Higher Values In Group Research Articles

The effects of optimizing blood inflow in the pedicle on perforator flap survival: A pilot study in a rat model.

BackgroundPerforator flaps have led to a revolution in reconstructive surgery by reducing donor site morbidity. However, many surgeons have witnessed partial flap necrosis. Experimental methods to increase inflow have relied on adding a separate pedicle to the flap. The aim of our study was to experimentally determine whether increasing blood flow in the perforator pedicle itself could benefit flap survival.MethodsIn 30 male Lewis rats, an extended posterior thigh perforator flap was elevated and the pedicle was dissected to its origin from the femoral vessels. The rats were assigned to three groups: control (group I), acute inflow (group II) and arterial preconditioning (group III) depending on the timing of ligation of the femoral artery distal to the site of pedicle emergence. Digital planimetry was performed on postoperative day (POD) 7 and all flaps were monitored using laser Doppler flowmetry perioperatively and postoperatively in three regions (P1-proximal flap, P2-middle of the flap, P3-distal flap).ResultsDigital planimetry showed the highest area of survival in group II (78.12%±8.38%), followed by groups III and I. The laser Doppler results showed statistically significant higher values in group II on POD 7 for P2 and P3. At P3, only group II recorded an increase in the flow on POD 7 in comparison to POD 1.ConclusionsOptimization of arterial inflow, regardless if performed acutely or as preconditioning, led to increased flap survival in a rat perforator flap model.

The impact of stocking density and dietary carbon sources on the growth, oxidative status and stress markers of Nile tilapia (Oreochromis niloticus) reared under biofloc conditions

The present study investigated the impact of stocking density and dietary carbon sources on the growth, oxidative status and stress markers of Nile tilapia (Oreochromis niloticus) reared under biofloc conditions. Six groups were established at three levels of stocking densities [20, 40 and 60 fish (50.47 ± 0.05 g) per m3] and fed the basal diet without carbon sources or with broken rice flour (BRF) or broken wheat grain flour (BWGF) in biofloc units. Water quality [pH, biological oxygen demand (BOD), Total ammonia-nitrogen (TAN), and nitrite-nitrogen (NO2)] values were increased significantly (P < 0.05) as the density increased and recorded the highest values in group (60 fish per m3) while dissolved oxygen decreased. Biofloc volume and bacterial counts were significantly (P < 0.05) lower in 20 fish m−3 and the highest values were in 40 fish per m3. Significantly increased growth and feed utilization were recorded in 40 fish per m3 fed with BRF. The lipid content lowered significantly (P < 0.05) in 60 fish m-3 group. Red blood cells count, hemoglobin and hematocrit values were reduced in fish stocked in high density while alanine transaminase (ALT) and aspartate transaminase (AST) increased in fish reared in low density. Glucose, cortisol, catalase and superoxide dismutase increased in fish reared at 20 fish m-3 and fed the basal diet. Thus, using of BRF for fish reared at 40 fish per m3 promotes growth and health status of Nile tilapia cultured in a biofloc system.

Structural and functional macular changes after cataract surgery in diabetic patients

Introduction. In recent years, the number of diabetic patients requiring cataract surgery has been on the rise. The aim of this study was to examine the effects of cataract surgery on visual acuity and changes in the central retinal thickness in diabetic patients with and without retinopathy, in relation to the duration of the disease, type of therapy, and the level of glycated hemoglobin and serum lipids. Material and Methods. The prospective study included 51 eyes of 34 patients divided into three groups. Preoperatively, all patients underwent best-corrected visual acuity evaluation with Snellen chart, cataract grading using lens opacities classification system III, as well as fundus examination and optical coherence tomography. Postoperative follow-up visits were scheduled after the first, fourth, sixth, eighth, and twelfth weeks after which the patients underwent best-corrected visual acuity evaluation and optical coherence tomography. The obtained values were statistically processed and analyzed in relation to the duration of the disease, the type of therapy, and the level of glycated hemoglobin and serum lipids. Results. Of 51 eyes, 5.9% developed macular edema during the fourth postoperative week with central retinal thickness &gt; 310 ?m. Subclinical central retinal thickness changes were registered in all groups with the highest values in group I (diabetics with retinopathy) in the sixth postoperative week. The average value of central retinal thickness in group I was 256 ? 11 ?m at baseline and 273 ? 11 ?m in week 6. The best-corrected visual acuity improved in all groups, without changes in central retinal thickness. Conclusion. Good visual acuity and absence of significant changes in macular thickness are helpful when making the decision to perform cataract surgery in patients with diabetes. Postoperative follow-up visits should include optical coherence tomography in addition to standard procedures.

