Normal Saline Control Research Articles

(130) Antibiotic Solutions are the Ideal Irrigation Choice for Inflatable Penile Implant Hydrophilic Surfaces

Abstract Introduction Inflatable penile prostheses (IPP) may be colonized by bacteria, which may contribute to clinical infections. Current attempts to reduce bacterial colonization include altered implant surface binding properties and mechanical irrigations with antiseptic solutions. Previous data has shown that prophylactically dipping IPPs in a solution of 2mg/mL vancomycin and 160μg/mL gentamicin (VG) reduces biofilm formation more than chlorhexidine gluconate (CHG) does. However, there is a paucity of data looking at VG as an irrigation step after a prophylactic dip. Objective To determine if VG irrigation of a previously CHG- or NS-dipped IPP decreases bacterial colonization more effectively than irrigation with normal saline. Methods Sterile 8mm diameter IPP pieces (Coloplast, Minneapolis, MN) were split into 4 groups with a minimum of 12 replicates each and submerged for 3 minutes in 3mL of normal saline (NS), 0.05% CHG in sterile water (Irrimax, Lawrenceville, GA), or VG (Sigma-Aldrich, Burlington, MA). Pieces were then rinsed in NS for five seconds, re-submerged in a separate well containing 2mL of NS or VG for 2 minutes, and finally rinsed for five seconds in a large volume of NS. After a 5 sec PBS rinse, pieces were incubated with 1 X 10^5 colony forming units per milliliter (CFU)/mL of methicillin-sensitive Staphylococcus aureus ATCC25923 in trypticase soy broth (TSB) for 48 hours. Samples were then rinsed with PBS and biofilm was removed by shaking in 0.3% Tween-20. Suspended bacteria were serially diluted, plated onto 3M PetriFilms (Maplewood, MN), and then colony counts were recorded. Mann-Whitney U tests were performed to compare outcomes, p<0.05 considered significant. Results Average bacterial counts with 95% CI are plotted in Figure 1. NS controls showed an average of 1.0E7 CFU/mL adherent bacteria. In this study, the introduction of VG to an NS or CHG-coated implant resulted in significant reduction in adherent bacteria; the NS-VG group showed a ~5 log decrease in adherent bacteria (3.0E1, standard deviation=3.3E4, p<0.01), and the CHG-VG group similarly showed a ~5 log decrease in adherent bacteria (4.4E2, standard deviation=6.9E5, p<0.01). Neither treatment group consistently reduced biofilm counts as effectively as the implant pieces incubated in VG as both a prophylactic dip and a rinse solution (~5 log decrease in counts, p<0.01). However, neither treatment group consistently reduced biofilm counts as effectively as the implant pieces incubated in VG as both a prophylactic dip and a rinse solution, also with a ~5 log decrease in adherent bacteria (1.0E2, standard deviation=2.4E2, p<0.01) (Figure 1). Conclusions VG is the ideal choice for both coating the implant prior to implantation and as an intraoperative irrigation solution. However, further studies are needed to compare VG with CHG as mechanical irrigants as opposed to static irrigants. Disclosure Yes, this is sponsored by industry/sponsor: Coloplast (material not financial support). Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast and Boston Scientific.

(129) Prophylactic Dips and Irrigation Solutions Can Considerably Alter the Antimicrobial Efficacy of Inflatable Penile Implant Hydrophilic Surface Coatings

