory Activity of Crude Extract of Aesculus Indica in Comparison with Aspirin on Carrageenan Induced Paw Edema in Rats

Objective: To determine the anti-inflammatory activity of crude extract of Aesculus Indica in rat model.Study design: Comparative studyPlace and duration of study: Pharmacy Department, Bahauddin Zakria University, Multan, Pakistan, from May 2017 to October 2017.Methodology:Twenty four healthy male and female Wistar rats (200-220gm) were included in the study, each rat was given single injection of 0.1 ml of 1% carrageenan, in normal saline in sub-planter region of the right paw for induction of edema. The rats were randomly divided by lottery method in to four groups; Group-1 served as positive control; Group 2 and 3 received crude extract of Aesculus Indica 100 mg/kg and 300mg/kg respectively; Group 4 was given aspirin at the dose of 12 mg/kg. The measurement of paw volume was made immediately by displacement technique using the plathysmometer before and at 1st, 2nd, 3rd and 4th hour after the carrageenan injection.Results: The result of the study confirmed the anti-inflammatory action of crude extract of Aesculus indica both at 100 mg/kg and 300 mg/kg. When group 1 was compared with group 2, 3 and 4, it revealed significant difference with p-value 0.002, 0.042 and 0.002 respectively. Similarly, comparison of group 2 with group 3 showed significant difference with p-value 0.02 while insignificant difference was found between group 3 and 4. Significant difference of p-value 0.03 was found when group 2 and 4 were compared.Conclusion: Crude extract of the Aesculus Indica showed significant anti-inflammatory properties which at high doses were almost comparable with that of aspirin.

Does the “obesity paradox” exist after transcatheter aortic valve implantation?

BackgroundTranscatheter aortic valve implantation (TAVI) for symptomatic aortic stenosis is considered a minimally invasive procedure. Body mass index (BMI) has been rarely evaluated for pulmonary complications after TAVI. This study aimed to assess the influence of BMI on pulmonary complications and other related outcomes after TAVI.MethodsThe clinical data of 109 patients who underwent TAVI in our hospital from May 2018 to April 2021 were retrospectively analyzed. Patients were divided into three groups according to BMI: low weight (BMI < 21.9 kg/m2, n = 27), middle weight (BMI 21.9–27.0 kg/m2, n = 55), and high weight (BMI > 27.0 kg/m2, n = 27); and two groups according to vascular access: through the femoral artery (TF-TAVI, n = 94) and through the transapical route (TA-TAVI, n = 15). Procedure endpoints, procedure success, and adverse outcomes were evaluated according to the Valve Academic Research Consortium (VARC)-2 definitions.ResultsHigh-weight patients had a higher proportion of older (p < 0.001) and previous percutaneous coronary interventions (p = 0.026), a higher percentage of diabetes mellitus (p = 0.026) and frailty (p = 0.032), and lower glomerular filtration rate (p = 0.024). Procedure success was similar among the three groups. The 30-day all-cause mortality of patients with low-, middle-, and high weights was 3.7% (1/27), 5.5% (3/55), and 3.7% (1/27), respectively. In the multivariable analysis, middle- and high-weight patients exhibited similar overall mortality (middle weight vs. low weight, p = 0.500; high weight vs. low weight, p = 0.738) and similar intubation time compared with low-weight patients (9.1 ± 7.3 h vs. 8.9 ± 6.0 h vs. 8.7 ± 4.2 h in high-, middle-, and low-weight patients, respectively, p = 0.872). Although high-weight patients had a lower PaO2/FiO2 ratio than low-weight patients at baseline, transitional extubation, and post extubation 12th hour (p = 0.038, 0.030, 0.043, respectively), there were no differences for post extubation 24th hour, post extubation 48th hour, and post extubation 72nd hour (p = 0.856, 0.896, 0.873, respectively). Chronic lung disease [odds ratio (OR) 8.038, p = 0.001] rather than high weight (OR 2.768, p = 0.235) or middle weight (OR 2.226, p = 0.157) affected postoperative PaO2/FiO2 after TAVI.ConclusionsWe did not find the existence of an obesity paradox after TAVI. BMI had no effect on postoperative intubation time. Patients with a higher BMI should be treated similarly without the need to deliberately extend the intubation time for TAVI.

