24th Hour Research Articles

Three-dimensional bioprinted materials in alginate-hyaluronic acid complex based hydrogel based bio-ink as absorbents for heavy metal ions removal

Major environmental and health effects arise from the presence of heavy metals in water, including lead (Pb²⁺), mercury (Hg²⁺), chromium (Cr⁶⁺), cadmium (Cd²⁺), and arsenic (As³⁺), which contribute significantly to water pollution and pose severe risks to ecosystems and human health. This study demonstrates the fabrication of 3D printed self-regenerative functional living materials, a fungi, by using mixture of sodium alginate and hyaluronic acid hydrogel as absorbents to remove the heavy metals from the environment. Bioprinting has emerged as a transformative technology for fabricating complex biological constructs. The bioprinting experiments, conducted with optimized parameters, revealed the viscoelastic behavior of the hydrogel, suitable for 3D bioprinting applications. MicroCT analysis indicated that the hydrogel's porosity and structural properties support fungal growth in a controlled three-dimensional setting. Microscopic analyses, including phase contrast microscopy, FESEM, and HRTEM, provided insights into the cellular morphology of the bioprinted constructs. Cell viability was assessed using flow cytometry with FDA and PI staining, showing a significant population of live cells, affirming the biocompatibility of the hydrogel. Additionally, the study explored the hydrogel's potential for heavy metal removal from water samples. Multi-element standard solutions containing Copper(Cu²⁺), Cadmium(Cd²⁺), Nickel(Ni²⁺), Cobalt(Co²⁺), and Ferrous(Fe³⁺) ions at different concentrations were incubated with hydrogel patches embedded with Aspergillus flavus. Atomic absorption spectrophotometry analysis showed rapid initial removal rates of metal ions, with maximum removal efficiency achieved around the 12th hour. Comparisons with a control hydrogel without the fungal strain demonstrated significantly enhanced removal efficiency due to the presence of Aspergillus flavus. This study highlights the dual functionality of sodium alginate with hyaluronic acid -based hydrogels for bioprinting fungi and for environmental remediation of heavy metals, offering promising applications in environmental cleanup.

Comparison of the Analgesic Effect of Erector Spinae Plane Block Versus Caudal Epidural Block Following Unilateral Pediatric Inguinal Hernia Surgery: A Prospective, Randomized Study

Background: Caudal epidural block (CEB) has long been used as a standard method for pain control in pediatric surgery. Erector spinae plane block (ESPB) is a newer technique that has attracted attention for its potential to provide analgesia in children. Aim: The aim of this study was to compare and evaluate the effectiveness of ESPB and caudal block on postoperative pain in pediatric patients who underwent unilateral inguinal hernia surgery. Methods: This prospective, randomized trial was conducted with a total of 60 pediatric patients, aged 1–8 years, in the ASA I–II group. The patients were randomly divided into two groups as Group CEB (n = 30), and Group ESPB (n = 30). In the caudal block group, 0.25% bupivacaine 0.5 ml/kg (max 20 ml) was administered in the caudal space, while in the ESPB block group, the block was performed with 0.5 ml/kg 0.25% (max 20 ml) bupivacaine at the L1 vertebral level. Face, legs, activity, cry, and consolability (FLACC) scores were recorded postoperatively at 1, 2, 4, 6, 12, and 24th hours. The first analgesic requirements and time for rescue analgesia were also recorded. Results: While no significant difference was noticed between the two groups’ FLACC scores at the zeroth hour, first hour, second hour, fourth hour, and sixth hour (i.e. postoperatively [P > 0.05]), the FLACC scores of 12th hour in the ESPB group were significantly lower than the caudal block group (P < 0.05). There was also no significant difference in intraoperative additional analgesia requirements between the groups (P > 0.05). The time to first postoperative analgesia in the ESPB group was higher than that in the caudal block group (P < 0.05). Conclusion: The ESPB provided superior postoperative analgesia to the CEB in pediatric patients undergoing inguinal hernia surgery, and ESPB can be used as a relatively safer postoperative multimodal analgesia approach as an alternative to CEB.

