Plain Saline Research Articles

Green Synthesis of Pure Superparamagnetic Fe3O4 Nanoparticles Using Shewanella sp. in a Non-Growth Medium

Conventional wet chemical methods for the synthesis of superparamagnetic magnetite nanoparticles (MNPs) are energy-intensive and environmentally unsustainable. Green synthesis using bacteria is a less-explored approach to MNP production. Large-scale biosynthesis of MNPs has heretofore been conducted using extremophilic bacteria that exhibit low growth rates and/or require strict temperature control. However, a decrease in material and energy costs would make such bioprocesses more sustainable. In this study, Shewanella putrefaciens CN-32, an iron-reducing bacterium, was employed to reduce amorphous iron oxyhydroxide and synthesize MNPs in a non-growth medium at ambient temperature and pressure. The synthesis was conducted using plain saline solution (0.85% NaCl) to avoid impurities in the products. X-ray diffraction and transmission electron microscopy indicated that the reduction products were MNPs with a pseudo-spherical shape and 6 ± 2 nm average size. Magnetometry showed that the particles were superparamagnetic with maximum saturation magnetization of 73.8 emu/g, which is comparable to that obtained via chemical synthesis methods. Using less than a quarter of the raw materials employed in a typical chemical co-precipitation method, we obtained a maximum yield of 3.473 g/L (>5-fold increase). These findings demonstrate that our simple and ecofriendly process can help overcome the current barriers for large-scale synthesis of high-purity magnetic nanopowders.

Assessment of Nursing Staff's Knowledge, Attitude and Practice Regarding Oral Hygiene Care in Intensive Care Unit Patients: A Multicenter Cross-sectional Study.

Oral care is one of the fundamental nursing care procedures used to decrease oral colonization, dental plaque, respiratory infections, patient stay, and cost. The importance of good oral hygiene for patients in intensive care units (ICUs) is well recognized, however, the most effective way to achieve good oral care in the ICU is unclear. Therefore, the aim of this study was to assess the knowledge, attitude, and practice of nursing professionals regarding oral healthcare in ICUs among various medical institutes across India. A questionnaire-based multicentric cross-sectional survey was conducted among registered nursing professionals employed at ICUs of three government tertiary healthcare centers (THC) of India: THC-I, THC-II, and THC-III located in the eastern and northern parts of India between February 2022 and July 2022. A total of 150 nurses completed the questionnaire form (response rate: 62.5%) comprised of 49 (32.7%) males and 101 (67.3%) females with a mean age of 35.69 ± 7.7 years. Nursing officers' knowledge surpassed that of staff nurses regarding the duration of toothbrushing (p = 0.033). Among interinstitutional comparisons, THC-I nurses showed the greatest knowledge regarding the duration of toothbrushing and the mechanism of preventing saliva accumulation to reduce microbial growth (p = 0.013 and p = 0.003, respectively). Based on total work experience, participants were segregated into three groups: Group I (<7 years), group II (7.1-13.9 years), and group III (>14 years). Group II surpassed the knowledge of denture removal during sleep, cleaning after every meal, and storing in personalized air-tight containers (p = 0.001 and p = 0.036, respectively). The majority from group II recommended plain saline as the material for oral hygiene maintenance in ICU patients (p = 0.008). Group III predominantly practiced the ideal handwashing technique pre- and post-patient contact which was statistically significant (p = 0.001). This study observed that a knowledge gap exists among the nurses of the three institutes across India pertaining to the oral hygiene care of ICU patients. Nurse's education and implementation of the proper oral hygiene measures for intubated patients in ICU setup is an essential need. Kumar S, Singh B, Mahuli AV, Kumar S, Singh A, Jha AK. Assessment of Nursing Staff's Knowledge, Attitude and Practice Regarding Oral Hygiene Care in Intensive Care Unit Patients: A Multicenter Cross-sectional Study. Indian J Crit Care Med 2024;28(1):48-57.

Efficacy of Dexamethasone Diluted Saline Irrigant on Postoperative Sequelae in Patients Undergoing Lower Third Molar Surgery: A Prospective Clinical Study.