PROSPECTIVE ANALYSIS OF THE PHYSIOLOGICAL CHANGES CAUSED BY PROLONGED USE OF N95-TYPE MASKS

TYPE: Late Breaking Abstract TOPIC: Pulmonary Physiology PURPOSE: INTRODUCTION: The clinical and physiological effects of long-duration use of N95-type masks without ventilation valves, on healthcare workers during the Coronavirus Disease-2019 (COVID-19) pandemic were evaluated. METHODS: All volunteering personnel working in operating theater using non-ventilated N95 type respiratory masks, minimum for a 2-hour non-interrupted duration were observed. The partial oxygen saturation (SpO2) and heart rate (HR) were recorded before wearing the N95 mask, and at 1st and 2nd hour. Volunteers were then questioned for any symptoms. RESULTS: Total of 116 measurements were completed in 29 (13 male, 16 female) eligible volunteers, each having 4 measurements, on different days. Median age was 32.5. Pre-mask, 1st hour, and 2nd hour median values for SpO2 were 98%, 97% and 96%, respectively (p<0.001). Median HR was 75 pre-mask, 79 at 1st hour, and 84/min at 2nd hour (p<0.001). Significant difference between all-three consecutive measurements of HR was achieved. Statistical difference was only reached between pre-mask and other SpO2 measurements (1st and 2nd hour). Complaints seen in group were head ache (34%), shortness of breath (23%), palpitation (19%), and nausea feeling (3%). Two individuals took off their masks to breathe, on 87th and 105th minutes, respectively. CONCLUSIONS: Long duration (>1 hour) use of N95-type masks cause significant reduction in SpO2 measurements and increase in heart rate. CLINICAL IMPLICATIONS: .Despite being a crucial personal protective equipment in COVID-19 pandemic, especially for health workers in operating rooms, it should be used with caution in people with known heart and/or pulmonary insufficiency, and with short intermittent time periods. DISCLOSURE: No significant relationships. KEYWORD: COVID-19

Antihyperglycemic, Antihyperlipidemic, and Antioxidant Effects of Salvia tingitana in Streptozotocin-Induced Diabetic Rats.

The study aimed to assess the antidiabetic effect of Salvia tingitana (S. tingitana). S. tingitana is an aromatic plant that belongs to the Lamiaceae family. Phytochemical analysis of the aerial parts of S. tingitana revealed the existence of terpenoids and flavonoids. In addition, S. tingitana possesses antimicrobial activity. The goal of the study was to obtain information about the antihyperglycemic, antihyperlipidemic, antioxidant abilities of S. tingitana aqueous extract. The effect of an acute and sub-chronic administration of S. tingitana aqueous extract (AEST) at the doses of 60 and 80 mg/kg on glucose, lipid profile, and lipoprotein profile was examined in normoglycemic and hyperglycemic rats. Additionally, a preliminary phytochemical screening and the antioxidant activity using DPPH assay were carried out. Rats treated with AEST at a dose of 60 mg/kg showed a significant decrease in the serum glucose levels during the single oral administration at the 4th and 6th hour of treatment in both normal and streptozotocin(STZ)-induced hyperglycemic rats. Interestingly, a dose of 80 mg/kg AEST produced a significant lowering effect on blood glucose levels at the 2nd, 4th, and 6th hour of treatment after a single oral administration in both diabetic and normal rats. Both doses of AEST (60 and 80 mg/kg) revealed a significant amelioration of lipid and lipoprotein profile. In addition, the qualitative and quantitative phytochemical analysis proved the presence of polyphenols compounds, flavonoids, and tannins. Results suggest that S. tingitana contains some secondary metabolites like alkaloids, phenols, flavonoids, and saponins. Importantly, the study revealed that the aqueous extract of S. tingitana has a very interesting antioxidant activity (IC50 = 553.21 μg/ml). The study illustrates the beneficial action of the aqueous extract of S. tingitana as an antihyperglycemic and antihyperlipidemic agent.

