Isotonic Solution Research Articles

Comparison of Efficacy of Epinephrine to Salbutamol and Ipratropium Bromide Combined in Acute Bronchiolitis

Background: Epinephrine, an alpha receptor agonist, has been suggested to be a supreme bronchodilator. A biologically active drug name Ipratropium bromide is helpful for the treatment of bronchiolitis among infants and improves on the signs and symptoms of bronchiolitis. Objective: To compare effectiveness of combined nebulized salbutamol with nebulized adrenaline and ipratropium bromide in bronchiolitis affected children in terms of mean improvement in RDAI score. Methodology: After approval from ethical committee this randomized control trial of 6 month duration is carried out by Randomization of patients in 2 groups. Group A received salbutamol (0.15mg/kg) combined with ipratropium bromide (250 micrograms per dose) with isotonic sodium chloride solution 0.9% (2 mL) and Group B received a dose of epinephrine (0.5mg/kg in concentration of 1:1000(max 5 mg), distributed by nebulizer with the help of a face mask with continuous oxygen flow at 6L/min Prior to each drug administration and at 30 mints, the researcher evaluated the condition of infant’s and records the respiratory rate, RDAI score9, heart rate and SaO2. RESULTS: Comparison of effectiveness of combined nebulized salbutamol with nebulized adrenaline and ipratropium bromide in bronchiolitis affected children in terms of mean improvement in RDAI score shows that at baseline in Group-A it was 10.73+1.59 and 10.98+1.42, p value was 0.27, it was reduced after 30 minutes of treatment in Group-A 3.23+0.52 and 2.67+0.47 in Group-B, p value was 0.001. Conclusion: We concluded that Epinephrine is better than salbutamol and ipratropium combined in terms of mean improvement in RDAI score Keywords: Bronchiolitis, children, salbutamol and ipratropium Bromide, Epinephrine.

Stability of benzylpenicillin for continuous intravenous infusions: An isotonic formulation for therapeutic use and a low-dose formulation for clinical trial

IntroductionThe objectives of this study were to develop a stability-indicating high performance liquid chromatography (HPLC) assay for benzylpenicillin (BPC) in pharmaceutical fluids, and to investigate the stability of (i) isotonic citrate-buffered BPC solutions at the clinically relevant concentration of 30 mg/mL, and (ii) low concentration citrate-buffered BPC intravenous infusions (5–30 μg/mL). MethodsThe stability of isotonic BPC solutions containing 3.4 or 7.2 mg/mL sodium citrate was compared against contemporary hypertonic solutions. The HPLC assay was shown to be stability-indicating following acidic, alkali, oxidative and elevated temperature stress testing. ResultsAfter 7 d storage at 4 °C and 24 h at 35 °C, the concentrations of isotonic BPC 30 mg/mL solutions containing 3.4 and 7.2 mg/mL sodium citrate were 96% and 95% respectively, compared to day 0. After 3 d at 4 °C and 24 h at room temperature (22 °C), the concentrations of isotonic BPC solutions with 3.4 and 7.2 mg/mL sodium citrate were 99% and 96% respectively, compared to day 0. These data were comparable to the hypertonic solutions and meet pharmacopeial stability requirements. Low concentration BPC infusions showed 0.5% and 2.5% degradation after 24 h storage at 22 °C and 35 °C, respectively. ConclusionsThe isotonic BPC 30 mg/mL formulation is simple to prepare and may offer clinical benefits in settings where hypertonic solutions are problematic. This study provides assurance that high- and low-dose isotonic BPC infusions are stable at room temperature and our findings may be applicable to in vitro studies of BPC.

The Effect of Nasal Irrigation on COVID-19 Patient’s Mild Symptoms of Respiratory Tract

BACKGROUND OF THE STUDY: Severe Acute Respiratory Syndrome Corona virus-2 (SARS CoV-2) is a virus that causes covid-19. The initial symptoms put forward by WHO since 2020 is fever accompanied by cough and shortness of breath. Currently, the loss of smell and taste, accompanied by other symptoms, tends to be a strong predictor of COVID-19. The nose is the entrance for air, that's why the nose has an important role in the breathing process. In addition to warming, humidifying, and filtering incoming air, the nose can also maintain respiratory tract homeostasis. The use of nasal irrigation with isotonic saline solution (NaCl 0.9%) is a way to improve mucociliary clearance function by activating cilia as an olfactory sensory system.
 