Background Third molar impaction surgery is one of the most commonyet challenging procedures done as a part of minor oral surgery. Years of research and improvisation of techniques have been done, yet there are still a lot of postoperative sequelae after surgical removal of the impacted tooth. In our study, we have compared the efficacy of dexamethasone diluted saline solution over plain saline solutionused as an irrigant in the reduction of postoperative sequelae for lower third molar surgery. Aim The aim of the study was to evaluate the efficacy of dexamethasone dilutedsaline solution over plain saline solutionin the reduction of postoperative sequelae for lower third molar surgery. Materials and methods The research was conducted atSaveetha Dental College and Hospitalin the Department of Oral and Maxillofacial Surgery. The study consisted of 48 individuals, 24 of whom haddexamethasone saline as an irrigant (8 mg of dexamethasone was diluted in 100 ml of plain saline) (Group 1), and 24 inwhom plain saline was used as an irrigant (Group 2) in the lower third molar surgery. Patients were evaluated postoperatively for pain and swelling. The postoperative swelling was measured on postoperative day two and day seven.Postoperative pain was measured onday two, day four, and day seven after surgery using a visual analog scale. Data were analyzed using SPSS (IBM Corp., Armonk, NY) with P-values less than 0.05 considered statisticallysignificant. The statistical test used to compare the outcomes between the two groups was the independent samples t-test. Results It was found that study participants in the dexamethasone saline irrigation group reported statistically significantly lesser pain than participants receiving plain saline irrigation on day two (P = 0.001), day four (P = 0.001), and day seven (P = 0.001), respectively. Also, there was a reduction in swelling among participants in the dexamethasone saline irrigation group when compared to the normal saline irrigation group, which was statistically significant (P = 0.001) on day two, while the postoperative swelling was not statistically significant onday seven (P = 0.08) between the two study groups. Conclusion Based on the results obtained, it can be concluded thatdexamethasone saline solution (8 mg/100 mL) was more effective as an irrigantin reducing the postoperative sequelaethan regular saline solution in the lower third molar surgery.

Mode I fracture behaviors of plain and PVA reinforced ice at Arctic low temperatures

Since the Mode I fracture of ice materials determines the safety and integrity of ice constructions, this study investigated Mode I fracture behaviorus of strengthened ice materials at Arctic low temperatures. Forty-five three-point bending (TPB) beams, including 12 plain saline water ice (PI) and 33 PVA reinforced saline water ice (PRI), were tested to investigate the mode I fracture behaviors of plain and reinforced ice at low temperatures. The investigated parameters included the low temperature (ranging from −10 °C to −80 °C), ice type (PI and PRI), and mass fraction of fibre (ωf = 0, 1, 2, and 3%), respectively. The failure modes, general P-δ and P-CMOD curves, initial cracking load, double-K fracture toughness, and fracture energy of PI and PRI at low temperatures were revealed. Meanwhile, the effects of temperature and PVA fibre content on fracture behaviors of PI and PRI were also discussed in details. Test results showed that as the temperature decreased from −10 °C to −30 °C, the increments in unstable fracture toughness of PI, PRIA, and PRIB were 414%, 757%, and 250%, respectively. Moreover, the fracture energy of PRI with 3% ωf was 113 times of PRI with 0%. Based on the results and mechanism explanation, three empirical formulae considering the influences of temperature on the unstable fracture toughness of PI, PRIA, and PRIB materials were proposed.