The Predictive Value of Serum Alkaline Phosphatase Level on the Degree of Neurological Impairment in Patients with Acute Cerebral Infarction

Objective: To analyze the correlation between the changes of ALP level and the degree of neurological impairment in patients with acute cerebral infarction. Methods: A total of 267 patients with acute cerebral infarction were selected as the cerebral infarction group, 181 elderly patients who were matched age and gender in the same period with the cerebral infarction group were selected as the control group by the physical examination. All the selected patients were tested for serum ALP, ALT, AST, Cr, BUN,TG, TC, LDL - C and HDL - C after eight hours on an empty stomach. In the 72nd hour of the patient's course of cerebral infarction, the degree of neurological impairment was assessed using NIHSS score. The relationship between serum ALP level and NIHSS score was analyzed. Results: According to NIHSS score, the patients with score of 5~15 were Group A , patients with score of 15~20 were Group B and score of 21~42 were Group C. Pearson correlation analysis showed that the serum ALP level of the three groups was positively correlated with NIHSS score. Multivariate regression analysis results showed that the high serum ALP level of the risk of cerebral infarction is a low serum ALP level 1.58 times. Conclusions Serum ALP level was increased in patients with acute cerebral infarction and was closely related to the degree of neurological impairment. Perhaps the serum ALP level may be used as a serum marker to predict the degree of neurological impairment in patients.

Improving Exclusive Breastfeeding Behavior of Primipara Mothers With Lactation Education and Individualized Counseling Intervention

IntroductionNew mothers often need support to establish and maintain breastfeeding, and they may find it difficult to access breastfeeding resources locally. Therefore, postpartum lactation education and counseling of primipara mothers were given by integrating into their routine follow-ups in the family health center. This study was conducted to determine the effect of lactation education and individual counseling intervention integrated into the routine follow-up visits of primipara mothers in family health centers on exclusive breastfeeding rates and breastfeeding behaviors during the first 6 months postpartum.MethodsA two-factor, pretest–posttest, controlled, semi-experimental, prospective study was conducted. The study was conducted in three family health centers in a city on the north coast of Turkey. The interviews with the primipara mothers were performed between the 24th and 72nd hours and at the 1st, 3rd, 4th, 6th months postpartum.ResultsThe rates of giving exclusive breastfeeding to the infants in the first 6 months were 68% in the study group and 38% in the control group, exhibiting a statistically significant difference between the groups with regard to breastfeeding frequency (p =.001).ConclusionsIt was determined that the education and counseling integrated into the existing health system were effective in increasing the EBF rates and breastfeeding behaviors of primipara mothers in the first 6 months after birth.

The circadian rhythm of calcium and bone homeostasis in Maasai.

ObjectivesEthnic groups differ in prevalence of calcium‐related diseases. Differences in the physiology and the endogenous circadian rhythm (CR) of calcium and bone homeostasis may play a role. Thus, we aimed to investigate details of CR pattern in calcium and bone homeostasis in East African Maasai.MethodsTen clinically healthy adult Maasai men and women from Tanzania were examined. Blood samples were collected every 2nd hour for 24 h. Serum levels of total calcium, albumin, parathyroid hormone (PTH), 25(OH)D, creatinine, C‐terminal telopeptide (CTX), bone‐specific alkaline phosphatase (BSAP), procollagen type 1 N‐terminal propeptide (P1NP), and osteocalcin were measured. Circadian patterns were derived from graphic curves of medians, and rhythmicity was assessed with Fourier analysis.ResultsPTH‐levels varied over the 24 h exhibiting a bimodal pattern. Nadir level corresponded to 65% of total 24‐h mean. CTX and P1NP showed 24‐h variations with a morning nadir and nocturnal peak with nadir levels corresponding to 23% and 79% of the 24‐h mean, respectively. Albumin‐corrected calcium level was held in a narrow range and alterations were corresponding to alterations in PTH. There was no distinct pattern in 24‐h variations of 25(OH)D, creatinine, osteocalcin, or BSAP.ConclusionsAll participants showed pronounced 24‐h variations in PTH and bone turnover markers CTX and P1NP. These findings support that Maasai participants included in this study have typical patterns of CR in calcium and bone homeostasis consistent with findings from other ethnic populations.