Comparative evaluation of crestal bone level in patients having low level of Vitamin D treated with dental implant with or without Vitamin D3 supplements.

Introduction: Vitamin D has been shown to play a vital role in bone mineral homeostasis by stimulating the intestinal absorption of calcium and phosphate. The critical role of Vitamin D in bone metabolism triggered the need to evaluate the effect of Vitamin D deficiency and hence replacement of the same on osseointegration of dental implants. This prospective study evaluated the crestal bone level in patients having low level of Vitamin D treated with dental implant with or without Vitamin D3 supplements.Materials and Methods: A prospective clinical study was conducted on 32 patients based on the inclusion and exclusion criteria. Patients were divided into two groups on the basis of Vitamin D level < 30 ng/ml (Group I: patients receiving Vitamin D3 supplements, i.e., cholecalciferol 1 g sachet 60,000 IU/month) or <30 ng/ml (Group II: not receiving Vitamin D3 supplements). The crestal bone level measurements were made with the help of Digimizer Image Analysis, MedCalc software.Results: All implants showed clinically acceptable crestal bone level at interval of 1 week (baseline), 3 months, and 6 months. There was a statistically nonsignificant difference seen for the values between the groups (P > 0.05) for all other values at various time intervals. However, there was a statistically significant/highly significant difference seen for the values between the groups (P < 0.01, 0.05) for 3 months distal with higher values for Group I as compared to Group II.Conclusion: From the study, it can be concluded that cholecalciferol has systemic effects on accelerating bone formation around titanium implant.

Effect of bollard coping and locator attachment on implant stability and patient satisfaction in single implant assisted mandibular overdenture (in-vivo study)

Objective This study was performed to evaluate the effect of bollard coping and locator attachment on immediately loaded single implant retained complete mandibular overdenture. Patients and methods Twenty completely edentulous patients were selected from the Outpatient Clinic, Prosthodontics Department, Faculty of Dental Medicine, Al Azhar University. For each patient complete maxillary and mandibular conventional complete denture were constructed. The patients were divided into two equal groups: group I: patients were treated by single implant assisted mandibular overdenture retained with a new design (bollard coping); group II: patients were treated by single implant assisted mandibular overdenture retained with locator attachment. The bollard coping retention was achieved by engagement of the undercut in the bollard coping to the chemical-curing silicone soft liner in the denture. The locator attachment retention was achieved by the mechanical interlock between the attachment and the metal housing in the denture. The stability of implants was measured by using the Osstell implant stability quotient (ISQ) system and patient satisfaction was evaluated by using a questionnaire. Measurements were taken at baseline, 3, 6, and 12 months after implant insertion. Independent t-test was used for comparison between groups while the comparison of within each group by time was done by one-way analysis of variance followed by post-hoc Tukey test. Results Patient satisfaction and ISQ values results showed higher values in group I than group 2 without any statistically significant difference. ISQ values in both groups over time showed a statistically significant difference between the baseline and 6 and 12 months, between 3 and 12 months, and between 6 and 12 months values. There were statistically nonsignificant difference resulted from the comparison of 3 and 6 months values. Conclusion There was an increase in the ISQ, and retention values for both groups during the follow-up period, but the difference was statistically insignificant between the two groups.