 AIM OF THE STUDY: To evaluate the effect of nasal irrigation to covid patients who has mild symptoms in the upper respiratory tract
 
 METHODOLOGY: The purpose of this study was to see the effectiveness of nasal irrigation using 0.9% NaCl in COVID-19 patients with mild symptoms, by looking at the average duration of time complaints felt by patients compared to those without nasal irrigation intervention 
 
 RESULTS: This study found a significant difference (p-value = 0.000) between the control group and the intervention group where the mean duration of symptoms in the intervention group was shorter than the control group.
 
 CONCLUSION: anosmia is a symptom in covid-19 which is almost always accompanied by symptoms of loss of taste, various theories on the cause of anosmia have been put forward since the covid-19 pandemic broke out. Improvements in symptom duration were found to be shorter in COVID-19 patients who performed nasal irrigation using 0.9% NaCl independently for 10 days so that in the future it is hoped that nasal irrigation will become part of the comprehensive management of COVID-19 patients who have mild symptoms, especially symptoms related to nasal and upper respiratory complaints.
 

Modern approach to the treatment of acute viral rhinosinusitis

Relevance: Treatment of acute viral rhinosinusitis is one of the current problems of modern medicine. Coldrelated diseases are now receiving a lot of attention due to the worldwide pandemic SARS-CoV-2, the choice of therapy becomes a difficult task even for experienced physicians. The study provides an assessment of the efficacy of treatment of patients with acute viral rhinosinusitis with combined phytotherapeutic agents. Materials and methods: During the study, 54 patients were followed up and divided into 2 groups: the study group (28 patients) and the control group (26 patients). During treatment, patients in the control group received basic treatment, which included: Nasal cavity irrigation with an isotonic saline solution (0.9% NaCl solution) [4] by 2 doses into each nasal half 3 times a day, topical glucocorticosteroids (Mometasone furoate) by 2 doses into each nasal half 2 times a day. Patients in the study group received: "Sinuvit" complex phytopreparation by 2 capsules after meals 2 times a day, nasal cavity irrigation with isotonic saline solution (0,9% NaCl solution) by 2 doses into each nasal half 3 times a day, topical glucocorticosteroids (Mometasone furoate) by 2 doses into each nasal half 2 times a day. The results of treatment were evaluated by means of subjective and objective indicators. Results: Efficient symptom relief was found in the study group, reflected in improved patient well-being and renewed physiological function of the mucociliary apparatus. Conclusion: Based on the obtained results of the study and our previous experience in treatment of rhinosinusitis, we have made a conclusion about the effectiveness of the presented scheme of treatment with combined phytotherapeutic agents.

Fraction of the T-Tubular Membrane as an Important Parameter in Cardiac Cellular Electrophysiology: A New Way of Estimation.

The transverse-axial tubular system (t-tubules) plays an essential role in excitation-contraction coupling in cardiomyocytes. Its remodelling is associated with various cardiac diseases. Numerous attempts were made to analyse characteristics essential for proper understanding of the t-tubules and their impact on cardiac cell function in health and disease. The currently available methodical approaches related to the fraction of the t-tubular membrane area produce diverse data. The widely used detubulation techniques cause irreversible cell impairment, thus, distinct cell samples have to be used for estimation of t-tubular parameters in untreated and detubulated cells. Our proposed alternative method is reversible and allows repetitive estimation of the fraction of t-tubular membrane (f t) in cardiomyocytes using short-term perfusion of the measured cell with a low-conductive isotonic sucrose solution. It results in a substantial increase in the electrical resistance of t-tubular lumen, thus, electrically separating the surface and t-tubular membranes. Using the whole-cell patch-clamp measurement and the new approach in enzymatically isolated rat atrial and ventricular myocytes, a set of data was measured and evaluated. The analysis of the electrical equivalent circuit resulted in the establishment of criteria for excluding measurements in which perfusion with a low conductivity solution did not affect the entire cell surface. As expected, the final average f t in ventricular myocytes (0.337 ± 0.017) was significantly higher than that in atrial myocytes (0.144 ± 0.015). The parameter f t could be estimated repetitively in a particular cell (0.345 ± 0.021 and 0.347 ± 0.023 in ventricular myocytes during the first and second sucrose perfusion, respectively). The new method is fast, simple, and leaves the measured cell intact. It can be applied in the course of experiments for which it is useful to estimate both the surface and t-tubular capacitance/area in a particular cell.

Saline versus Balanced Crystalloids for Adults with Aneurysmal Subarachnoid Hemorrhage: A Subgroup Analysis of the SMART Trial.