Effects of Curcumin and Doxorubicin on the Viability of Neuroblastoma Cancer Cell Line

Aim: Neuroblastoma has a very important place among childhood diseases, and despite all the methods used in treatment, it is very difficult to prevent neuroblastoma invasion. The number of studies showing that curcumin, the most active component of turmeric, is not toxic, is increasing day by day. In this study, the anticancer activities of curcumin (Cur), one of the important active compounds, were demonstrated in the Neuroblastoma cancer cell line (Na2B). Method: Neuroblastoma cell line was used in the study. To determine the IC50 doses of Dox and Cur, Na2B cells line were cultivated with an automatic pipette. MTT analysis was performed to analyze cell survival (viability). Inhibition levels in the cells were determined at 24 and 48 hours. Results: While the IC50 of Na2B cell proliferation was approximately 124.5 uM at the 48th hour in Dox-treated cells, the IC50 value of Cur at the 48th hour was found to be 224.6 uM. Conclusion: These results showed that Cur could be an alternative agent in the treatment of neuroblastoma, and its fewer side effects compared to other chemotherapeutic agents such as Dox would increase its preferability.

Study on the neurotoxicity of the temephos impregnated kenaf cellulose nanofiber (KCNF+T) aerosols against the female Aedes aegypti mosquitoes.

The study has generated visible aerosols with the diameter of 11 to 35 µm from the kenaf cellulose nanofiber (KCNF) impregnated with the temephos (KCNF+T) in water suspension. The study aimed to determine whether the KCNF+T aerosols are capable to elicit neurotoxicity in the adult mosquitoes via the respiratory exposure route by observing their behavioural response and measuring its body acetylcholine esterase (AChE) activity. Adult Aedes aegypti mosquitoes were assigned to one negative control group and three treatment groups namely, distilled water (vehicle control), KCNF and KCNF+T. The study adopted the MS1911 whereby the aerosols generated are released into the insecticide bioassay glass chamber (IBGC) separately to achieve four different aerosols concentrations of 6.4 ml/m3, 12.8 ml/m3, 19.2 ml/m3, and 25.6 ml/m3. Then the 20 sugar-fed mosquitoes were released free-flying into each IBGC to observe its behavioural response (knockdown) at 30, 60, 120, 180, 240, 300 minutes intervals and 24th hour mortality. Results showed that only mosquitoes exposed to KCNF+T aerosols exhibited persistent knockdown. There was significant difference (p< 0.05) between observation intervals with the cumulative knockdown of 84.8%, 92.8%, 99.0%, 100.0%, 100.0%, 100.0% compared with the KCNF aerosols. Further, it was distinctive that only KCNF+T is capable to cause the female mosquitoes moribund/mortality at the 24th hour with 90% at the lowest aerosol concentration of 6.4 ml/m3. The neuroenzyme assay on the mosquito that died from the KCNF+T exposure verified to have reduced AChE enzyme activity. The behavioural response and reduction of the AChE activity strongly suggests the temephos from the KCNF+T aerosols has been released into the mosquito body causing the neurotoxicity but KCNF alone is not neurotoxic.

Amcasertib Increases Apoptosis While Decreasing Invasive and Migrating Abilities in Breast Cancer Stem Cells

Objective: A relationship exists between breast cancer stem cells (BCSCs) and the chemo-resistance and recurrence of aggressive breast tumors. Amcasertib is a small chemical compound and multiple kinase inhibitor that inhibits downstream Nanog and other cancer stem signaling pathways in cancer stem cells by targeting several serine-threonine kinases. In this study, we aimed to investigate the cytotoxicity and anticancer effects of Amcasertib on BCSCs, gaining insight into the targetability of BCSCs. Method: We used the combined xCELLigence-Real-Time Cell Analyzer (RTCA) equipment to analyze cytotoxicity and cell proliferation. We detected the IC50 dosages of Amcasertib at 24, 48, and 72 hours and examined its effects on apoptosis, cell cycle, invasion, and migration over 48 hours. We used flow cytometry for assays of apoptosis and cell cycle, and the CytoSelect 96-well Cell Migration and Invasion Assay Kit for evaluating invasion and migration. Results: Our results showed that Amcasertib has cytotoxic properties, with an IC50 dosage of 1.9 μM at the 48th hour. In addition, Amcasertib significantly induced apoptosis in BCSCs, despite not affecting the cell cycle. Moreover, Amcasertib decreased BCSCs’ invasion and migratory properties, part of epithelial-mesenchymal transition (EMT). Conclusion: In conclusion, our findings provide crucial information for understanding the potential of Amcasertib in targeting BCSCs. In addition, we suggest that Amcasertib could be a beneficial drug for breast cancer treatment by targeting BCSCs.