Abstract Introduction Inflatable penile prostheses (IPP) experience surface-associated bacterial biofilms, which may contribute to clinical infections. Current attempts to reduce bacterial colonization include antibiotic coatings, altered implant surface binding properties, and mechanical irrigations. 0.05% chlorhexidine gluconate (CHG) has been proposed as a hydrophilic surface coating and mechanical irrigation for IPP surgery. One study demonstrated reduced surface bacterial colonization on an IPP hydrophilic surface dipped and irrigated with CHG 15psi compared to normal saline. However, CHG’s efficacy has not been compared to that of an antibiotic, particularly in preventing colonization by bacteria that are commonly implicated in IPP infections. Objective To characterize the utility of 0.05% chlorhexidine or vancomycin/gentamicin (VG) as both an antibiotic dip and an intraoperative irrigation in reducing bacterial colonization on hydrophilic IPP surfaces. Methods Sterile 8mm diameter IPP pieces (Coloplast, Minneapolis, MN) underwent the following treatment protocols. 1: IPP pieces were split into three groups (10 replicates each) and submerged for 3 minutes in normal saline (NS), 0.05% CHG in sterile water (Irrimax, Lawrenceville, GA), or a solution of 2mg/mL vancomycin and 160μg/mL gentamicin (VG) (Sigma-Aldrich, Burlington, MA) 2: IPP pieces were split into six groups (>14 replicates each) and submerged for 3 minutes in either NS, 0.05% CHG, or VG. Pieces were then rinsed in NS for five seconds and re-submerged in a separate well containing NS, 0.05% CHG, or VG. The pieces were rinsed in NS to remove any unbound solution and then incubated with 1*10^5 CFU/mL of methicillin-sensitive Staphylococcus aureus ATCC25923 in trypticase soy broth (TSB) for 48 hours. Samples were then rinsed with PBS and adherent bacteria were removed by shaking in 0.3% Tween-20. Suspended bacteria were serially diluted, plated onto 3M PetriFilms (Maplewood, MN), and counted. Mann-Whitney U tests were performed to compare outcomes, p<0.05 considered significant. Results Average bacterial counts with 95% CI’s for protocols 1 and 2 are plotted in Figures 1a and 1b respectively. NS controls showed an average of 1.1E7 CFU/mL adherent bacteria. Pre-dipping the implant in 0.05% CHG inhibits bacterial growth with a nearly ~2 log decrease (4.9E5 CFU/mL, p<0.01) in counts. Pre-dipping with VG had greater potency, with a ~5 log decrease (3.7E1 CFU/mL. p<0.01). However, exposure of the previously dipped IPP surface to an antiseptic irrigation solution altered antimicrobial properties (Figure 1b). NS controls showed an average of 6.0E7 CFU/mL adherent bacteria. The introduction of NS or CHG to the VG-coated implant material resulted in a near-complete loss of antimicrobial efficacy, with a 0.5 log decrease (NS) and a slight increase (CHG) in bacterial growth (NS: 5.5E7 CFU/mL, p=0.433; CHG: 6.2E7, p=.983). VG dipping followed by VG irrigation resulted in retention of antimicrobial properties, with a similar 5 log decrease. Conclusions Dipping of the implant surface with VG was more effective than 0.05% CHG. Furthermore, the choice of irrigation solution appears to alter the efficacy of antimicrobials bound to the hydrophilic IPP surface. Surgeons should be cautious using CHG or NS as an irrigation solution, and, if utilized, should take care to limit the contact time with the antibiotic-coated implant. Disclosure Yes, this is sponsored by industry/sponsor: Coloplast (material not financial support). Clarification: Industry funding only - investigator initiated and executed study. Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast and Boston Scientific.

INCREASED TNF-? mRNA EXPRESSION IN PBMC CELLS INFECTED WITH HEPATITIS B VIRUS EXPOSED TO PURPLE SWEET POTATO EXTRACT (Ipomoea batatas L.)

Hepatitis B Virus infection is a serious health problem throughout the world that can cause death. Purple sweet potatoes contain quite high levels of anthocyanins. Anthocyanins have been widely proven to act as immunostimulators by influencing levels of the cytokine TNF-?. This study aims to prove that purple sweet potato extract has an effect on TNF-? mRNA expression in PBMC cell cultures infected with the hepatitis B virus. The research sample was a PBMC cell culture taken from an asymptomatic chronic Hepatitis B patient. The samples from the normal saline control group were 18 wells and the treatment group with purple sweet potato extract with an anthocyanin content of 0.265 mg/100g was 18 wells. Purple sweet potato extract is made using the maceration technique. PBMCs were isolated from blood using Ficoll-Paque. PBMC cells were cultured in 24 well plates with complete RPMI 1640 medium. Examination of TNF-? mRNA expression using Relative 1-step qRT-PCR quantification. The results showed the mean difference in TNF-? mRNA expression between the treatment and control groups: 20.08 fg/µL (p<0.05), there was a significant increase in TNF-? mRNA expression. The results of this study can be concluded that administration of purple sweet potato extract in vitro can increase TNF-? mRNA expression in PBMC cultures infected with hepatitis B virus.

The effect of adding dexmedetomidine or dexamethasone to bupivacaine-fentanyl mixture in spinal anesthesia for cesarean section.

Many strategies are available to prevent spinal-induced hypotension in cesarean section, especially the use of a low dose of spinal anesthesia combined with adjuvants. This study investigated the effect of adding either dexmedetomidine or dexamethasone to the intrathecal bupivacaine-fentanyl mixture on the postoperative analgesia duration, after elective cesarean section. This prospective, randomized, double-blind study was conducted on 90 full-term parturients undergoing elective cesarean section, who were randomly distributed into three groups. They all received spinal anesthesia with the bupivacaine-fentanyl mixture (2.5 ml), in addition to 0.5 ml normal saline (control group), 5 μg dexmedetomidine dissolved in 0.5 ml normal saline (dexmedetomidine group), or 2 mg dexamethasone (dexamethasone group). The time to the first request of morphine rescue analgesia was recorded, in addition to the total dose of morphine consumed in the first 24 h after surgery, the postoperative numerical rating score (NRS), and maternal and fetal outcomes. As compared to the control group and the dexamethasone group, the use of dexmedetomidine as an additive to the bupivacaine-fentanyl mixture significantly prolonged the time to the first request of rescue analgesia, decreased postoperative morphine consumption, and decreased the pain score 4 and 6 h after surgery. There was an insignificant difference between the control and dexamethasone groups. The use of dexmedetomidine as an additive to bupivacaine-fentanyl mixture in spinal anesthesia for cesarean section prolonged the postoperative analgesia and decreased the postoperative opioid consumption in comparison to the addition of dexamethasone or normal saline.