Whether the composition of intravenous crystalloid solutions affects outcomes in adults with aneurysmal subarachnoid hemorrhage (aSAH) remains unknown. Therefore, we determined whether the use of saline is associated with lower risk of disability and death in aSAH patients compared to balanced crystalloids. We conducted a post hoc subgroup analysis of the Isotonic Solutions and Major Adverse Renal Events Trial (SMART), a pragmatic, unblinded, cluster-randomized, multiple-crossover clinical trial that enrolled 15,802 adults between June 2015 and April 2017. We compared intravenous administration of saline to balanced crystalloids in consecutively enrolled aSAH patients aged 18 years or older whose ruptured aneurysm was procedurally secured at a single academic center in the United States. The primary outcome was the score on the modified Rankin scale (mRS, range, 0 [no symptoms] to 6 [death]) at 90 days obtained from a prospective institutional stroke registry. Secondary outcome included death by 90 days. Logistic or proportional odds regression models were used to test for between-group differences adjusted for age, hypertension, aSAH grade, and procedure type. Of the 79 aSAH patients procedurally treated during the SMART study period, 78 were enrolled (median age, 58 years; IQR, 49 to 64.5; 64% female), with 41 (53%) assigned to saline and 37 (47%) to balanced crystalloids. Plasma-Lyte was the primary balanced crystalloid used. Among 72 patients with 90-day mRS assessment, the adjusted common odds ratio, aOR, for mRS was 0.68 (95% CI, 0.28-1.63; P=0.39), with values less than 1.0 favoring saline. By 90 days, 2/39 patients (5%) in the saline group and 9/35 (26%) in the balanced-crystalloids group had died (aOR, 0.06; 95% CI, 0.00-0.50; P=0.02). Among procedurally treated aSAH patients, the risk of disability or death at 90 days did not significantly differ between saline and balanced crystalloids. Death occurred less frequently with saline than balanced crystalloids.

Intravenous maintenance fluid therapy practice in the pediatric acute and critical care settings: a European and Middle Eastern survey.

The ideal fluid for intravenous maintenance fluid therapy (IV-MFT) in acutely and critically ill children is controversial, and evidence-based clinical practice guidelines are lacking and current prescribing practices remain unknown. We aimed to describe the current practices in prescribing IV-MFT in the context of acute and critically ill children with regard to the amount, tonicity, composition, use of balanced fluids, and prescribing strategies in various clinical contexts. A cross-sectional electronic 27-item survey was emailed in April-May 2021 to pediatric critical care physicians across European and Middle East countries. The survey instrument was developed by an expert multi-professional panel within the European Society of Pediatric and Neonatal Intensive Care (ESPNIC). A total of 154 respondents from 35 European and Middle East countries participated (response rate 64%). Respondents were physicians in charge of acute or critically ill children. All respondents indicated they routinely use a predefined formula to prescribe the amount of IV-MFT and considered fluid balance monitoring very important in the management of acute and critically ill children. The use of balanced solution was preferred if there were altered serum sodium and chloride levels or metabolic acidosis. Just under half (42%, 65/153) of respondents believed balanced solutions should always be used. Respondents considered the use of isotonic IV solutions as important for acute and critically ill children. In terms of the indication and the composition of IV-MFT prescribed, responses were heterogeneous among centers. Almost 70% (107/154) respondents believed there was a gap between current practice and what they considered ideal IV-MFT due to a lack of guidelines and inadequate training of healthcare professionals. Conclusions: Our study showed considerable variability in clinical prescribing practice of IV-MFT in acute pediatric settings across Europe and the Middle East. There is an urgent need to develop evidence-based guidelines for IV-MFT prescription in acute and critically ill children. What is Known: •The administration of maintenance intravenous fluid therapy is a standard of care for a lot of hospitalized children •Maintenance intravenous fluid therapy prescriptions are often based on Holliday and Segar's historical guidelines even if this practice has been associated with several complications. What is New: •This study provided information on the prescribing practice regarding fluid restriction, fluid tonicity, and balance. •This study showed considerable variability in clinical prescribing practice of intravenous maintenance fluid therapy across Europe and the Middle East.