Real World Effectiveness of Orphenadrine Citrate 35 mg + Paracetamol 450 mg (Norgesic®) on Low Back Pain of Filipino Patients

Introduction: Low back pain (LBP) is a prevalent musculoskeletal condition, believed to impact as many as 84% of adults during their lifetime. It ranks among the primary reasons for limitations in activity, absenteeism from work, and reduced productivity, resulting in significant costs to health, social, and economic systems. Furthermore, the Philippines has been identified as one of the countries where 56% of its population suffers from weekly body aches. Thus, the study determined the effectiveness of orphenadrine citrate 35 mg + paracetamol 450 mg (Norgesic®) in relieving acute, non-specific moderate to severe musculoskeletal LBP among adult Filipino patients in a real-world setting. Methods: A prospective, multi-center, uncontrolled, open label, longitudinal study was done. Study participants were recruited via purposive sampling by their attending physicians, and they were given Norgesic® according to local prescribing guidelines and standard clinical practices. Pain levels were measured using the visual analogue scale (VAS), while self-reported physical disability was assessed using the Roland-Morris Disability Questionnaire (RMDQ). Patients were monitored until their low back pain completely resolved or for a maximum of ten (10) days. This real-world evidence study also documented any adverse effects occurring during this ten-day period. Results: The median onset of pain relief in the 255 study participants occurred an hour after the first dose of Norgesic® tablet, the fastest by 30 minutes and the slowest by the 8th hour, and it lasted for six (6) hours. At baseline, the median VAS score was seven (7) which subsequently decreased to 0 by day 7 up to day 10 and differed significantly from baseline (p&lt;0.0001). The median number of Norgesic® tablets consumed for pain relief likewise decreased from three tablets on day 1 to one tablet on day 7 to none on the succeeding days until the end of study period. The mean duration of LBP before total resolution, was 5.1 SD ± 2.2 days. The incremental increase in the proportion of those with complete resolution (VAS score=0) was highest by day 7. The median physical disability score significantly decreased to zero (0) on day 11 from nine (9) at baseline. Adverse events reported in 22 participants were generally mild dizziness and somnolence, which lasted for 1-6 days and resolved with rest. Conclusion: In this study, orphenadrine 35 mg + paracetamol 450 mg (Norgesic®) was noted to be effective in alleviating acute nonspecific moderate to severe musculoskeletal LBP of Filipino patients. In addition, Norgesic® aided study subjects in regaining functional capacity for them to continue with their impaired activities of daily living. Only few non-severe, self-limiting adverse reactions were noted during the treatment period.

Colon-Specific Delivery of Naproxen Pellets for Rheumatoid Arthritis: Development, Optimization, and Evaluation Using a 3-Level Randomized Full Factorial Design

Rheumatoid arthritis (RA) is characterized by increased joint pain and stiffness, particularly in the morning, which requires medication for treatment. Our research described here was aimed to develop, evaluate, and optimize coated naproxen pellets for colon-specific delivery using the carboxymethyl Leucaena leucocephala gum for the chronotherapy of RA. The extrusion-spheronization process was used for the preparation of the pellets followed by coating in a fluidized bed processor with materials such as Eudragit® S 100 and L 100. An 11-run, 2-factor, 3-level, randomized full factorial design was used to analyze the impact on the responses by varying the levels of independent factors to obtain the optimized formulation. The drug release of all the formulation batches at the 4th hour varied from 1.24 to 17.22% in the upper gastrointestinal (GI) tract; while the release of the drug at the 10th hour varied from 76.87 to 98.39% at the colonic pH. Furthermore, it was observed that the optimized formulation exhibited an increased release of naproxen in the presence of cecal matter collected from rats. We suggest that the prepared optimized formulation of the coated pellets of naproxen shows promise for the chronotherapeutic treatment of early morning symptoms associated with RA.

Formulation and Evaluation of Nanoparticle Loaded Hydrogel Containing Antifungal Agent for the Treatment of Onychomycosis Using Factorial Design.