Hyponatremia Under Various Specialties

Purpose: Hyponatremia is frequently observed electrolytes derangement in both medical and surgical specialties with a variety of underlying illnesses. The rapidity of sodium derangement and symptoms at the time of presentation help to decide its management plan. Many times, treating primary disease specifically along with just conservative steps for hyponatremia i.e., plain water restriction, adding salt, or infusion isotonic saline help achieve desirable results. Patients and methods: This observational study was conducted at the Indus Hospital and Health Network (IHHN) from July 2017 to April 2020 with the approval of Interactive and Research Development (IRB-IRD). All those (age &gt;14 years) of either gender, admitted under various specialties with hyponatremia (serum sodium&lt;135 meq/L) were enrolled after taking consent. Their history, demographics, volume status, and investigation were done and hyponatremia was categorized as mild (130 to 134 meq/L), moderate (125 to 129 meq/L), and severe (&lt;125 meq/L). The outcome was noted on the pre-formed questionnaire as Sodium improve/ unimproved, discharged, expired. Results: Out of 262 patients with a male to female ratio of 0.8/1 (123/139), the most prevalent comorbid was hypertension 177 (67.6%), followed by CKD 171 (65.3%) and DM 142 (54.2%). The majority 102 (38.9%) had a moderate degree of hyponatremia while hypovolemia was the predominant volume status observed in 131 (50%) patients. Symptomatic hyponatremia was present in 38 (14.5%) patients. The majority of patients recovered and discharged 234 (89.3%), of which only 2 patients required hypertonic saline.

Intravenous Administration of Tranexamic Acid Significantly Improved Clarity of the Visual Field in Arthroscopic Shoulder Surgery. A Prospective, Double-Blind, and Randomized Controlled Trial

To determine whether intravenous administration of tranexamic acid (TXA) before shoulder arthroscopic rotator cuff repair surgery can improve arthroscopy visual clarity. This was a prospective, double-blind, randomized, and placebo-controlled study. From May 2016 to April 2018, patients requiring arthroscopic rotator cuff repair were enrolled and randomly assigned to either the TXA group. receiving 1000 mg of TXA intravenously 10 minutes before surgery. or the placebo group. receiving the same volume of plain saline. Patients with pre-existing liver/renal disease, coagulopathy, or concurrent use of anticoagulation medications were excluded. Visual clarity was rated using a Numeric Rating Scale from grade 1 (poor) to grade 3 (clear) every 15 minutes throughout the surgery. Secondary outcomes included estimated perioperative blood loss, operative time, degree of shoulder swelling, postoperative subjective pain score, inpatient duration, and associated comorbidities were recorded. Both parametric and nonparametric methods were used for the statistical analysis. In total, 72 patients were enrolled, 37 in the TXA group and 35 in the placebo group. The demographic data were similar between the 2 groups. Visual clarity was found to be significantly better in the TXA group, with a greater percentage of grade 3 vision clarity (53.7 ± 18.9 % vs 40.5 ± 22.1%, P= .036). The average visual score in the TXA group (2.5 ± 0.2) also was better than that of the control group (2.3 ± 0.3) (P= .048). The postoperative subjective pain score was significantly lower in the TXA group (3.0 ± 1.5) than in the control group (4.3 ± 2.0) (P= .009). In addition, postoperative analgesic usage was significant lower in the TXA groups (9.6 ± 9.7 morphine milligram equivalent) than in the control group (14.7 ± 13.4 morphine milligram equivalent) (P= .037). Other parameters, such as operative time, estimated perioperative blood loss, degree of shoulder swelling, and duration of inpatient stay were similar between the 2 groups. None of the patients developed complications after surgery. Intravenous administration of TXA is an alternative way to improve visual clarity in arthroscopic shoulder surgery. It also reduces subjective pain and analgesic consumption in the early postoperative period without significant side effects. Therapeutic studies level II.

The effect of topical epinephrine 1:1000 with and without infiltration of 1% lidocaine with epinephrine 1:100,000 on endoscopic surgical field visualization: a double-blind randomized controlled study.