Comparison of Mean Pain Score with Inguinal Block under Gen. Anes. versus Subarachnoid Block in Adult Pts UIH

Objective: To compare the mean pain score with inguinal block under general anesthesia versus subarachnoid block in adult patients undergoing inguinal hernioplasty. Design of the Study: Randomized controlled trial Study Settings: This cross-sectional study was conducted at Department of Anesthesiology, Sir Ganga Ram Hospital, Lahore from January 2021 to June 2021. Materials and Methods: Sample of 200 cases was included through non probability purposive sampling. In group A, patients were given inguinal block and in group B, patients were given subarachnoid block. In Inguinal block group, a 10mL of Bupivacaine (0.5%) will be given at junction of 2/3 form umbilicus and 1/3 from anterior superior iliac spine after administration of general anesthesia with laryngeal mask airway. Patients were followed at 1, 2 and finally on 4 hours after surgery for measurement of pain. Results: The mean age of 39.63±6.50 years. Out of total 200 patients, 186 (93%) were males and 14 (7%) were females. The mean pain score at 1st hour in inguinal group was 0.76±0.87 whereas pain score in Subarachnoid block was 1.18±0.92. Similarly after 2nd hour inguinal group pain score was 0.88±0.84 and with Subarachnoid block was 1.33±1.04. At 3rd hour, with inguinal block mean pain score was 1.02±0.92 and with Subarachnoid block was 1.80±1.20. At 4th hour, with inguinal block mean pain score was 1.59±1.07 and with Subarachnoid block was 3.09±1.60. Statistically there is highly significant difference of mean pain score between both groups i.e. p-value&lt;0.05. There was drastic increase in mean main score at 4th hour with subarachnoid block as compared to inguinal block showing that inguinal block is more effective in reducing pain after 4 hours of surgery. Conclusion: It was concluded from results of this study that inguinal block is more beneficial in controlling pain after inguinal hernia surgery as compared to subarachnoid block Keywords: Inguinal Hernia, Inguinal block, Spinal anesthesia, General anesthesia

Alteration in central vascular and cognitive functions during simulated work conditions in males – a secondary analysis from a randomised controlled trial

Background: Alteration in the central vascular hemodynamics is speculated to influence cognitive functions, including executive functions in young adults. Prolonged sitting is associated with compromised central vascular functions, which activity micro-breaks could mitigate. However, the association between the carotid vascular hemodynamic alteration and the executive functions is yet to be explored. Methods: We administered a randomised controlled trial investigating the effects of various intensities' micro-breaks on central vascular and cognitive functions during simulated work conditions for four hours. The carotid artery hemodynamics and cognitive functions were measured by Duplex ultrasound at 0th, 2nd and 4th hour and computer-based Flanker tests at 0th, 1st, 2nd, 3rd and 4th hour of visit days, respectively. From the randomised controlled trial, we extracted the secondary data of carotid artery hemodynamics and cognitive functions change at the 4th hour from the baseline and analysed for any relation. Results: Though we observed linear relation between the carotid artery hemodynamics and the executive functions, the relation was not statistically significant. we found a significant reduction in carotid artery diameter during prolonged sitting (0.03 cm [95%CI 0.01, 0.05]), velocity (10.35 cm/s [95%CI -2.85, 17.86]) and shear rate during interrupted sitting (174.39 [95%CI 65.67, 283.11]) We found increased accuracy during prolonged sitting (12.7% [95%CI 0.66, 24.81]) and sitting with light-intensity activity breaks (6.92% [95%CI 1.39, 12.44]). We did not find any significant relation between the change in central vascular functions (carotid artery diameter, velocity, shear rate and blood flow) and the cognitive functions during three different work conditions. Conclusion: Though a significant relation between carotid artery function and cognitive function could not be established, microbreaks can mitigate the vascular and cognitive risks associated with prolonged sitting.