SLNs are hopeful carriers for the topical delivery of antifungal drugs. This research aimed to develop a topical gel combining Efinaconazole-loaded SLNs with fluconazole to enhance the treatment of onychomycosis. The objective was to formulate a nail gel that capitalizes on the localized action and improved adherence of efinaconazole, a crucial agent in treating nail disorders like onychomycosis. The formulation utilized an alcohol-based system with specialized ingredients to ensure low surface tension and optimal wetting properties. Fluconazole, a broad-spectrum third-generation triazole antifungal, was included for its systemic and superficial antifungal activity. It works by inhibiting the formation of ergosterol, a key component of fungal cell membranes, by blocking the fungal cytochrome P-450 enzyme. The SLN-based delivery system allows for the slower release of Efinaconazole, while fluconazole diffuses more rapidly. The optimized gel formulation showed sustained drug release, with Efinaconazole releasing 32.85% of the drug by the 8th hour, compared to 74.05% for fluconazole during the same period. A stability study on the F4 formulation, which utilized Carbopol 934, was conducted according to ICH guidelines and demonstrated that the gel maintained its quality attributes, such as color, odor, homogeneity, pH, and viscosity over 6 months of testing. These results indicate that the F4 topical gel formulation is stable and suitable for long-term use.

Treatment of Domestic Wastewater Using Membrane Bioreactor (MBR) Pilot Plant: A Case Study of Wastewater from Kklung Hok’s Treatment Pond and The Environmental Research and Training Centre (ERTC), Pathumthani, Thailand

This research performant of Membrane Bioreactor (MBR) pilot plant for treatment of Wastewater from Khlung Hok’s treatment pond volume of 250 liter and The Environmental Research and Training Centre (ERTC) volume of 100 liter, both wastewater was mix on MBR. Aeration was fed at air flow rate 150 l/min over two hours to provide the oxygen for microorganisms. Further, Aeration was fed continuously for 6 hours. sample were collected every one hour. Result found that: the wastewater variation of pH, DO, BOD, COD, NH4+, NO2– concentration of the feed tank from Khlung Hok’s treatment pond were 7.16, 0.60 mg/l, 95mg/l, 157 mg/l, 34.96 ppm and NO2 not found and from ERTC’s wastewater were 6.87, 0.41 mg/l, 93 mg/l, 160 mg/l, 21.23 ppm and 0.043 ppm, respectively. After air flow in MBR over 2 hour the concentration of influent was found 6.64, 0.60 mg/l, 48 mg/l, 105.67 mg/l, 22.30 ppm and 0.031 ppm, respectively. And during the whole process effluent pH concentration were between 6.64-7.46, DO were between 1.11-5.8 mg/l. The removal BOD efficiency were over 89.58% (on 5th hour), COD were over 75.39% (on 4th hour), NH4 were over 53.61% of (on first hour) and were over NO2 48.71% of (on 2nd hour), respectively. Result indicated that effective removal BOD, COD, NH4+ and NO2– by MBR could be achieved and increased in scale for use in the fieldwork or the treatment of wastewater in the environment.

Coexistence of HHV-8-Associated Plasmacytic Multicentric Castleman Disease, Kaposi's Sarcoma, and Multiple Myeloma in a HIV-Negative Patient.

Multicentric Castleman disease (MCD) is a rare, aggressive lymphoproliferative disorder. Human herpesvirus-8 (HHV-8) has an important role in the pathogenesis of the disease and its association with Kaposi's sarcoma has been reported, especially in people living with human immunodeficiency virus (HIV). In this report, we present the case of HHV-8 positive MCD accompanied by Kaposi's sarcoma and multiple myeloma in an HIV-negative patient. A 78-year-old man with Kaposi's sarcoma presented with B symptoms, pancytopenia, lymphadenopathy, and splenomegaly. The bone marrow biopsy demonstrated 70% lambda-restricted monotypic plasma cell infiltration consistent with plasma dyscrasia. Also, the patient was diagnosed with HHV-8 positive MCD as a result of inguinal lymph node excisional biopsy. Treatment was initiated including ganciclovir and methylprednisolone and followed by rituximab. The patient passed away at the 24th hour of rituximab infusion due to shock. MCD and associated malignancies are difficult to treat and have a poor prognosis. More studies and data are needed to manage these patients. Multicentric Castleman disease (MCD), often linked with human herpesvirus-8 (HHV-8) and Kaposi's sarcoma, is rare and aggressive condition, particularly in human immunodeficiency virus (HIV)-positive patients.The coexistence of MCD, Kaposi's sarcoma, and multiple myeloma is exceptionally rare in HIV-negative, immunocompetent patient.This case highlights the challenges in diagnosing and managing complex presentations of MCD and related malignancies, with poor outcomes despite treatment.