The objective of this study is to determine whether the infiltration of 1% lidocaine with 1:100,000 epinephrine in addition to topical application of 1:1000 epinephrine significantly improves surgical field grading scale score over topical 1:1000 epinephrine alone. A prospective, double-blind, randomized, controlled study was performed of 40 patients undergoing bilateral endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). Patients were enrolled and randomly assigned to receive infiltration with 1% lidocaine with 1:100,000 epinephrine on 1 side of the nasal cavity vs plain saline on the other side in preparation for ESS. Both groups received topical application of 1:1000 epinephrine. Surgical videos were recorded and Wormald surgical field grading scale was assigned by 2 blinded reviewers. The number of extra 1:1000 epinephrine pledgets used during the surgery, estimated blood loss, and surgical duration were also recorded. There were no statistically significant differences in Wormald surgical field grading scale, number of extra pledgets used, or estimated blood loss between the nasal cavity side infiltrated with 1% lidocaine with 1:100,000 epinephrine in comparison to infiltration with saline. The side infiltrated with 1% lidocaine with 1:100,000 epinephrine had a reduced operative time compared to the side infiltrated with saline (p = 0.002). There were no differences in postoperative bleeding from questionnaire completed by patient at the first postoperative visit. Addition of infiltration of 1% lidocaine with epinephrine 1:100,000 to topical application of epinephrine 1:1000 for preparation of ESS does not significantly improve surgical field of view compared to topical epinephrine alone.

Fentanyl versus midazolam as additive to local anesthetic mixture for peribulbar block during posterior segment surgery in adult patients a prospective randomized double-blind study

ObjectivesTo evaluate analgesic and hemodynamic outcome of fentanyl or midazolam as additives to local anesthetic mixture (LAM) for peribulbar block (PBB) during posterior chamber surgery.MethodsOne hundred thirty-two ASA status I to III adult patients aged 50–75 years scheduled for posterior segment surgery (intraocular foreign body and elective vitrectomy) were enrolled in this prospective, randomized, double-blind trial from which 12 patients were excluded. After signing a written fully informed consent for study participation, patients were grouped into 3 groups (40 patients in each group); group C received local anesthetic mixture plus 1 ml plain saline, group F received local anesthetic mixture plus 25 μg fentanyl in 1 ml saline and group M received local anesthetic mixture plus 1 mg midazolam in 1 ml saline. The primary outcome was the onset time of eyelid and globe akinesia. Also, the duration of the block was assessed in the three studied groups. Intraoperative and postoperative hemodynamic measures were assessed. Postoperative analgesia was hourly-assessed using Visual analogue scale (VAS) and rescue analgesia was provided at visual analogue score of > 3.ResultsThe number of patients who had fast eyelid and globe akinesia was significantly higher with significantly lower total 15-min score in group F than the other groups. Intraoperative and postoperative hemodynamic measures were non-significantly different between studied groups. Duration of the block was significantly longer in groups F and M than group C with significantly longer duration in group F. The number of patients who required postoperative rescue analgesia was significantly lower with significantly lower number of requests in group F than the other groups.ConclusionAdditives to local anesthetic mixture during peribulbar block provided satisfactory anesthetic outcome than local anesthetic mixture alone. Fentanyl was superior to midazolam in terms of significantly speed up onset, longer block duration with significantly longer postoperative analgesia and lesser consumption of rescue analgesia. Both additives provided adjusted hemodynamic measures comparable to the control group.Trial registrationPan African Clinical Trials Registry (PACTR201708002496243) registered 03/08/2017 retrospectively.

The Main Factors of Uranium Accumulation in the Ishim Plain Saline Lakes (Western Siberia)

Hydrochemical analysis of the high-salinity lakes in the Ishim Plain (>250–300 g/L) located at the border with the Northern Kazakhstan uranium ore province is performed. The studies have shown that the main factor of concentration and redistribution of uranium in the lake basins of the Ishim Plain are the processes of intense salt deflation causing sanding of lakes and uranium depletion in the near-surface layer of the bottom deposits. The correlation between the hydroxide forms of uranium binding in the bottom lacustrine deposits of the Ishim Plain and the coffinite composition of the Semizbai deposit makes it possible to consider this province to be promising for the discovery of hydromineral uranium deposits.