Comparative Evaluation of the Effect of Different Chelating Agents on Mineral Content and Erosion of Radicular Dentine: A FESEM-EDS Analysis.

Irrigating solutions play an important role in the debridement and disinfection of the root canal space, and thus, it is crucial to comprehend their effects on the composition and surface structure of radicular dentine. This study evaluated and compared the effects of 17% ethylenediaminetetraacetic acid (EDTA), 9% 1-hydroxyethylidene-1,1-bisphosphonate (HEBP) and 0.2% chitosan on the mineral content and erosion of radicular dentine when used as a final rinse. Sixty extracted human mandibular premolar teeth were decoronated and instrumented to ProTaper size F2. After final instrumentation, the samples were randomly divided into 4 groups (n=15) according to the type of final irrigant used: Normal saline (control), 17% EDTA, 9% HEBP and 0.2% chitosan. Field emission scanning electron microscopy was used to assess the erosion of radicular dentine, and energy dispersive X- ray spectroscopy was used to quantify the radicular dentine mineral composition at the coronal, middle and apical levels of all the prepared samples after final irrigation. The one-way analysis of variance was used for intra-group and inter-group comparisons of means, the Kruskal Wallis test for intra-group and inter-group comparisons of medians and Tukey's post hoc test for pairwise comparisons. There was no significant difference in the levels of calcium (Ca), phosphorus (P) and Ca/P ratio after final rinse with 17% EDTA, 9% HEBP and 0.2% chitosan at all three root levels (p>0.05); except at the coronal level, where 0.2% chitosan caused significantly less alteration in Ca levels and Ca/P ratio than 17% EDTA and 9% HEBP respectively (p<0.05). 17% EDTA, 9% HEBP and 0.2% chitosan caused no erosion at the middle and apical levels. Meanwhile, 17% EDTA and 9% HEBP caused moderate erosion at the coronal level. Alternatives to 17% EDTA during final irrigation can be 9% HEBP and 0.2% chitosan. (EEJ-2023-06-078).

Effect of magnesium sulfate perioperative infusion on postoperative catheter-related bladder discomfort in male patients undergoing laparoscopic radical resection of gastrointestinal cancer: a prospective, randomized and controlled study

BackgroundLaparoscopic radical resection of gastrointestinal cancer is associated with a high incidence of postoperative catheter-related bladder discomfort (CRBD). Studies on the benefits of magnesium sulfate intravenous infusion during the perioperative period post-laparoscopic surgery are yet lacking.MethodsA total of 88 gastrointestinal cancer male patients scheduled for laparoscopic radical resection were randomly divided into two groups: normal saline (control) and magnesium. In the magnesium group, a 40 mg/kg loading dose of intravenous magnesium sulfate was administered for 10 min just after the induction of anesthesia, followed by continuous intravenous infusion of 15 mg/kg/h magnesium sulfate until the end of the surgery; the control group was administered the same dose of normal saline. Subsequently, 2 μg/kg sufentanil was continuously infused intravenously by a postoperative patient-controlled intravenous analgesia (PCIA) device. The primary outcome was the incidence of CRBD at 0 h after the surgery. The secondary outcomes included incidence of CRBD at 1, 2, and 6 h postsurgery, the severity of CRBD at 0, 1, 2, and 6 h postsurgery. Remifentanil requirement during surgery, sufentanil requirement within 24 h postsurgery, the postoperative numerical rating scale (NRS) score at 48 h after the surgery, magnesium-related side effects and rescue medication (morphine) requirement were also assessed.ResultsThe incidence of CRBD at 0, 1, 2, and 6 h postoperatively was lower in the magnesium group than the control group (0 h: P = 0.01; 1 h: P = 0.003; 2 h: P = 0.001; 6 h: P = 0.006). The incidence of moderate to severe CRBD was higher in the control group at postoperative 0 and 1 h (0 h: P = 0.002; 1 h: P = 0.028), remifentanil requirement during surgery were significantly lower in the magnesium group than the control group. Sufentanil requirements during the 24 h postoperative period were significantly lower in the magnesium group than the control group. The NRS score was reduced in the magnesium group compared to the control group in the early postoperative period. Magnesium-related side effects and rescue medication (morphine) did not differ significantly between the two groups.ConclusionsIntravenous magnesium sulfate administration reduces the incidence and severity of CRBD and remifentanil requirement in male patients undergoing radical resection of gastrointestinal cancer. Also, no significant side effects were observed.Trial registrationChictr.org.cn ChiCTR2100053073. The study was registered on 10/11/2021.