Preparation and Evaluation of Itraconazole Nanoparticle Lipid Carrier Gel for Dermatophytosis

Fungal infection is one of the common dermatological diseases. Drug delivery systems for topical use have shown significant advantages in targeting the drug to the action site in the body and also reduces the systemic side effects. Itraconazole was chosen as a model drug with low aqueous solubility. In the present study an attempt was made to prepare itraconazole loaded nanostructured lipid carrier (NLC). Different formulations were prepared by hot homogenization technique using solid lipid and liquid lipid (Compritol 888 &amp; Caprol PGE 860) and surfactants (Poloxamer 188, tween 80). All the Formulations were characterized for drug content, entrapment efficiency, particle size, poly dispersity index, zeta potential &amp;in vitro drug release and FTIR was done to study any interaction between excipients. The best formulation shows better drug release and entrapment efficiency 83.2%. the best formulation F3 showed better in-vitro drug release 55.46% at the end of 8th hour. The F3 was made into gel using Carbopol as a gelling agent. SEM study revealed that the NLC gel shows the particle size was found to be 500 nm in size smooth surfaces. NLC gel shows Drug release of NLC gel followed non- Fickian diffusion. NLC gel were stable at 40 ± 2ֹ°C and 75 ± 5% RH. Thus, the prepared NLC gel proved to be a potential candidate as a topical nanoparticulate sustained drug delivery system for itraconazole (BCS class II drug). keywords: Itraconazole, Nanoparticle Lipid Carrier, Lipids.

Assisted oocyte activation significantly improves zygote formation, cleavage, and implantation rates in patients with a history of fertilization failures.

Fertilization check performed at the 18th hour following classic in vitro fertilization procedure (IVF) or intracytoplasmic sperm injection (ICSI) is a critical stage in assisted reproduction. The success of the treatment is significantly reliant on the quantity of zygotes exhibiting two pronuclei. Consequently, low fertilization rates or complete fertilization failure are highly undesirable outcomes for both patients and reproductive specialists. Applying additional calcium ionophore for oocyte activation subsequent to ICSI may offer benefits and potentially enhance treatment outcomes, particularly for patients who have experienced low or absent fertilization rates (FR) in previous treatment cycles. The aim of the study is to evaluate the efficacy of Ca2+ ionophore application for oocyte activation. A retrospective analysis of 924 oocytes obtained from 120 patients who underwent ICSI cycles with a history of low or no fertilization as a result of previous unsuccessful treatment rounds. The next ART cycle followed with additional oocyte Ca2+ ionophore activation applied in 57 of the cases in order to optimize the treatment process (Group 1), and 63 patients were included and their outcomes followed as a control group (Group 2).We conducted a comparative analysis of results in both groups. The study's primary outcomes encompassed fertilization, cleavage embryo quality, blastocyst rate, and established clinical pregnancies. At day 1fertilization check we had 274/386 zygotes (71%FR) in group 1 and 132/410 in group 2 (32.2%FR), (P<0.0001). Twenty-two (34.9%) cycles in group 2 resulted in total fertilization failure (TFF). At the cleavage stage top-quality embryos from group 1 were significantly higher (P = 0.0021) in comparison to group 2. Forty-eight embryo transfers (ET) were performed in group 1 resulting in 41.67% clinical pregnancies versus 33 ET and only 4 pregnancies (12.12%) for group 2 (P = 0.0044). The results confirm the appropriateness of assisted oocyte activation as an additional method in cases of previous fertilization failure cycles.

Transfer and persistence of microbiota markers from the human hand to the knife: A preliminary study