Features of right lobe liver transplantation from living related donor

Aim. To determine the peculiarities of liver transplantation using right lobe graft from living related donor with and without the middle hepatic vein inclusion.Materials and methods. The study has analyzed preoperative, intraoperative and postoperative data of 76 recipients who underwent right lobe living donor liver transplantation with different types of hepatic vein reconstruction: group 1 – patients who received a right lobe liver graft with a middle hepatic vein, and group 2 – recipients of right lobe liver graft without the middle hepatic vein. For comparative analysis, we used biochemical and regional hemodynamic parameters in both groups during the first week and on days 10, 14, 21 and 30 after transplantation.Results. In group 1, the higher values of Qpv – 649 ± 220 ml/min, 1222 ± 491 ml/min; 1264 ± 372 ml/min; 1166 ± 284 ml/min; 1016 ± 211 ml/min; 1095 ± 301 ml/min were observed compared to group 2 – 643 ± 230 ml/min; 1127 ± 385 ml/min; 1132 ± 372 ml/min; 1030 ± 263 ml/min; 980 ± 254 ml/min; 922 ± 293 ml/min on days 0, 1, 3, 5, 7 and 30 after transplantation, respectively, (P &lt; 0.05). Peak systolic velocity (PSV) and resistance index of hepatic artery (RIha) were increased to higher values in group 2 (from 0.54 m/s to 0.69 m/s and from 0.63 to 0.69, respectively, P &lt; 0.05) compared to group 1 (from 0.58 m/s up to0.62 m / s and from 0.62 to 0.69, respectively, P &lt; 0.05). In the postoperative period, the level of total bilirubin in group 1 (grafts with middle hepatic vein) was significantly lower and the level of transaminases was higher than in group2. In the group of recipients, who had a graft with middle hepatic vein, the frequency of small-for-size syndrome (SFSS) was lower compared with group 2 (17.94 % vs 27.00 %, P &lt; 0.05).Conclusions. When performing the right lobe liver transplantation, the middle hepatic vein presence in the graft is correlated with a decrease in the frequency of postoperative complications and small for size syndrome development. Adequate venous outflow with sufficient volume of right lobe liver graft determines the functional graft mass.

Association of Bleeding Time and Clotting Time with ABO Blood Groups Among Healthy Adults

Background&#x0D; Haemostasis is the stoppage of bleeding. Bleeding time (BT) and Clotting time (CT) assess the integrity of haemostatic mechanisms. Assessment of Hematological parameters like bleeding time, clotting time and blood grouping are a very important before initiating any surgical procedure. Blood group has clinical importance in transfusion medicine and medico legal cases. Some studies have showed epistaxis and thrombosis found in O blood group individuals. Earlier studies showed the conflicting results regarding association of blood group with clotting time and bleeding time.&#x0D; Objectives&#x0D; The aim of the study was to assess the distribution of ABO blood groups in males and females with age group of 17-21yrs and determination of BT and CT among males &amp; females. To analyze the relationship between the blood groups, BT and CT.&#x0D; Method&#x0D; The study was conducted in Department of Physiology, Mamata Medical College. The study included 205 healthy volunteers of age group between 18-21years. Blood grouping, bleeding time and clotting time were determined. Statistical analysis done by un paired t test for calculating gender wise CT and BT and ANOVA and Post Hoc test for assessing relationship between BT, CT and blood groups.&#x0D; Results&#x0D; Our study results showed that blood group O was predominant in both males and females. Clotting time and bleeding time is statistically higher in females compared to males. Results showed clotting time is statistically significant (0.011) only between group A &amp; group O, with higher value in group O but not the bleeding time.&#x0D; Conclusion&#x0D; Blood group O was the most common group. BT and CT were higher in females than males. May be due to high estrogen and lower fibrinogen levels in females. CT and BT maximum in blood group O due to more activation of von Willebrand's Factor.

Vertebra-disc ratio as a new predictor for curve progression in early thoracic AIS with bracing treatment