Origin of the Term “Isotonic”

IntroductionIn our 1st and 2nd abstracts to EB2022, we addressed the inconsistency in the definitions of tonicity1 and the problems of introducing both osmolarity and effective osmolarity2 and resolved these issues. In this abstract, we introduce the origin of the term “isotonic”, which further clarifies the confusion about tonicity and leads to an understanding of the membrane (m)‐dependency of tonicity, one of the 3 properties of tonicity3.MethodLogical reasoning.Results1) The term “isotonic” was coined by the botanist Hugo de Vries in the 19th century4. In his experimental setup, if S1 caused a certain degree of shrinkage of a cell and S2 caused the same degree of shrinkage of the same cell, then S1 and S2 were considered “isotonic solutions” because they have an equal “water attracting force”. We now know that it is the impermeant solute particles (imp‐SP) in S1 and S2 that pull water to their compartments in the osmosis systems S1‐m‐S3 and S2‐m‐S3, respectively, where S3 refers to the intracellular fluid (ICF) of the cell. That time, De Vries seemed not to be aware that when his S1 is isotonic to S2, S1 and S2 are both hypertonic to S3, or vice versa, S3 is hypotonic to S1 and S2.2) The term “x‐tonic (i.e., hypertonic or isotonic or hypotonic)” compares the 2 water attracting forces in an osmosis system, such as S1‐m‐S3 or S2‐m‐S3. Obviously, it is the imp‐SP that exert this “water attracting force” (more appropriately this “pressure”). If we call this pressure “the osmotic tone” (i.e., the osmotic energy or strength), then the meaning of the term “x‐tonic” is clear: It compares the 2 osmotic tones in an osmosis system such as S1‐m‐S2. Lack of an understanding of this point leads to the following illogical descriptions about tonicity: a common saying “S1 is isotonic to the cell” compares an apple with an orange and another common saying “S1 is isotonic” is not a complete sentence. These illogical statements result from the inconsistency in the definitions of tonicitywe addressed previously1 and increase the level of confusion about what tonicity is, which we have addressed previously1, 3.3) The logic that if a cell swells/shrinks in a solution, the solution is hypotonic/hypertonic to ICF is commonly reflected in the literature, but this reverses the cause and effect: It is because the ICF is hypertonic/hypotonic to the solution, so that the ICF wins/loses the water competing game (i.e., osmosis) across the cell membrane, or in other words, the winner (ICF) gains water and volume (cell swelling)/the loser (ICF) loses water and volume (cell shrinkage).ConclusionsThis abstract and our previous works listed in the References section together eliminate all problems related to the concept of tonicity.

Osmotic stress and regulatory volume decrease in Crithidia fasciculataparasites

Regulatory volume decrease (RVD) describes the response to hypoosmotic stress in many cells including the parasitic flagellate Crithidia fasciculata. Hypoosmotic stress causes initial swelling, the cell expels excess liquid and returns to a normal volume. This process is not able to withstand excessive osmotic stress. We use the MTT (3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyl‐2H‐tetrazolium bromide) Assay is used to assess cell viability, while microscopy images and spectroscopic light scatter used to follow changes in cell shape and size. It was found that after being placed in 70% hypotonic (30% isotonic) solution, cells did not recover from hypoosmotic stress. We are currently developing protocols for this little‐studied parasite and investigating the mechanisms of RVD in Crithidia fasciculata including the role of the osmoregulatory contractile vacuole.

Dependence of the Rate and Completeness of Fibrin Clot Destruction on the Acoustic Dose and Ultrasound Intensity.

The kinetics of fibrin clot destruction under catheter-delivered 32- to 45-kHz ultrasound (US) has been studied at 36°C-38°C in isotonic saline solution. A pseudo-first-order rate constant increased linearly from 0.06/min to 0.57/min with increasing US intensity I0 from 21.6 to 51.2 W/cm2. At I0=4.4 and 11.4 W/cm2, the degree of clot destruction did not exceed 11%-15% regardless of the time of US exposure. Starting from I0=21.6 W/cm2, the maximum achievable level of clot destruction increased linearly with US intensity, reaching 68% at I0=51.2 W/cm2 after 3 min of US exposure. Thus, US intensity is a key parameter determining the maximum achievable level of clot destruction. However, an increase in US intensity above 30 W/cm2 is limited by the intensified negative sonochemical effect on the enzymatic system of hemostasis caused by an increase in inertial cavitation. The best effect can be achieved with ultrasound of a sufficiently high intensity that ensures a large contribution of stable cavitation, generating microstreaming flows, and a minimum contribution of inertial cavitation, generating microjets and shock waves.