The stability of Staphylococcal bacteriophages with commonly used prosthetic joint infection lavage solutions.

The aim of this study was to assess the viability of four Staphylococcal bacteriophages when exposed to different concentrations of commonly used lavage solutions in the surgical treatment of prosthetic joint infections (PJI). Four tailed Staphylococcal bacteriophages and six different lavage solutions (chlorhexidine 4%, hydrogen peroxide 3%, acetic acid 3%, povidone iodine 10%, sodium hypochlorite 0.5%, and Vashe solution) at 100%, 1%, and 0.01% concentrations were used in this experiment. In addition, the temporal impact of exposing bacteriophages to these lavage solutions was also evaluated at 5-min exposures and 24-h exposures. The results show that the titers of the four bacteriophages were statistically significantly decreased for all lavage solutions (100% and 1%) at 5-min exposures and 24-h exposures. However, with 0.01% concentrations of the lavage solutions, only acetic acid caused a statistically significant decrease in bacteriophage titers compared to normal saline control. Our findings suggest that tailed Staphylococcal bacteriophages do not remain stable in high concentrations of the most commonly used lavage solutions. However, at very dilute concentrations the bacteriophages do remain viable. This has important clinical ramifications in that it shows when using bacteriophage therapy for PJI it is critical to thoroughly wash out any lavage solutions before the introduction of therapeutic bacteriophages especially when acetic acid is used.

Subacute Toxicity of Microgranulated Myrmecodia platytyrea Aqueous Tuber Extract (gMPAE)

Introduction: Myrmecodia platytyrea, locally known as ‘Sarang Semut’, is an epiphytic plant native to Asia and the Asia Pacific. The tubers were traditionally used to manage cancer, hyperuricemia, and coronary heart diseases. Scientifically, the aqueous tuber extract has potential pharmacological benefits, including anti-cancer, anti-diabetic, and anti-inflammatory properties. Since the extract had no acute or subacute toxic effects, it might be used as a supplement to reduce inflammation and improve physiological functioning with better bioavailability than conventional preparations. This study aims to investigate the subacute toxicity of the microgranulated aqueous extract of M. platytyrea tuber (gMPAE). Methods: The formulation of the microgranules was established and analysed using a scanning electron microscope (SEM). The subacute oral toxicity study was carried out. The female nulliparous and non-pregnant ICR mice were divided into three groups (n=5), a group treated with normal saline (control group), a group treated with a placebo (blank microgranules), and a group treated with gMPAE, orally once daily for 28 days. Results: The gMPAE was produced using a spray-dry method and displayed microparticles with irregular shapes typical for spray-dried formulations. The sub-acute toxicity study showed no physical or behavioural changes in both placebo or gMPAE-treated mice compared to the control mice, with no mortality observed after 28 days of treatment and no signs of delayed occurrence of toxic effects 14 days post-treatment. Conclusion: Standardised spray-dried microgranules of M. platytyrea tuber aqueous extract were successfully developed to enhance the extract’s efficacy and are safe to be used as health supplements.