ObjectivesPrevious studies have reported various predictors for curve progression in braced adolescent idiopathic scoliosis (AIS) patients. However, the reported predictors might be insufficient for patients with early AIS. The aim was to investigate whether the initial vertebra-disc ratio (VDR) could serve as an effective predictor for curve progression in early thoracic AIS (premenarchal and Risser 0) undergoing brace treatment. Patients and methodsThis study reviewed a consecutive series of early thoracic AIS girls with thoracic curve. All patients had accepted brace treatment and had regular follow-up. According to the bracing outcomes, patients were divided into two groups: Group P (progressed, curve progressed over six degrees or indicated for surgery) and Group NP (non-progressed). ResultsTotally 203 girls were included. There were 73 and 130 patients in Groups P and NP, respectively. The patients in Group P had greater initial VDR (1.9 ± 0.5 vs. 0.8 ± 0.4, P < 0.01) than Group NP. During the follow-up, it showed continuous higher values in Group P than Group NP. The logistic regression analysis revealed that initial VDR had an effective value for predicting curve progression in the braced early AIS girls. The ideal cut-off point of initial VDR was 1.5 for the prediction of curve progression. ConclusionThe initial VDR could serve as an effective predictor for curve progression in braced early AIS girls. Evaluation of this new parameter should be carefully performed at the bracing initiation.

Postmastectomy upper limb lymphedema: Combined vascularized lymph node transfer and scar release with fat graft expedites surgical and patients’ related outcomes. A retrospective comparative study

Lymphedema resulting from breast cancer treatment is a chronic condition that can significantly compromise quality of life. Several works have documented the efficacy of vascularized lymph node flap transfer (VLNT) for the treatment of advanced-stage lymphedema. Given that the axillary scar may contribute to the patient's existing lymphedema, the authors assumed that combining VLNT and scar release with fat graft could be an effective strategy of treatment. The purpose of this study is to compare the efficacy in the reduction of limb circumference and health-related quality of life between a combined strategy, namely, VLN transfer (VLNT) and axillary scar release with fat grafting, and only VLNT for patients affected by postmastectomy upper limb lymphedema. The idea. All patients with stage II and III breast cancer-related lymphedema operated between January 2012 and January 2016 were retrospectively identified, and only those treated by combined VLNT and scar release (Group A) or only VLNT (Group B) were included. The outcomes were assessed clinically by limb circumference measurement and radiologically by lymphoscintigraphy. Lymphedema-related quality of life was evaluated preoperatively and at 1 year follow-up through the LYMQOL questionnaire. Thirty-nine patients met inclusion criteria (Group A = 18; Group B = 21). Mean follow-up was 29 months for Group A and 32 months for Group B. Flap survival rate was 100%, with no donor site morbidity in all patients. A statistically significant difference between the circumference reduction rates (RR) at above elbow level was observed at 3 and 6 months of follow-up comparing the two groups (p<0.00001), with higher values in Group A than in Group B. No significant difference was detected comparing RR values at above and below elbow at 12 and 24 months postoperatively. LYMQOL metrics showed significantly better scores (p<0.0001) in all domains at all follow-up appointments in Group A. Patients with postmastectomy upper limb lymphedema can benefit from combined lymph node transfer and axillary scar release with fat graft, as this approach seems to fasten the onset of improvement and to have a positive impact on patients' quality of life.

Proinflammatory cytokine levels and peri-implant parameters among cigarette smokers, individuals vaping electronic cigarettes, and non-smokers.

Tobacco smoking compromises the prognosis of dental implant treatment and is associated with increased risk of peri-implant bone loss and increased implant failure rate. There is a dearth of studies that have compared clinical, radiographic, and immunological peri-implant parameters among cigarette smokers (CS), individuals vaping e-cigarettes (e-cigs), and non-smokers (NS). This study aimed to compare clinical and radiographic peri-implant parameters and levels of matrix metalloproteinase (MMP)-9 and interleukin (IL)-1β levels among CS, individuals' vaping e-cigs, and NS. Thirty-two CS (group 1), 31 individuals vaping e-cigs (group 2), and 32NS (group 3) were included. Demographic- and implant-related data were collected using a structured baseline questionnaire. Peri-implant plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were recorded and marginal bone loss (MBL) were assessed using standardized digital radiographs. Enzyme-linked immunosorbent assay was used to assess levels of MMP-9 and IL-1β in peri-implant sulcular fluid. Pearson correlation coefficient was used to analyze for correlations of MMP-9 and IL-1β levels with peri-implant parameters. BOP showed significantly higher values in group 3 as compared with groups 1 and 2 (P < 0.01). PI (P < 0.01), PD ≥ 4mm (P < 0.01), and mean concentrations of MMP-9 (P < 0.001) and IL-1β (P < 0.01) were significantly higher in groups 1 and 2 than group 3. MBL was significantly higher in group 1 as compared with group 2 and group 3 (P < 0.01). Significant positive correlations were found between MMP-9 (P=0.0198) and IL-1β (P=0.0047) levels and MBL in group 1; and a significant positive correlation between IL-1β and MBL in group 2 (P=0.0031). Peri-implant health was compromised among CS than vaping individuals and NS. Increased levels of proinflammatory cytokines in CS and vaping individuals may suggest greater peri-implant inflammatory response.