Dysregulated Mitochondrial Respiration Occurs With Aging

Numerous metabolic changes occur in skeletal muscle with aging. At the crossroads of these changes lies the cellular energy highway, the mitochondrial reticulum. Aging is associated with altered patterns of mitochondrial dynamics and morphology, which are thought to be primarily driven by mitochondrial fragmentation. This fragmentation phenomenon may also lead to altered mitochondrial respiration with aging. We used a mouse model and measured parameters of respiration in muscle mitochondrial preparations to evaluate the hypothesis of aging‐related effects on metabolism and energy substrate partitioning. Mixed skeletal muscle of C57/Bl6 mice (n=32) was excised from single hind‐limbs of young males (YM) (n=8), old males (OM) (n=8), young females (YF) (n=8) and old females (OF) (n=8). Tissues were homogenized in an isotonic solution supplemented with 0.15% protease inhibitor. Mitochondria were isolated by differential centrifugation and their concentrations were determined by BCA analysis. Isolated mitochondria (0.1mg of mitochondria/mL of respiration medium) were then respired using a Clarke‐Type Electrode at 25°C with 100 nM of ADP and either 10 mM Pyruvate+ 2.5 mM Malate (P+M) or 40 uM Palmitoyl‐L‐Carnitine+ 1 mM Malate (PC+M) as substrates. Respiratory Control Ratios (RCR) were calculated as the quotient of State 3 (ADP‐stimulated respiration) and State 4 (recovery rate post ATP synthesis) respiratory rates (State 3/State 4) and compared between substrate and age. ADP to oxygen ratios (P:O) were calculated by dividing the amount of ADP added to the respiratory chamber by the oxygen consumption rate (nmol of O2/mg of mitochondria/minute) of state 3 respiration. RCR in both P+M and PC+M significantly decreased with aging [P+M (p<0.05): YM (4.1±0.9) vs. OM (2.7±1.1); YF (5.1±1.4) vs. OF (3.2±2)] [PC+M (p<0.05): YM (4.2±0.9) vs. OM (2.4±0.7); YF (3.4.±0.5) vs. OF (2.2±0.9)]. P:O in both P+M and PC+M did not significantly change with aging [P+M: (p=0.69): YM (2.9±0.3) vs. OM (2.9±0.2); YF: (p=0.07): (3±0.1) vs. OF (2.9±0.1)] [PC+M:(p=0.65); YM (2.9±0.4) vs. OM (2.9±0.3); (p=0.22): YF (2.9±0.2) vs. OF (2.7±0.3)]. While there were no significant changes in the P:O the age related decreases in the RCR were characterized by a lower capacity to respire derivatives of both CHO and FA. Decreased State 3 respiration and RCR typically corresponds to loss of respiratory capacity and loosening of coupling efficiency. Because exercise increases mitochondrial function and biogenesis it may be prudent to study older animals after exercise training. We plan to further investigate the structural changes in the mitochondrial reticulum and proteome that may be altering mitochondrial function in aging.

Physical and Biochemical Mechanisms Associated with Beef Carcass Vascular Rinsing Effects on Meat Quality: A Review.

Carcass vascular rinsing and chilling involves infusing a chilled isotonic solution (98.5% water and a blend of mono- and di-saccharides and phosphates) into the vasculature immediately upon exsanguination. Primary purposes of carcass vascular rinsing are to (1) effectively remove residual blood from the carcass; (2) lower internal muscle temperature rapidly; and (3) optimize pH decline by effective delivery of glycolytic substrates in the rinse solution. Previous studies have revealed that the beef carcass vascular rinsing early postmortem positively affects meat quality, product shelf-life, and food safety. Thus, the objective of this review is to provide a more comprehensive understanding of the physical and biochemical mechanisms associated with beef carcass vascular rinsing, focusing on the relationship between quality attributes (CIE L*, a*, b*; chemical states of myoglobin; oxygen consumption and sarcomere length) and muscle metabolic response to various substrate solutions (Rinse & Chill®, fructose, sodium phosphate, and dipotassium phosphate) that stimulate or inhibit the rate of glycolysis early postmortem. In addition, this review discusses the absence of metabolite residues (phosphorus, sodium, and glucose) related to the application of the chilled isotonic solution. This review primarily focuses on beef and as such extending the understanding of the mechanisms and meat quality effects discussed to other species associated with vascular rinsing, in particular pork, may be limited.

Vascular rinsing and chilling carcasses improves meat quality and food safety: a review.