Apohemoglobin-Hpatoglobin Promotes Blood Flow in Sickle Cell Disease Mice

In sickle cell disease (SCD), a single change in the β-globin gene coding sequence results in the production of hemoglobin S (HbS). This HbS polymerizes when deoxygenated, causing red blood cell (RBC) sickling, hemolysis, anemia, reduced blood flow in small vessels, activation of vascular endothelial cells, vaso-occlusion, and ischemia. These abnormalities lead to various clinical complications, including fatigue, painful vaso-occlusive crises (VOC), reduced quality of life, organ damage, and early death. The management of SCD involves supportive care, pain management, blood transfusions, and disease-modifying therapies, all aimed at alleviating symptoms and improving the overall quality of life for affected individuals. We propose a new therapy that uses a biologic called apohemoglobin-haptoglobin (apoHb-Hp), which scavenges free circulating Hb and heme. This study examined the efficacy of apoHb-Hp in reducing vaso-occlusion in a mouse model of sickle cell disease (SCD) using transgenic mice expressing HbSS-Towne (sickle cell mice) and compared them to mice expressing normal Hb, HbAA-Towne. A single dose (10 mg/kg) of normal saline (control), Haptoglobin (Hp), or apoHb-Hp was administered before the experiment, and twenty-four subcutaneous venules were selected and mapped after baseline selection. The same vessels were re-examined for stasis at 2, 8, 24, and 48 hours, and the percentage of stasis was calculated. The results demonstrated that microvascular stasis occurs spontaneously in the Towns transgenic mice model but can be reduced by a single dose of the apoHb-Hp complex. In another set of experiments, mice were pretreated with the apoHb-Hp complex or Hp and then challenged with hypoxia-reoxygenation (hypoxia of 10% oxygen for one hour) and followed for 48 hours. Hypoxia induced microvascular stasis, also known as vaso-occlusion, which increased post-hypoxia and slowly disappeared over time in Towns mice. The study showed that pre-treatment with the apoHb-Hp complex or Hp improved the rates of recovery from vaso-occlusive crises. A single dose of the apoHb-Hp complex also reduced vascular stasis. In the last study, we administered Hb mixed with either Ringer's lactate, apoHb-Hp complex, or Hp to Towns mice fitted with the dorsal window. We knew that exogenous Hb could cause vascular stasis in Towns mice, so we aimed to investigate the effectiveness of the apoHb-Hp complex compared to Hp in preventing Hb-induced vascular stasis. The Hb infusion led to maximal stasis within an hour in the control group. Therefore, microvascular stasis occurred one hour after infusing Hb alone or with equimolar apoHb-Hp complex and Hp. Our results showed that mice co-infused with Hb + apoHb-Hp complex or Hb + Hp had significantly lower stasis levels compared to mice infused with Hb alone. Surprisingly, the apoHb-Hp complex was more effective than Hp alone in reducing Hb-induced stasis. These findings provide insight into the underlying mechanisms of the apoHb-Hp complex and demonstrate its efficacy in reducing vaso-occlusion. Further studies are necessary to optimize the therapeutic use of the apoHb-Hp complex.

Comparison of smear layer removing efficacy of Cold Atmospheric Pressure (CAP) Plasma Jet with different chelating agents. An ex-vivo study

The present study aimed to assess the effectiveness of different final irrigation regimens (Cold Atmospheric Pressure Plasma Jet, MTAD, and EDTA) in removing the smear layer from intra-radicular dentin using a Scanning Electron Microscope (SEM). Eighty-four mandibular premolars were prepared with ProTaper Universal hand files and were equally divided into four groups i.e. Normal saline (control), EDTA, MTAD and CAP Plasma Jet. Prepared samples in the control, EDTA and MTAD groups were irrigated with 5 milliliters of the irrigant, and it was retained for 2 min. In the CAP Plasma Jet group, the plasma plume was directed towards the canal lumen for 2 min. The smear layer removal of all the groups was evaluated at the coronal, middle and apical thirds. Statistical analysis was performed using Kruskal–Wallis test followed by Dunn’s test. Evaluation by SEM showed that the smear layer removal ability of MTAD and EDTA were significantly better than CAP Plasma Jet (p < 0.05). While CAP Plasma Jet showed results comparable to EDTA in the coronal third. In the middle and apical third of the canal, its effect was comparable to the control group (p > 0.05). MTAD and EDTA aided in better smear layer removal than the CAP Plasma Jet in the coronal, middle, and apical third of the test samples. CAP Plasma jet performed better in the coronal third.

Nicotine plays a protective role in rats with induced viral pneumonia with polyinosinic-polycytidylic acid through α7nAChR

ObjectiveTo study the effect of nicotine in rat model of pneumonia induced by polyinosinic-polycytidylic acid [Poly (I:C)] and explore the underlying mechanism. MethodsTwenty-four healthy adult male Sprague-Dawley (SD) rats (200–250 g) were randomly divided into normal saline control group (NS group); Poly (I:C) group; nicotine group (NIC group); and α7 nicotinic acetylcholine receptor (α7nAChR) antagonist group (α-BGT group) (n = 6 each). Rats in the Poly (I: C), NIC, and α-BGT groups were administered 1.5 mg/mL 100 μL Poly (I:C) intranasally to establish pneumonia model. In α-BGT group, 1 μg/kg α-bungarotoxin (α-BGT) was intraperitoneally injected 45 min before intranasal Poly (I:C), and 400 μg/kg nicotine was intraperitoneally injected 15 min after α-BGT injection. The NIC group received an equal volume of NS in place of α-BGT while the other treatments were same. The Poly (I:C) group received equal volume of NS in place of nicotine while the other treatments were same as in NIC group. In the NS group, only NS was administered at all three time points. PaCO2, PaO2, and PaO2/FiO2 levels were determined 24 h after administration of Poly (I:C). After euthanization, rat lung tissues were extracted for pathological examination, and wet weight/dry weight (W/D ratio) was determined. Expression of tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-1β, and interferon (IFN)-γ in lung tissue was determined by ELISA. q-PCR was used to detect nuclear factor kappa-B P65 (NF-κBP65). ResultsCompared with NS group, Poly (I:C) and α-BGT groups showed significantly increased W/D ratio, PaCO2, TNF-α, IL-6, IL-1β, and IFN-γ content, NF-κB P65 expression, and reduced PaO2 and PaO2/FiO2 (p < 0.05), along with obvious signs of pathological injury. Nicotine pre-treatment reduced W/D ratio, PaCO2, proinflammatory cytokines, NF-κBP65 expression, and increased PaO2 and PaO2/FiO2 levels. The above effects were negated in α-BGT group. ConclusionPre-administration of nicotine improved Poly (I:C)-induced pneumonia by activating the cholinergic anti-inflammatory pathway.