The Role of Clinical and Morphological Factors in Evaluation of Donor Liver Suitability for Transplantation

To study the predictive value of intraoperative biopsies of the donor liver, we performed analysis of all cases of liver donation in Moscow for the period 01 January 2015 to 31 December 2016. The number of donors included in the study amounted to 228 people. All donors were certified of death by neurological criteria (brain death). Were formed 3 groups of donors. The control group consisted of 136 donors whose livers were explanted and successfully transplanted. The study group 1 was composed of 62 donors in whom livers were deemed unsuitable for transplant by cryostat sections of liver biopsy. The study group 2 (n2=30) included donors, which in the cryostat sections revealed contraindications to liver donation, but in the paraffin sections samples revealed that livers meet the criteria of suitability for transplantation. The morphological criteria of suitability included macrovesicular steatosis less than 60%, microvesicular steatosis of any degree of severity, fibrosis is not above class 2 by Knodell, necrosis of hepatocytes less than 10%. Comparative analysis of the investigated groups revealed that the groups had no statistically significant difference by age (44,7; 47,6; 47,5; p=0,17), cause of death (stroke/TBI, p=0,12), values ALT1 and AST1 at admission (R=0,26, p=0.3 respectively), total bilirubin of blood before explantation (p=0.06), the dose and the nature of vasopressor support (p=0,09). There was a statistically significant difference between the groups in ALT2 and AST2 before explantation with the highest values in group 1 (p=0,03, p=0,03, respectively), the level of total bilirubin blood at admission with the highest values in the 1st and 2nd groups (p=0.001). Comparative analysis of the results of histological study revealed a statistically reliable difference in terms of "protein dystrophy of hepatocytes" with a predominance of severe degeneration in group 1, amounting to 34,8% (p=0.007), "macrovesicular steatosis" with the prevalence of steatosis exceeding 60% in group 1 (56,3%, p=0,0005), "fibrosis of portal tracts", class 2 according to Knodell was observed in 67.2 % of donors included in group 1. Findings presented allow us to conclude that among all considered cases in 86.8% clinical and morphological data of the donor correlated, indicating a fairly high level of sensitivity of the method of frozen sections to assess the suitability of the donor liver for transplantation. In 30 cases (13,2%) visual and clinical assessment of liver transplant match criteria the suitability of the donor liver, but the final decision was made by the specialists of the transplant center on the basis of histological picture of the biopsy that had unsatisfactory features that led to the loss of viable donor organs under conditions of scarcity.

Endocardial Fibroelastosis of the Left Ventricle Affects Right Ventricular Performance in Fetuses with Hypoplastic Left Heart Syndrome: A Prospective Study Using M-Mode, PW- and Tissue Doppler Techniques.

Myocardial function (MF) of the systemic right ventricle (RV) influences the postnatal course of neonates with hypoplastic left heart syndrome (HLHS). Our study examines whether the presence of endocardial fibroelastosis of the left ventricle (LV EFE) influences MF of the RV in HLHS fetuses. A prospective study was conducted including 10 controls (group 1), 10 HLHS fetuses with (group 2) and 10 without LV EFE (group 3) - all matched for gestational age. M-mode was used to assess tricuspid plane systolic excursion (TAPSE) and the shortening fraction (SF). PW-Doppler-derived and PW-TDI-derived velocities were assessed. E/A, E/e', e'/a' ratios and the myocardial performance index (mpi') were calculated. The examination of MF revealed significantly lower s'velocities (p < 0.05) and higher values for SF in group 2 compared to group 3. e'/a' ratio, et' (ejection time), E wave velocity, E/e' and SF showed significantly higher values in group 2 compared to group 1. In group 2 a' velocity increased significantly over gestational age. In group 3 but not in group 2, TAPSE increased during gestation. These significant differences in MF between the groups might lend support to the notion of negative ventricular-ventricular interaction in the case of HLHS with LV EFE possibly influencing surgical outcomes.