Rinse & Chill® technology (RCT) entails rinsing the vasculature using a chilled isotonic solution (3°C; 98.5% water and a blend of dextrose, maltose, and sodium phosphates) to rinse out the residual blood from the carcass. Infusion of pre-chilled solutions into intact animal carcasses immediately upon exsanguination is advantageous in terms of lowering the internal muscle temperature and accelerating chilling. This technology is primarily used for purposes of effective blood removal, favorable pH decline, and efficient carcass chilling, all of which improve meat quality and safety. Although RCT solution contains some substrates, the pre-rigor muscle is still physiologically active at the time of early postmortem and vascular rinsing. Consequently, these substrates are fully metabolized by the muscle, leaving no detectable residues in meat. The technology has been commercially approved and in continuous use since 2000 in the United States and since 1997 in Australia. As of January 2022, 23 plants have implemented RCT among the 5 countries (Australia, US, Canada, New Zealand, and Japan) that have evaluated and approved RCT. All plants are operating under sound Sanitation Standard Operation Procedures (SSOP) and a sound Hazard Analysis Critical Control Point (HACCP) program. No food safety issues have been reported associated with the use of this technology. RCT has been adapted by the meat industry to improve product safety and meat quality while improving economic performance. Therefore, this review summarizes highlights of how RCT technically works on a variety of animal types (beef, bison, pork, and lamb).

Protective Role of Diospyros lotus L. in Cisplatin-Induced Cardiotoxicity: Cardiac Damage and Oxidative Stress in Rats

Cisplatin is a powerful chemotherapeutic drug that is used to treatment a wide variety of cancers. Despite clinical data demonstrating the cardiotoxic effect of cisplatin, few studies have been carried to improve the cardiotoxicity of cisplatin. In cisplatin-induced toxicity, oxidative stress plays a critical role. This study determined the effect of Diospyros lotus L. fruit (DL), a powerful antioxidant plant, on heart damage caused by cisplatin through histological examination and oxidative stress parameters. Twenty eight male rats were randomly divided into four groups. An isotonic solution was given to the control group. A single dose of 7 mg/kg cisplatin was administered intraperitoneally to the cisplatin group. 1.000 mg/kg DL was given by gavage for 10 days to the DL group. Cisplatin and DL were administered together in the same doses to the treatment group. Thiobarbituric acid reactive substances (TBARS) levels, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) activities, and total glutathione (GSH) level were measured in the heart tissue of the experimental rats. Histological examination was also performed to determine any damage to the hearts of the experimental rats. While TBARS levels in the cisplatin group increased significantly, SOD, CAT, GPx activities, and total GSH level decreased significantly. TBARS levels decreased significantly and SOD, CAT, GPx activities and GSH levels increased with DL treatment. According to the histological examination, histopathological differences were observed in the cisplatin group. Histopathological findings were either absent or decreased in the DL-treated group. Results of the study showed that DL therapy reduced oxidative stress and histological changes caused by cisplatin. DL could be a potential candidate for reducing cardiac damage caused by cisplatin.

Effect of topical bovine colostrum in wound healing of corneal surface after acute ocular alkali burn in mice

The purpose of this study was to evaluate the effect of bovine colostrum (BC) in the regeneration of corneal epithelial cells on an ocular alkali burn model. Twenty-four C57BL/6 mice were categorized into two gender/age-matched groups for treatment. Two days after inducing a corneal alkali burn in all left eyes with 4 μl of sodium hydroxide 0.15 mol/l, both eyes of group 1 were treated with BC 4 times per day, and both eyes of group 2 were treated with isotonic saline solution (SS). The epithelial defect was photographed and measured by fluorescein staining on days two, four, seven, and ten. Ocular burn damage was assessed with a pre-established classification in clock hours from the limbus. After 10 days both eyes were processed, half of the group's corneas were assessed histopathologically, and the other half was used for pro/anti-inflammatory cytokine quantification using ELISA. BC treated (Group 1) corneas revealed significantly improved fluorescein staining score for limbal involvement when compared to SS treated (Group 2) corneas at days 4 (p = 0.013), 7 (p < 0.001), and 10 (p < 0.001), respectively. No differences were noted in limbal involvement at day 2 between the two groups (p > 0.99). The overall change (difference in slope) in fluorescein staining for limbal involvement between days 2 and 10 was −0.1669 (p = 0.006). Histologic examinations and cytokine measurements of group 2 demonstrated a strong inflammatory component compared to group 1. Our data indicates that topical application of BC facilitates corneal re-epithelialization and wound healing by suppressing the inflammatory process in an ocular alkali burn model.