245 - The Radioprotective Effects of Propolis and Caffeic Acid Phenethyl Ester on Radiation-Induced Oxidative/nitrosative Stress in Brain Tissue

Head and neck cancer patients treated with radiotherapy suffer severe side effects during and following their treatment. Efforts to decrease toxicity of irradiation to normal tissue, organs and cells have led to searching for cytoprotective agent. Investigations for effective and non-toxic compounds with radioprotective capability led to increasing interest in antioxidant such as Propolis and Caffeic acid phenethyl ester (CAPE). The aim of this study was to evaluate the antioxidant and radioprotective effects of Propolis and CAPE on radiation-induced oxidative/nitrosative stress in the brain tissue. Fourty Sprague-Dawley rats were randomly divided into five groups. Group 1 (Irradiation (IR) + Propolis) received total cranium irradiation and propolis was given orally through an orogastric tube daily. Group 2 (IR+CAPE) received total cranium irradiation plus CAPE, was dissolved in dimethyl sulfoxide (DMSO) just before giving to the rats, intraperitoneally (IP) every day. Group 3 (IR) received 5 Gy of gamma irradiation as a single dose to total cranium plus 1 ml saline daily. Group 4 received daily plain DMSO. Group 5 received daily plain saline. At the end of the 10 day time period, xanthine oxidase (XO), nitric oxide synthase (NOS) activities, nitric oxide (NO●) and peroxynitrite (ONOO–) levels were significantly higher in IR group compared to all other groups. In conclusion, the results suggest the radioprotective ability of Propolis and CAPE involving prevention of radiation-induced oxidative/nitrosative damage.

Time and Space Evolution of Shallow Saline Groudwater Dynamic in Inland Area of Jiyang County，Shandong Province, China

Inland plain shallow saline water has great exploitation potentiality. Based on field water testing, water level monitoring, pumping test, as well as indoor leaching experiment, applying mathematical statistics, Pipers trilinear nomograph and PHREEQC chemistry simulation methods, saline water area of the town of Sungeng Jiyang was studied. The results showed as follows: (1) Inland shallow groundwater presents “weather-evaporative” dynamic type; (2)The shallow saline water and middle-deep groundwater belonging to different flow system; (3) Because of the creeping flow and aqueous medium riched in clay, inland shallow groundwater mineralized significantly. In saline water area inland plain, the unique features of groundwater circulation result in brackish water dynamic relative stability.

Determination of Nutrient Contents and In vitro Gas Production Values of Some Legume Forages Grown in the Harran Plain Saline Soils.

The aim of this study was to determine the nutritive value of some legume species in salt-affected soils of South-East Anatolian region using chemical composition and in vitro gas production kinetics. In this study, Lotus corniculatus, Trifolium alexandrinum, Medicago sativa were sown and tested in four different locations. A 3 by 4 factorial design with 3 legume species and 4 salt levels (non salty electrical conductivity (EC)<4 dS/m; low salt: 4 dS/m>EC<8 dS/m, medium saline: 8 dS/m>EC<16 dS/m and high salt: 16 dS/m>EC) was used in the study. Results indicated that salinity and plants had no significant effect on ash and ether extract. Dry matter (DM), acid detergent fiber, digestible dry matter, dry matter intake (DMI) were affected by plant, salinity and plant×salinity interaction. On the other hand neutral detergent fiber, relative feed value (RFV), and DMI were affected by salinity and plant×salinity interaction. Mineral contents were affected by plant species, salinity and salinity×plants interactions. In vitro gas production, their kinetics and estimated parameters such as were not affected by salinity whereas the gas production up to 48 h, organic matter digestibility, metabolizable energy (ME), and net energy lactation (NEL) were affected by plant and plant×salt interaction. Generally RFVs of all species ranged from 120 to 210 and were quite satisfactory in salty conditions. Current results show that the feed value of Medicago sativa is higher compared to Lotus corniculatus and Trifolium alexandrinum.

Application of Stabilizer to Improvement the Saline Soil in Lor Nur Lacustrine

Considering the Lop Nur Lacustrine plain saline soil is a special soil which with poor engineering properties such as collapsible and expansion. Through an experimental research on the saline soils stabilized by lime, cement and a polymeric solidified material was conducted. The unconfined compressive strengths and water-related stability of stabilized saline soils were discussed. It was shown that unconfined compressive strength and water-related stability of stabilized Lacustrine plain saline soils attained corresponding engineering standards and that it could be used as roadbed fillings., which could provide a reference to prevent and treatment about the dangers of Lop Nur Lacustrine plain saline soil.