Evaluation of the effect of Garlic on the expression of NF-κB in DMBA-induced oral carcinogenesis in albino rats: An Animal study

Background: Nuclear factor-kappa B (NF-κB) is a key player in the process of carcinogenesis via regulating various steps, thus it is an attractive target for cancer therapy. Many medicinal plants and nutraceuticals can modulate NF-κB signaling pathway. The aim of this study is to investigate the chemopreventive and immunomodulatory effect of garlic in 7, 12 Dimethylbenz [a] anthracene (DMBA) induced oral carcinogenesis by assessing the expression of NF-κB.Material and methods: DMBA was used to induce oral cancer in 75 male albino rats. The animals were randomized into five groups (1 control and 4 experimental groups). The control group received no DMBA nor garlic extract, the other groups received either DMBA, garlic extract alone or both of them. Results: NF-κB immunoexpression revealed the highest values in group (2) and group (5) showing a highly significant difference.Conclusion: The aqueous garlic extract could prevent oral cancer through inhibition of NF-κB activation, where its effect is more pronounced in the initiation phase than the promotion and progression phases.

Occupational stress of anesthesia: Effects on aging

BackgroundAnesthesiology has been identified as a stressful specialty. Chronic psychological stress may lead to biological aging and skin aging. Study objectiveThe primary outcome was to measure physical health and emotional well-being. Secondary outcomes include skin aging analysis, telomere shortening in anesthetists. DesignThis is a prospective observational study. SettingsUniversity of Alexandria. PatientsStudy was carried out on 366 ASA I–II physicians 30–50yr. InterventionsPhysicians were categorized into two equal groups, Group A (183) were anesthesia physicians and Group B (183) were physicians in less stressful specialties (laboratory specialties). Subgroup analysis was performed comparing 10years' intervals from (30–40) and from (40–50). MeasurementsPhysical health and emotional well-being were evaluated. All physicians were exposed to validated assessment scales for the upper face and the lower face for skin aging analysis. Blood sampling were drowned from all physicians during their working hours for analysis of telomere length, markers of oxidative stress. ResultsThe two studied groups showed comparable demographic data and years of work. Physical health score and emotional health score showed higher values in Group A than Group B. Upper and lower face aesthetic unit summary score showed higher values in Group A than Group B. Telomere (TTAGGG) repeats for terminal restriction fragments (TRF) of Group A individuals revealed a significant decrease of TRF compared to Group B (p=0.001*). ConclusionBiological and skin aging is evident in anesthetists who are chronically exposed to occupational stress, with obvious shorter telomere length, higher lower and upper face scores, and free radicals.

Bone Healing and Hormonal Bioassay in Patients with Long-Bone Fractures and Concomitant Head Injury

Objective: The aim of this study is to investigate healing of fractures in patients with concomitant head injuries and to measure blood hormone levels to elucidate the mechanism of a possible accelerated osteogenesis. Materials and Methods: One hundred and sixty-two patients were included in this study and divided into 3 cohorts: group A with head injuries only (n = 52); group B with head injuries as well as long-bone fractures (n = 50); group C with long-bone fractures only (n = 60). Fracture-healing parameters including time of appearance and thickness of the bridging callus, and blood hormonal assays were measured and compared using Student's t test. Results: The mean time to healing was significantly lower in cohort B (6.9 ± 2.9 weeks) than C (22.4 ± 8.7 weeks; p = 0.001). The mean thickness of the healing callus was significantly higher in cohort B (26.3 ± 9.7 mm) than C (8.1 ± 5.9 mm; p = 0.002). The mean healing rate was also higher in cohort B (4.5 ± 2.3 mm/week) than C (0.38 ± 0.21 mm/week; p = 0.001). Blood hormonal assays in group B showed higher values of parathyroid hormone and growth hormone than in group C. However, adrenaline and noradrenaline values were lower in group B than in group C at all measured time intervals, and correspondingly leptin was lower in all groups (p = 0.001). Corticosteroid values were normal in group B compared to slightly higher values in group C, also at all measured time intervals. Conclusion: In this study, healing of fractures in patients with concomitant head injuries was accelerated, thereby indicating an involvement of a combined neurohormonal mechanism.