Local injection of bone-marrow derived mesenchymal stromal cells alters a molecular expression profile of a contact frostbite injury wound and improves healing in a rat model

IntroductionFrostbite is a traumatic injury of the tissues upon low temperature environment exposure, which is characterized by direct cell injury due to freezing-thawing followed by development of an acute inflammatory process. Severe frostbite can lead to necrosis of soft tissues and loss of a limb. Mesenchymal stromal cells (MSCs) have a unique ability to modulate pathogenic immune response by secretion of paracrine factors, which suppress inflammation and mediate more efficient tissue regeneration. It should be noted that potential of stem cell therapy for frostbite injury treatment has not been investigated so far. Here, we evaluated a healing capacity of bone-marrow derived MSCs for the treatment of contact frostbite injury wound in a rat model. MethodsCold-contact injury in a Wistar rat model was induced by 1-minute tight application of the cooled probe (−196 ⁰C) to the skin surface of the left hip. Rat bone marrow MSCs were phenotypically characterized and used for local injections into non-damaged tissues surrounding the wound of animals from the experimental group. The second group of rats was treated in the same manner with 1 mL of isotonic sodium chloride solution. Analysis of cytokine and growth factor expression profile in сold-contact injury wounds was performed on days 5, 9, and 16 using immunoblotting and enzyme-linked immunosorbent assay. Animal recovery in MSC-treated and vehicle-treated groups was evaluated by several criteria including body weight recording, determination of eschar desquamation and re-epithelialization terms, assessment of wound closure kinetics, and histological scoring of the wounds on day 23. ResultsIt turned out that a single subcutaneous administration of MSCs around the wound site resulted in elevated expression of pro-survival and pro-angiogenic VEGF-A and PDGF and 3–5-fold decrease in pro-inflammatory IL-1β as compared with the frostbite wound treated with a vehicle. Moreover, treatment with MSCs caused accelerated wound re-epithelialization (p < 0.05) as well as a better histological score of the MSC-treated wounds. ConclusionsThus, our data suggested that the use of MSCs is a promising therapeutic strategy for the treatment of cold-induced injury wounds.

Management of traumatic ulcerative keratitis in a Red Serow

Red Serow Capricornis rubidus is an elusive herbivore native to the montane forests of the Himalaya. Currently it is categorized as ‘Vulnerable’ in the IUCN Red List and placed under Schedule I species of the Wildlife Protection Act, 1972. A serow was presented with complaints of mild inappetence, irritability, sporadic scratching of head over the enclosure barrier and serous ocular discharge from the left eye. Based on detail clinical examination, the animal was diagnosed with unilateral conjunctivitis, corneal oedema, and ulcerative keratitis. A combination of Xylazine @ 1.5mg/ kg body weight and Zolatile® (zolazepam and tiletamine) @ 2.5 mg/kg body weight was used to chemically restrain the animal, followed by auriculo-palpebral nerve block using 1 ml of 2 % lignocaine hydrochloride. The affected eye was adequately cleaned with isotonic sterile Normal Saline solution (NSS). Combination of 0.5 ml of ceftriaxone and 0.5 ml of flubiprofen was injected into upper and lower palpebral conjunctiva. The cornea and the third eyelid flap were carefully sutured using 5-0 and 3-0 Vicryl, respectively. Finally, tarsorrhaphy was done using 2-0 nylon. Post-operative care consisted of an antibiotic regimen of Cephalaxin @ 20 mg/ kg body weight b-i.d-twice in a day for seven days along with probiotic supplement (Vizylac®) and Vitamin A capsules (Aquasol A®) orally once daily for the next 30 days. The animal showed complete recovery within 30 days of proper treatment, monitoring, care and management.

Efficacy decametoxin in vitro for quick inactivation of respiratory coronavirus

Despite the fact that specific prophylaxis agents have already been widely introduced into medical practice in all countries of the world, and antiviral drugs are being developed and are undergoing the first stages of clinical trials, SARS-CoV-2 continues to spread in the human population. In this regard, an urgent medical problem today is the expansion of the arsenal of effective disinfectants and antiseptics, the action of which would be aimed at the rapid and complete inactivation of extracellular coronavirus, which is a very important element in controlling the spread of COVID-19.&#x0D; The aim of the study was to evaluate the ability of decamethoxin to have a virucidal effect against SARS-COV-2 and other human coronaviruses on the model of respiratory coronavirus IBV (infectious bronchitis virus) with an exposure time of 30, 60 and 120 seconds.&#x0D; Classical and modern virological research methods were used in the work: determination of the cytotoxic effect of decamethoxin in cell culture by the effect on their viability, cultivation, accumulation and determination of the infectious titer of IBV by cytopathic action in cell culture; assessment of the virucidal effect of decamethoxin by the suspension method to determine the residual infectious titer of the virus in cell culture by the method of limiting dilutions.&#x0D; The effectiveness of the antiseptic decamethoxin from the group of quaternary ammonium compounds was studied in relation to the prototype strain of the IBV (infection bronchitis virus) coronavirus family in vitro. It has been established that an isotonic solution of decamethoxin at a concentration of 100 μg/ml completely inactivates 3.0 lg(TCD50/0.1 ml) of the prototype respiratory coronavirus strain with a clinically significant contact time of 30–120 seconds at room temperature(18–24 оС). Decamethoxine has been shown to be an effective, fast-acting antiseptic capable of completely inactivating a prototype coronavirus strain. The revealed virucidal properties of decamethoxine in pharmacopoeially significant concentrations in relation to coronavirus allow to recommend it as an antiseptic in the development of methods for non-specific prevention of coronavirus infection in humans.