New scientific techniques and methods are always needed to link the perpetrators to the incident or the crime scene. Recent microbiota studies based on NGS (Next-generation sequencing) show that various biological samples from crime scenes have the potential to be used in forensic investigations. Especially when DNA traces belonging to more than one person are insufficient to fully determine the genetic profile, a secret sample, such as a microbiota sample created by the suspect's touch, can be used. In this preliminary study, a fictionalized experimental model was designed to investigate the transfer and persistence of the hand microbiome on the knife handle, which has a high potential to be used in criminal incidents, by metagenomic analysis methods. In addition, it was aimed to determine the transfer of specific bacterial species identified only to the person among the five participants onto the knife handle and their persistence over time. In the first stage of the research, samples were collected from the hands of 5 volunteer participants using the swap method, including their palms. Then, after each participant held a different knife, samples were collected from the knife handles via swabs from different angles of the knives at 4 and 24 h and analyzed by metagenomic methods. The findings of this preliminary study showed that the heatmap graphs generated after UniFrac distance analysis were not successful in establishing any similarity between the hand samples and the post-transfer knife handle samples. Nonetheless, it was observed that the transfer of bacterial species detected in the hand samples to knives differed according to the individuals and some bacterial species were transferred to the knife samples held by the participants. The number of bacterial species detected that are specific to each participant's hand sample was 302 in total, and it was determined that a total of 8.28 % of these bacterial species were transferred to the knife handle samples of the 4th hour and 6.95 % to the knife samples of the 24th hour. In the presented study, considering the transfer of some bacterial species in the hand microbiome, which are effective in the variation between individuals, onto the knife; It has been evaluated that some rare bacterial species can be important potential markers to associate the object with the perpetrator.

Changes in hematopoietic stem cell numbers following acute exercise in non-athlete marathon runners

PurposeHematopoietic stem cell (HSC) transplant is one of the curative methods for some patients with hematological malignancies. Granulocyte colony-stimulating factor (G-CSF) is the most common drug used to mobilize CD34+ cells, generally found in small numbers. Recent evidence showed that exercise causes transient mobilization in HSC. However, the type and intensity of exercise have not been fully revealed. We aimed to detect a significant increase in stem cell levels following 60 ​min of running at a personalized running pace. Materials/methodsEighteen runners, 48.2 ​± ​1.9 years with peak oxygen consumption of 46.2 ​± ​1.4 ​ml/kg/min, were enrolled in the study. The cardiopulmonary exercise test was performed to determine the individual running pace, and the participants ran 60-min on a treadmill at an intensity close to their ventilatory threshold (VT). The blood sampling for HSC count was performed before, immediately after, at the 1st, 4th and 24th hour after the 60-min running. ResultsThe CD34+ HSCs were 13.9 ​± ​2.3 ​cells/μl before and significantly increased immediately after to 19.5 ​± ​3.6 ​cells/μl (p ​< ​0.05). The consecutive HSC counts were 15.3 ​± ​2.2, 19.5 ​± ​4.8 and 15.1 ​± ​3.4 ​cells/μl at the 1st, 4th, and 24th hour, respectively. ConclusionThe individual data showed that some runners had higher HSC levels than the transplantation limit before and after the 60-min running trail, which was maintained for 24 ​h. Pre-running high CD34+ HSCs may reflect an adaptive response to regular exercise, with a 60-min run near the VT further elevating HSCs. Individualized exercise may be a valuable tool to mobilize the CD34+ HSCs in peripheral blood for donors.

VNOTES scarless and painless endometrial cancer staging surgery.

Sentinel lymph node dissection is performed in endometrial cancer surgery instead of staging surgery, particularly when the disease is advanced and confined to the uterus. The aim of this study is to share our sentinel lymph node detection rates via the vaginal natural orifice transluminal endoscopic surgery method with the literature and to demonstrate a safer and more comfortable surgical treatment process. The analysis includes the patients who underwent surgery sentinel lymph node dissection for endometrial cancer utilizing indociyanin green in our center between January 2022 and June 2024. In all, of 24 endometrial cancer patients underwent surgery sentinel lymph node dissection, nonendometrioid (serous) pathology was observed in only 1 (4%) patient, our other patients (96%) had endometrioid adenocarcinoma pathology. The rates of our sentinel lymph node dissection bilateral and symmetric are 96% (23/24), 94% (22/24), and 79% (19/24), respectively. We would like to emphasize that we successfully used vaginal natural orifice transluminal endoscopic surgery approach on four of our patients who were unsuitable for laparoscopic and robotic surgery due to pain scores of 2 at the 12th hour after surgery and low lung capacity. Vaginal natural orifice transluminal endoscopic surgery and sentinel lymph node dissection will be considered as surgical options in other gynecological cancers due to the comfort it brings to the patient in endometrial cancer.

Effect of Tetrapropylammonium Chloride Quaternary Ammonium Salt on Characterization, Cytotoxicity, and Antibacterial Properties of PLA/PEG Electrospun Mat.