Effect of intrathecal clonidine versus fentanyl on bupivacaine spinal block in transurethral resection of prostate surgeries.

Aims:Our study aimed at comparing the onset, degree and recovery time of sensory and motor block, the hemodynamic effects and postoperative pain relief using intrathecal bupivacaine alone, bupivacaine along with fentanyl and clonidine.Materials and Methods:A total of 90 patients, undergoing transurethral resection of prostate (TURP) surgeries under spinal anesthesia were studied. Patients were randomly divided in a double-blind manner into three groups of 30 patients each. Group A (control) patients given subarachnoid block with 0.5% hyperbaric bupivacaine with 0.5 ml of normal saline. Group B patients were given subarachnoid block with 0.5% hyperbaric bupivacaine along with fentanyl 25 μg. Group C patients were given subarachnoid block with 0.5% hyperbaric bupivacaine 10 mg along with clonidine 30 μg and 0.3 ml of normal saline. After administering the subarachnoid block, vitals were recorded before and after surgery. Level of sensory block, the duration of motor block (DOMB), duration of sensory blockade (DOSB), the quality of postoperative analgesia using linear visual analog scale (VAS), and side effects were evaluated.Results:The time required to attain a maximum height of the block was significantly more in Group B as compared to Groups A and C, which was statistically significant. However, there was no statistically significant difference between Groups A and C. The mean DOSB in Groups A, B, and C were 90.83 ± 9.48 min, 135.33 ± 12.59 min, and 155.17 ± 17.49 min, respectively. The mean DOMB in Groups A, B, and C were 83.83 ± 6.52 min, 115.50 ± 14.70 min and 120.67 ± 11.50, respectively. Time of the first request of analgesia in Groups A, B and C in postoperative period were 132.50 ± 21.53 min, 296.00 ± 50.07 min, and 311.83 ± 65.34 min. patients had. VAS was significantly of higher value in Group A than Groups B and C.Conclusions:Intrathecal clonidine in a combination of bupivacaine for TURP provides more satisfactory anesthesia and analgesia and has less side effects.

Intraoperative trans-fontanellar cerebral ultrasonography in infants during cardiac surgery under cardiopulmonary bypass: an observational study.

This study was performed to evaluate the feasibility of intraoperative point-of-care trans-fontanellar cerebral ultrasonography (TFCU) to obtain blood flow velocity (BFV) reference values at the internal carotid arteries (ICAs) and peri-callosal part of the anterior cerebral artery (pACA) during pediatric cardiac surgery under cardiopulmonary bypass (CPB). TFCU was performed at three time points (after induction of anesthesia, during CPB, after CPB) in 35 infants. BFV was measured at both ICAs and pACA through the anterior fontanelle with an ultrasound sector probe. We divided patients into Group S (<5kg, n=16) and Group L (≥5kg, n=19) for comparisons according to weight. We also analyzed BFV in low cerebral regional oxygen saturation (rSO2) data. All measurements of the BFV at both the ICAs and the pACA were possible. BFVs at the ICAs were lower in Group S than in Group L at all three time points. BFVs at the pACA were similar in both groups except higher value in Group L after CPB. When the rSO2 was <50, most BFVs (14 of 15 measurements) were lower than the median BFV value during CPB. However, a low rSO2 did not always reflect low BFV before and after CPB. Point-of-care TFCU can determine BFV at the ICAs and pACA during pediatric cardiac surgery. BFV differs according to the patient's size and CPB application. TFCU can be a practical cerebral blood flow monitoring method when rSO2 changes without any specific reason in infants.ClinicalTrials.gov NCT01996020.