Comparison between intranasal dexmedetomidine and intranasal ketamine as premedication for procedural sedation in children undergoing MRI: a double-blind, randomized, placebo-controlled trial

Providing anesthesia to children undergoing MRI is challenging. Adequate premedication, administered noninvasively, would make the process smoother. In this study, we compare the efficacy of intranasal dexmedetomidine (DXM) with the intranasal administration of ketamine for procedural sedation in children undergoing MRI. We studied 150 children, between 1 and 10 years of age, divided randomly into three groups (DXM, K, and S). For blinding, every child received the intranasal drugs twice; syringe S1, 60 min before, and syringe S2, 30 min before intravenous (IV) cannulation. For children in group DXM, S1 contained DXM (1 μg/kg) and S2 was plain saline. Children in group K received saline in S1 and ketamine (5 mg/kg) in S2 whereas children in group S received saline in both S1 and S2. The child's response to drug administration, ease of IV cannulation, the satisfaction of the anesthesiologist and child's parents with the premedication, and the total propofol dose required for the satisfactory conduct of the procedure were compared. We also compared the time to awakening and discharge of the child as well as the occurrence of any side effects with these drugs. Both DXM and ketamine were equally effective as premedication in these patients. Most of the children accepted the intranasal drugs with minimal discomfort; 90.4 % of the anesthesiologists in the DXM group and 82.7 % in the ketamine group were satisfied with the conditions for IV cannulation whereas only 21.3 % were satisfied in the saline group. The total dose of propofol used was less in the study groups. Furthermore, children in group DXM and group K had earlier awakening and discharge than those in group S. DXM and ketamine were equally effective, by the intranasal route, as premedication in children undergoing MRI.

Inadvertent Subcutaneous Injection of Hypertonic Saline Solution During Lipofilling

Subcutaneous infiltration with a mixture of plain saline and adrenaline is a useful option in lipoharvesting for autologous fat grafting. This report presents the case of 34-year-old woman who experienced inadvertent subcutaneous injection of hypertonic saline solution during body fat harvesting. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266 .

Improving noradrenaline infusion technique

In-vitro studies have shown that mass flow rate disturbances, e.g. hypertensive peaks during the onset of infusion, depend primarily on infusion set characteristics 1-4. Our aim was to determine in vitro whether a very low deadspace volume and anti-reflux valve infusion line assembly more accurately delivered a noradrenaline infusion compared with a standard double-pump assembly. We filled 50-ml syringes with either 500 μg.ml−1 noradrenaline bitartrate in saline 0.9%, or plain saline 0.9%. Both were infused using syringe pumps connected either to a standard Y-extension set without anti-reflux valve and fitted with a stopcock, or to a very low deadspace volume set with anti-reflux valve (Edelvaiss-Vset+M™,Doran international, Toussieu, France). Both were flushed with 0.5 mg.ml−1 noradrenaline or saline using the syringe pump's purge function. Drug delivery was measured in vitro using an ultraviolet spectrophotometer and a flowmeter. Saline and noradrenaline infusions started simultaneously at 8 ml.h−1 and 2 ml.h−1, respectively. Two increases (0.5 mg.h−1) and two decreases (0.5 mg.h−1) in noradrenaline flow were initiated with the sum of the two flow rates always equal to 10 ml.h−1. Tubing mimicking the central venous catheter volume was added at the distal end of each infusion set. Ten tests were performed consecutively for each infusion method. The median (IQR [range]) time (min:s) required to reach steady state after the onset of noradrenaline infusion, and flow rate increase/decrease, was significantly different (all Mann-Whitney U test p < 0.0001) when comparing standard vs very low deadspace extension assemblies: 40:00 (39:45 – 45:12 [19:57 – 49:37]) vs. 12:34 (9:27 – 13:51 [6:34 – 17:33], 14:31 (12:51 – 15:36 [10:12 – 19:27]) vs. 09:29 (8:03 – 10:59 [3:27 – 16:40]) and 16:43 (14:16 – 19:15 [12:13 – 21:36]) vs. 10:47 (9:09 – 11:16 [4:49 – 15:14]), respectively. On starting saline and noradrenaline flows, the standard extension set flushed with noradrenaline solution induced an unwanted drug bolus (Fig. 3). These results are in accordance with previous studies, including ours, demonstrating that the use of a very low deadspace infusion set with anti-reflux valve improves the accuracy of drug delivery 2-4. The major advantage of the double-pump method is that it increases the sum of flow rates thanks to carrier flow, whereas a diluted drug infused alone at a high flow rate means the drug infusion pump needs frequent changing. However, this method does require a Y-extension set and the problem of flushing remains. Flushing with noradrenaline solution reduces the response delay of the infusion line but induces an unwanted bolus. Therefore, the best way to optimise the double-pump method is to reduce the deadspace volume of the Y-extension set. Our results should be confirmed by a randomised clinical trial comparing noradrenaline infusion methods.