In this study, poly(lactic acid) (PLA)-tetrapropylammonium chloride (TCL)-poly(ethylene glycol) (PEG) nonwoven networks were produced using PLA, PEG with different concentrations (3, 5, 7, and 9 wt%), and TCL. PEG is included as a plasticizer in PLA polymer, which has high biocompatibility but a brittle structure. The importance of this study is to investigate the effect of TCL salt on the characterization of PLA-PEG nanofibers. For this research, the cytotoxicity test system responsible for the fibroblast cell line (L929) was evaluated with the liquid absorption capacity (LAC) and drying time tests for its use in wound dressings. The addition of TCL salt reduced bead formation in PLA-PEG nanofibers and increased the homogeneity of fiber dispersion. The smoothest and most homogeneous nonwoven networks were obtained as PLA-5TCL-PEG. It was also reported that this nonwoven network exhibited liquid absorption behavior with a maximum increase of 150% compared to the PLA-PEG nonwoven network and had the highest Young's modulus value of 12.97 MPa. In addition to these tests, evaluations were made with Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), drying time test, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and mechanical tests. In addition, high cell viability was observed in L292 mouse fibroblast cells at the end of the 24th hour, again with the effect of TCL salt. In addition, antibacterial activity was tested against gram-negative E. coli and gram-positive S. aureus bacteria, and it was observed that there was no antibacterial activity. Since PLA-TCL-PEG nonwoven webs have a maximum cell viability of 133.27%, they are recommended as a potential dermal wound dressing.

Comparative Analysis of Epidural Dexamethasone and Epidural Morphine (EM) for Postoperative Pain Control After Total Abdominal Hysterectomy: A Randomized Clinical Trial

Background: Epidural anesthesia is commonly utilized for pain management following lower abdominal surgeries; however, the search for an optimal analgesic additive continues. Objectives: This study aimed to compare the efficacy of epidural dexamethasone versus epidural morphine (EM) in managing postoperative pain after total abdominal hysterectomy. Methods: This randomized controlled trial enrolled patients undergoing total abdominal hysterectomy (TBAH) and assigned them to two groups: Group D (Dexamethasone), which received epidural dexamethasone (8 mg) with bupivacaine, and Group M (Morphine), which received epidural morphine (10 mg) with bupivacaine. Marcaine (bupivacaine) 0.25% was used in both groups. Baseline characteristics, surgical outcomes, physiological parameters, pain management, adverse effects, and blood sugar levels were analyzed and compared between the groups. Results: The groups exhibited similar initial characteristics and surgical outcomes. Vital signs, including heart rate (HR), mean arterial pressure, respiratory rate, and oxygen saturation, remained consistent before and after surgery. The Dexamethasone group (Group D) demonstrated superior pain control compared to the Morphine group (Group M). Patients in Group D required pain medication for a significantly shorter duration (24 hours vs. 36 hours, P &lt; 0.05), representing a 50% reduction in medication duration. Additionally, Group D patients required fewer rescue analgesics (1.2 doses vs. 2.1 doses, P &lt; 0.05), indicating a 43% decrease in the need for additional medication. The time to a visual analog scale (VAS) score exceeding 4 was significantly longer in Group D, indicating less intense pain for an extended period. Although no significant differences were observed in common postoperative side effects, Group D exhibited a lower incidence of these effects, albeit not statistically significant. Furthermore, Group D showed a significantly lower incidence of hyperglycemia at the 8th hour post-surgery compared to Group M (P &lt; 0.05), suggesting a potential benefit of epidural dexamethasone in mitigating hyperglycemia risk. Conclusions: Epidural dexamethasone appears to offer superior analgesic efficacy compared to epidural morphine in postoperative pain management after total abdominal hysterectomy. The findings suggest that Group D (Dexamethasone) experienced improved pain management, reduced medication requirements, and a lower incidence of hyperglycemia. Further research with larger cohorts and extended follow-up is warranted to validate these findings and guide clinical practice.