Acerola Fruit as a Possible Antimelanotic Agent in White Shrimp (Litopenaeus vannamei)

This study aimed to testify acerola’s inhibitory activity on melanosis in farmed white shrimp (L. vannamei). Shrimp samples underwent immersion in different treatments (control group (C), metabisulphite solution group (M), and acerola solution group (A)). Quality Index Method (QIM) was used to measure the shrimp shelf life, during 21 days, where microbiological, chemical, and sensory analyses were performed at each 3 days. Groups C and A exceeded the limit of mesophilic bacterial count within 15 days of storage, and for M the period was 18 days. As for the psychrophilic bacteria, C and A both crossed the limit on day 12 and M on the 15th day. Group M had the highest TVBN and pH means, followed by A and lastly C. Yet, TMA analysis showed highest values in group C, second A, and finally M. Sensory analysis determined the shelf life of groups C, M, and A as 10.5, 14.6, and 12.3 days, respectively. There were not many significant differences between the groups in all analyses; hence, dipping shrimp in acerola solutions would not suffice to inhibit melanosis formation. Further studies are needed to fully determine acerola’s antimelanosic potential.

Genetic Polymorphism and Messenger Ribonucleic Acid Concentrations of TNFα and TGFβ Genes in Patients with Chronic Lower Limb Infections.

The number of chronic lower limb infections and their complications as venous and diabetic ulcers and chronic calf dermatitis is increasing worldwide. The clinical course and outcome in the immune responses to infection have been shown to be associated with genetic polymorphisms. The aim of study was to investigate frequencies of chosen single nucleotide polymorphisms (SNPs) in TNFα and TGFβ genes in patients with chronic lower limb infections and evaluate expression of messenger ribonucleic acid (mRNA) concentrations in chronic leg ulcers. Patients were divided into three groups: (group A) chronic venous leg ulcers, (group B) chronic post-traumatic non-healing wounds, and (group C) infected ischemic necrosis of the foot. Blood donors comprised the control group. Detection of polymorphisms was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and gene expression by real-time PCR methods. Patients in all groups showed higher frequency of TNFα gene polymorphism -308GG and lower frequency of -308GA genotypes than controls. The mutated homozygote AA was higher in groups A and B than in controls. The TGFβ74GG genotype was represented at highest values in group B. The GC genotype was found in all groups at a similar concentration lower than in controls. Genotypes TGFβ29TT and TC were represented at similar concentrations as controls. Analyses showed that the presence of the polymorphic allele -308A of TNFα gene was correlated with an increased concentration of gene expression in patients with chronic leg ulcers (group A). In the case of both TGFβ gene polymorphisms the presence of polymorphic allele C resulted in increased TGFβ gene expression. Comparison of genotypes in polymorphic sites in TNFα and TGFβ genes with their expression concentrations showed that the presence of polymorphic alleles could predispose to increased production of their proteins. Patients with prolonged non-healing wounds should have their genotypes studied, and in cases of mutation, long-term antibiotic and immune protein supply should be considered.

Effects of different food on growth and survival of first-feeding taimen Hucho taimen (Pallas, 1773) larvae

A study was conducted to compare growth and survival of Hucho taimen larvae from 21 to 76 days after hatch (DAH) fed one of three diets: formulated feed alone (group F); a co-feeding diet of water fleas, tubifex and formulated feed (group C); or live food of water fleas and tubifex (group L), and to investigate the potential use of dietary L-alanyl-L-glutamine (L-AG) in larval taimen for a more nutritious starter diet. Triplicate groups of 5000 fish were randomly assigned to each aquarium provided with water from a flow-through system, and fed to apparent satiation. The results show that larvae can feed efficiently on floating crumbled particles of formulated feed. Weight gain of larvae fed only formulated feed was significantly lower than other groups at 34 DAH (P < 0.05). At the end of the experiment, weight gain reached the highest value in group F and was lowest in group L (P < 0.05). Condition factor reached the highest values in group F and lowest in group C (P < 0.05). Specific growth rate was in accordance with weight gain at 76 DAH. Survival showed no differences among the groups (P > 0.05). In conclusion, H. taimen larvae can be fed formulated feed alone and L-AG may be used as a feeding attractant during the weaning process, which should lead to a better understanding in the rearing improvement in the feeding of larvae.