Effect of Piascledine-bacterial nanocellulose combination on experimental cutaneous wound healing in rat: Histopathological, biochemical and molecular studies.

The study investigated the wound healing potential of Piascledine (an avocado/soybean mixture) alone and in combination with bacterial nanocellulose on rat cutaneous wounds. Full-thickness excisional wounds (2 cm in diameter) were induced on the backs of 60 Sprague-Dawley rats, divided into four groups, treated with daily topical application of bacterial nanocellulose (BNC), Piascledine 10% (PSD 10%) and Piascledine+bacterial nanocellulose (PSD + BNC) (10 mg/disk) and normal saline (control) for 20 days. Wounds were monitored daily, and at 10, 20 and 30 days post-injury (DPI), tissue samples were collected for biochemical, histopathological and molecular analyses. Treated rats with PSD and PSD + BNC showed a significant decrease in the wound area compared with other groups. PSD and particularly PSD + BNC modulated inflammation, improved fibroplasia and angiogenesis and scar tissue formation at short term. At the long term, they reduced the scar tissue size and improved collagen fibres alignment, tissue organization and remodelling as well as re-epithelialization. PSD enhanced matrix metalloproteinase-3 (MMP-3) gene expression, collagen and glycosaminoglycans (GAGs) synthesis and decreased tissue inhibitor of metalloproteinase-1 (TIMP-1) gene expression at various stages of wound healing. The study concluded that topical application of Piascledine, particularly in combination with bacterial nanocellulose, promotes wound healing activity by modulating inflammation, regulating MMP-3 expression and enhancing collagen and GAGs synthesis.

Comparison between low-volume local anesthetic with intravenous dexamethasone and conventional volume without dexamethasone for superior trunk block after arthroscopic shoulder surgery: a randomized controlled non-inferiority trial

IntroductionThis study aimed to investigate whether low-volume local anesthetic with intravenous dexamethasone can reduce the incidence of diaphragmatic paresis while maintaining the analgesic duration compared with conventional volume of local...

Efficacy of pre-emptive peripheral nerve block using 0.25% bupivacaine for postoperative analgesia in patients undergoing maxillofacial surgeries under general anesthesia

Background: Conventional analgesia using non-steroidal anti-inflammatory drugs not only provides inadequate pain relief but also can produce a multitude of systemic adverse effects. During oral and maxillofacial surgeries, inhibition of central sensitization by pre-incision nerve blocks with local anesthetic can reduce postoperative pain, may curtail analgesic requirement, and thereby can provide better patient comfort. Aims and Objectives: This study aimed to evaluate the effectiveness of pre-incisional peripheral nerve block using 0.25% bupivacaine over placebo for postoperative pain relief in patients undergoing oral and maxillofacial surgery under general anesthesia. Materials and Methods: One hundred and twenty patients of 18–35 years of either sex, American Society of Anesthesiologists physical status class I and II had undergone oral and maxillofacial surgeries were divided into two groups to receive bupivacaine 0.25% (Study group, n=60) normal saline (Control group, n=60) for nerve block before surgical incision. Postoperative pain was assessed by Visual Analog Scale (VAS) score and verbal response scale (VRS) score. The number of rescue analgesia was required in the first 24 h and the incidence of any complications associated with this agent was documented. Results: The VAS score was found considerably lower in the bupivacaine group compared with the control group in the first 24 h of postoperative period (P&lt;0.05). A similar trend was observed with VRS score in the first 16 h of postoperative period (P&lt;0.05). The number of rescue analgesia required in the control group was much higher in comparison with the study group. There was no serious adverse event in both the groups. Conclusion: Bupivacaine 0.25% as pre-emptive analgesia can be used to reduce postoperative pain and analgesic requirements in maxillofacial surgeries.

Ameliorative effect of nebivolol in doxorubicin-induced cardiotoxicity.