Balanced Crystalloid versus Saline in Adults with Traumatic Brain Injury: Secondary Analysis of a Clinical Trial.

Balanced crystalloids may improve outcomes compared with saline for some critically ill adults. Lower tonicity of balanced crystalloids could worsen cerebral edema in patients with intracranial pathology. The effect of balanced crystalloids versus saline on clinical outcomes in patients with traumatic brain injury (TBI) requires further study. We planned an a priori subgroup analysis of TBI patients enrolled in the pragmatic, cluster-randomized, multiple-crossover Isotonic Solutions and Major Adverse Renal Events Trial (SMART) (ClinicalTrials.gov: NCT02444988, NCT02547779). Primary outcome was 30-day in-hospital mortality. Secondary outcomes included hospital discharge disposition (home, facility, death). Regression models adjusted for pre-specified baseline covariates compared outcomes. TBI patients assigned to balanced crystalloids (n = 588) and saline (n = 569) had similar baseline characteristics including Injury Severity Score 19 (10); mean maximum head/neck Abbreviated Injury Score, 3.4 (1.0). Isotonic crystalloid volume administered between intensive care unit admission and first of hospital discharge or 30 days was 2037 (3470) mL and 1723 (2923) mL in the balanced crystalloids and saline groups, respectively (p = 0.18). During the study period, 94 (16%) and 82 (14%) patients (16%) died in the balanced crystalloid and saline groups, respectively (adjusted odds ratio [aOR], 1.03; 95% confidence interval [CI], 0.60 to 1.75; p = 0.913). Patients in the balanced crystalloid group were more likely to die or be discharged to another medical facility (aOR 1.38 [1.02-1.86]; p = 0.04). Overall, balanced crystalloids were associated with worse discharge disposition in critically injured patients with TBI compared with saline. The confidence intervals cannot exclude a clinically relevant increase in mortality when balanced crystalloids are used for patients with TBI.

Morphofunctional characteristics of the mucous membrane of the masticatory apparatus in experimental carcinogenesis

BACKGROUND: Diseases of the gastrointestinal tract are often accompanied by changes in the oral cavity. This is largely due to the morphological and functional unity of the oral mucosa and the entire digestive tract. Therefore, the role of a dentist is important in early oncological alertness for detecting malignant neoplasms at an early stage of their development.&#x0D; AIM: Present the results of a morphological study of the mucous membrane of the mouth of an animal during experimental carcinogenesis.&#x0D; MATERIAL AND METHODS: The study was carried out on 168 sexually mature outbred white male rats kept under standard vivarium conditions. The animals were divided into the following groups: control 84 individuals and experimental 84 animals with simulated colon adenocarcinomatosis. Every 30 days of the experiment, 12 animals were withdrawn from the control and experimental groups. Carcinogenesis was modeled by the introduction of 1,2-dimethylhydrazine dihydrochloride, previously diluted with isotonic sodium chloride solution. Using a histological study, the mucous membrane of the mouth was studied in animals of both examined groups.&#x0D; RESULTS: The dynamics of morphological changes in the mucous membrane of the animals mouth was revealed against the background of the development of adenocarcinomatosis of the large intestine; the development of destructive-degenerative and sclerotic changes in the mucous membrane of the mouth of animals with simulated adenocarcinomatosis of the large intestine, the severity of which increased in accordance with the period of development of the neoplasm, was established.&#x0D; CONCLUSION: The revealed changes in the large intestine and the mucous membrane of the animals mouth, caused by a simulated chemical carcinogen, indicate a high risk of developing a malignant tumor with spread to all parts of the gastrointestinal tract.