The Effect of a Combination of Ethanol Extract from Leaves and Flowers of Plumeria acuminate L. Against Aedes aegypti Larvae

Aedes aegypti is the primary vector that causes dengue virus (DENV) infection. Ae. aegypti resistance to abate (Temephos) has occurred in Indonesia and several other countries. Innovations are needed to develop alternative ingredients that can be used as natural larvacides. The Plumeria acuminate L. is an Indonesian plant with metabolites that have the potential to act as larvicides. This study aims to determine the potential combination of ethanol extract of P. acuminate L. leaves and flowers as a larvicide for A. aegypti. A laboratory experimental study with a post-test-only control group design was carried out on Ae. aegypti larvae instar III. The larvicide test was carried out according to WHO standards in 2005 with concentrations of 10000, 7500, 5000, and 2500 ppm, as well as control (water and 1% DMSO), with 20 larvae for each concentration. The observation was carried out at the 24th and 48th hours with 3 repetitions. Larval mortality data was analyzed using one-way ANOVA statistical tests to determine significant differences and lethal concentrations (LC50 and LC90) were calculated using probit analysis using SPSS software. The mortality of Ae. aegypti larvae due to the administration of a combined ethanolic extract of P. acuminate L. leaves and flowers was the highest at doses of 10000 and 7500 ppm, which was 100% with lethal concentrations of LC50 and LC90 of 3364.715 and 6293.759 ppm at the 24th hour observation, whereas at the 48th-hour observation, lethal concentrations were detected at 1767.998 and 2941.138 ppm, respectively. One-way ANOVA analysis test showed a significant difference in Ae. aegypti larval mortality due to the administration of a combined ethanol extract of P. acuminate L. leaves and flowers at 24th-hour observation (p = 0.000) and (p = 0.013) at 48th hour observation. The combination of ethanol extract of P. acuminate L. leaves and flowers showed larvicidal activity against Ae. aegypti larvae as evidenced by larvae mortality which were influenced by concentration and observation time.

Does Monopolar Electrocautery Affect the Fetus during Cesarean Section?

Background and Objectives: This study aimed to assess the impact of monopolar electrocautery on the fetus during cesarean section. Materials and methods: A retrospective analysis was conducted with 552 patients delivered by cesarean section. Patients were grouped based on usage of monopolar electrocautery. In 272 patients, monopolar electrocautery was used to separate the tissues before the delivery. In 280 patients, no electrocautery was used. Newborn vital signs, Apgar scores, umbilical cord blood parameters, newborn serum parameters collected within 6th postpartum hour, and rate of newborn intensive care unit admission were compared. Results: The 1st and 5th minute Apgar scores were significantly higher in the electrocautery group; however, this difference lost its significance at the 10th minute. The median newborn pulse rate (148 (7) vs. 146 (6) beats per minute, p = 0.026), umbilical cord blood pH, and partial oxygen pressure were significantly higher in the electrocautery group compared to the no-electrocautery group (7.34 ± 0.06 vs. 7.31 ± 0.06, p < 0.001, and 25.5 (14.77) vs. 23 (16.08) mmHg, p = 0.025, respectively). The median umbilical cord blood serum calcium level was 1.51 (0.64) mmol/L in the electrocautery group, which was significantly lower than 1.9 (0.82) mmol/L in the no-electrocautery group (p = 0.002). The incidence of hypoglycemia was significantly lower in the electrocautery group than in the no-electrocautery group (2.2% vs. 5.7%, p = 0.035). Conclusions: Monopolar electrocautery during cesarean section affects the fetus, but it is safe to use it. Electrocautery is independently associated with umbilical cord blood pH and calcium level. Electrocautery may be associated with a lower incidence of hypoglycemia.

Is a two-hour monitoring period sufficient and safe for patients undergoing ultrasound-guided percutaneous liver mass biopsy?: A prospective and multicenter experience.

To investigate whether patients undergoing percutaneous liver mass biopsy (PLMB) can be safely discharged following a two-hour monitoring period. A multi-center prospective analysis was conducted for 375 patients (196 males and 179 females), mean age 63 ± 12.45 years (range 37-89) who underwent PLMB between August 2023 and March 2024. Patients were monitored for 24 h, and complications were classified as minor or major. The timing of complications was categorized into three groups: within the first two hours, between the 2nd and 24th hours, and within 1 week after 24 hours. Minor complications occurred in 18.93% (71/375) and major complications in 2.13% (8/375). Most minor complications (80.2%, 57/71) appeared within the first two hours, 12.7% (9/71) between 2 and 24 h, and 7.1% (5/71) after 24 h. All major complications (62.5%, 5/8) except late-onset cases, occurred within the first two hours. No major complications occurred between 2 and 24 h. Late-onset major complications occurred in 37.5% (3/8) after 24 h. The two-hour monitoring period did not adversely impact patient management regarding minor complications and is safe for identifying all major complications except for late-onset ones. Extending the post-biopsy recovery period does not significantly improve patient care.