This study aimed to investigate the potential of nebivolol in preventing doxorubicin-induced cardiotoxicity by targeting the inflammatory, oxidative, and apoptotic pathways. Twenty-eight male rats were randomly divided into four groups, each consisting of seven rats. The control group received standard diets and unrestricted access to water. The rats in the normal saline (N/S) group were administered a 0.9% normal saline solution for two weeks. The doxorubicin group (the "induced group") received doxorubicin at a dosage of 2.5 mg/kg three times per week for two weeks. The nebivolol group received an oral dose of 4 mg/kg of nebivolol for the same duration. The cardiac tissues of rats treated with doxorubicin exhibited increased levels of tumor necrosis factor, interleukin-1, malondialdehyde, and caspase-3 compared to the normal saline control group (p<0.05), along with decreased levels of total antioxidant capacity and Bcl-2. These results show that doxorubicin is harmful to the heart. The administration of nebivolol significantly reduced the cardiotoxic effects induced by doxorubicin, as indicated by a statistically significant decrease in the levels of inflammatory markers, specifically tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) (p<0.05). The nebivolol group exhibited a significant decrease in malondialdehyde levels, which serves as a signal of oxidation, in cardiac tissue compared to the doxorubicin-only group (p<0.05). Additionally, the nebivolol group showed a significant increase in overall antioxidant capacity. Nebivolol dramatically attenuated doxorubicin-induced cardiotoxicity in rats, likely by interfering with oxidative stress, the inflammatory response, and the apoptotic pathway.

Pericapsular nerve group block in hip arthroplasty: A prospective randomized trial.

This study aimed to evaluate the analgesic effect of the ultrasound-guided pericapsular nerve group (PENG) block in hip arthroplasty (HA) surgery. A prospective double-blinded, randomized study. Tertiary institutional clinical care. Fifty patients, more than 50 years old of both genders, were chosen according to the American Society of Anesthesiologists classification, with physical status I-III, and scheduled for unilateral HA surgeries. Patients were randomized to receive either a sham PENG block with 20 mL of normal saline (control group) or a PENG block with 20 mL of bupivacaine 0.25 percent (PENG group). From the onset of the first request for rescue opioid analgesia, preoperative pain scores before and after block (at rest and with a raised straight leg), the incidence of quadriceps weakness after the block, intraoperative fentanyl consumption, post-operative pain scores, and morphine consumption, besides the presence and frequency of adverse events, were recorded. The patients undergoing PENG block with bupivacaine had prolonged durations before the first analgesic request, lower perioperative pain scores, less intraoperative rescue fentanyl, and less post-operative morphine consumption than the control group, with nonsignificant motor weakness after the block and similar adverse events. The PENG block provided effective perioperative analgesia for HA with prolonged duration of analgesia, nonsignificant motor effects, reduced perioperative opioids consumption, and no major side effects.

Effects of prenatal nicotine exposure on vascular endothelial function and structure in offspring rats

To clarify the effect of prenatal nicotine exposure (PNE) on vascular endothelial function (VEF) in offspring rats, and to explore whether these effects are long-lasting and sex-dependent. Pregnant Sprague-Dawley rats were randomized into two groups and exposed to either 102 mg/mL nicotine (experimental group) or normal saline (control group) through a subcutaneously implanted osmotic micropump. Vascular rings from the thoracic aorta were collected from offspring rats at 1, 4, and 12 months of age. The specimens were used to determine VEF using functional tests and to observe morphologic and pathologic changes of blood vessels in hematoxylin and eosin-stained samples with light microscopy. The percentage of acetylcholine-induced endothelium-dependent vasorelaxation (EDV) of the thoracic aorta was significantly higher in the experimental group than in the control group in 1-, 4-, and 12-month-old female offspring rats (18.68±2.32 vs. 13.85±6.10, 17.44±3.91 vs. 10.77±5.77, and 30.96±22.26 vs. 18.94±13.61, respectively; P &lt;0.05). The percentage of acetylcholine-induced EDV was significantly lower in the experimental group than in the control group in 1-, 4-, and 12-month-old male offspring rats (10.31±4.05 vs. 16.05±14.80, 5.57±2.81 vs. 12.12±5.62, and 11.98±7.24 vs. 58.87±32.43, respectively; P &lt;0.05). The hematoxylin &amp; eosin-stained vascular rings of the offspring rats displayed an uneven lumen, scattered intimal thickening, partial shedding and vacuolar degeneration of endothelial cells, and inflammatory cell infiltration and phagocytosis in the experimental group. In addition, overt smooth muscle atrophy in tunica media, disordered cell arrangement, and unclear structure of the elastic fiber layer was observed. None of these histopathologic changes were found in the control group. In adult offspring rats, PNE not only affected the VEF of the thoracic aorta but also led to pathologic changes in the vascular structure. Additionally, the effects of PNE on VEF were sex-specific, manifesting primarily as significantly improved VEF in female offspring rats and significantly impaired VEF in male offspring rats, lasting into adulthood.

Vitamin C supplementation modulates crude oil contaminated water induced gravid uterine impaired contractile mechanism and foetal outcomes in Wistar rats.

Crude oil is a common environmental contaminant that impacts the reproductive functions of women. Understanding the contractile mechanism of the gravid uterus and how it impacts fetal outcomes during crude oil-contaminated water (CCW) exposure is still evolving. This study investigates the effect of vitamin C supplementation during the ingestion of CCW from Bayelsa, Nigeria, on the contractile mechanism of the gravid uterus and fetal outcomes. Fifteen nulliparous pregnant rats were randomly divided into 3 groups of 5 rats each and treated with normal saline (control), CCW (2.5 mL), and CCW + vitamin C (10 mg/kg bwt), respectively. Treatments were via oral gavage from gestation days 1-19. Gas chromatography-mass spectrometry of CCW, uterine oxidative biomarkers, and invitro contractile activity of excised uterine tissue to acetylcholine, oxytocin, magnesium, and potassium were determined. Furthermore, uterine responses to acetylcholine after incubation with nifedipine, indomethacin, and N-nitro-L-arginine methyl ester were also recorded using the Ugo Basile data capsule acquisition system. Fetal weights, morphometric indices, and anogenital distance were also determined. Acetylcholine, oxytocin, magnesium, diclofenac, and indomethacin-mediated contractile mechanisms were significantly impaired with CCW exposure; however, vitamin C supplementation significantly attenuated the impaired uterine contractile activity. Maternal serum estrogen, weight, uterine superoxide dismutase, fetal weight, and anogenital distance were significantly reduced in the CCW group compared to the vitamin C supplemented group. Ingestion of CCW impaired the uterine contractile mechanism, fetal developmental indices, oxidative biomarkers, and estrogen. Vitamin C supplementation modulated these by elevating uterine antioxidant enzymes and reducing free radicals.

Intestinal topical lidocaine spray improves the efficacy and safety of endoscopic sigmoid polypectomy.

Endoscopic polypectomy can prevent colorectal cancer. Adequate surgical field visualization is crucial to complete resection. To prevent visual field loss caused by intestinal peristalsis, we investigated the efficacy and safety of topical lidocaine spraying during the endoscopic sigmoid polypectomy (ESP). Retrospective analysis was performed on 100 ESP patients admitted from July 2021 to October 2021, among which 50 patients received lidocaine (case group) and other 50 patients received normal saline (control group). Lidocaine or saline was sprayed on the colonic mucosa within 5 cm above and below the polyps before polypectomy. The en-bloc resection rate (EBRR) and complete resection rate (CRR) were primarily evaluated. Secondary outcomes included EBRR for polyps located in the 5-11 o'clock position, sigmoid colon peristalsis frequency, degree of exposure to the surgical field, operative times, and adverse events. There were no significant differences in the basic demographic characteristics between the two groups. EBRR and CRR in the case group were 72.9% and 95.8%, and in the control group were 53.3% and 91.1%, respectively. The EBRR of sigmoid polyps located at the 5-11 o'clock positions was significantly higher in the case group (82.8%) than in the control group (56.7%) (P = 0.03). Sigmoid colonic peristalsis was significantly inhibited after lidocaine spraying (P < 0.01). There was no statistical difference in the operative times and adverse event rates between the two groups. Topical spraying lidocaine around polyps can safely and effectively reduce intestinal peristalsis, thus improving the EBRR of sigmoid polypectomy.

COOLED BOILED WATER VERSUS STERILE NORMAL SALINE IN WOUND CLEANSING, A RANDOMIZED CONTROLLED TRIAL

Introduction: Wound cleansing plays a vital role in wound management. Although various solutions have been recommended for cleansing wounds, normal saline is favoured as it is an isotonic solution and is not thought to interfere with the normal healing process. Cooled boiled water is commonly used in community settings for cleansing wounds because it is easily accessible, efcient and cost-effective; however, there is an unresolved debate about its use. The aim of the study was to test whether there are differences in wound infection and w Aims And Objectives: ound healing rates when wounds are irrigated with cooled boiled water compared to sterile normal saline. Can this approach be used in a community environment without risk? Subjects were randomly assigned to wound cleansing with cooled Method: boiled water (experimental group) or sterile normal saline (control group). Wound assessment was conducted at each hospital visit, and an assessment of wound size was conducted once a week. The main outcome measures, occurrence of a wound infection and wound healing, were assessed over a period of 6 weeks. Study ndings indicate that cooled b Conclusion: oiled water is a safe alternative to sterile normal saline for wound cleansing and this method can be safely applied to community setting.