Hydrogen-Rich Saline Prevents Early Neurovascular Dysfunction Resulting from Inhibition of Oxidative Stress in STZ-Diabetic Rats

ABSTRACTPurpose: Diabetic retinopathy (DR) is characterized by increased oxidative and nitrosative stress, both of which lead to neurotoxicity and vascular permeability. Previous studies on a variety of organs indicate that hydrogen-rich saline not only has considerable antioxidant and anti-inflammatory properties, but also suppresses oxidative stress-induced injury. In the present study, we assessed the effects of hydrogen-rich saline on neurovascular dysfunction and oxidative stress in an animal model (rat) of DR.Materials and Methods: Male Sprague-Dawley rats with streptozotocin (STZ)-induced diabetes mellitus (DM) were injected intraperitoneally with 5 ml/kg hydrogen-saturated (experimental) or plain (control) saline daily for one month. Visual function and blood–retinal barrier (BRB) integrity were evaluated by electroretinography (ERG) and bovine serum albumin (BSA)-fluorescence, respectively. Histological changes in the inner retina were assessed by light microscopy. Biomarkers of oxidative stress, including 4-hydroxynonenal (4-HNE) and 8-hydroxy-2-deoxyguanosine (8-OH-dG), and antioxidant enzymes, including superoxide dismutase, glutathione peroxidase, glutathione reductase and glutathione transferase, were evaluated by ELISA. Synaptophysin and brain-derived neurotrophic factor (BDNF) levels were measured by immunoblotting.Results: STZ-diabetic rats were marked by clearly reduced b-wave amplitudes and oscillatory potentials, DM-related BRB breakdown and histological changes in the inner retina, all of which were suppressed following treatment with hydrogen-rich saline. Furthermore, hydrogen-rich saline reduced oxidative stress, increased antioxidant enzyme activities and preserved synaptophysin and BDNF levels in the diabetic rat retina.Conclusions: Based on its inhibition of oxidative stress and up-regulation of anti-oxidative enzymes, we conclude that hydrogen-rich saline is a potentially valuable therapeutic modality for the treatment of DR.

Effects of Red Ginseng Extract on the Epididymal Sperm Motility of Mice Exposed to Ethanol

The protective effects of red ginseng extract and ginseng wine against ethanol-induced male reproductive toxicity were evaluated in male mice using computer-assisted sperm analysis. Mice were divided into 4 groups of 10 and fed plain saline, 6 g/kg per d of ethanol in saline, red ginseng extract plus ethanol, or a fermented preparation of red ginseng extract daily for 5 weeks. We found that the average seminal vesicle weight was significantly lower in the ethanol-treated group compared to the control group, while those of the ginseng-treated groups tended to be higher than the ethanol-treated group. We found a significant decrease in sperm motility and progressiveness in mice treated with ethanol for 5 weeks, while administration of ethanol plus red ginseng extract appeared to minimize the negative effects of ethanol toxicity on male fertility. Serum testosterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH) were insignificantly lower in the ethanol-treated group than in the control group.

Effects of epidural clonidine and neostigmine following intrathecal labour analgesia: a randomised, double-blind, placebo-controlled trial

Background The limited duration of spinal labour analgesia combined with problems associated with maintenance of epidural analgesia, have prompted the search for combinations that could prolong spinal analgesia. A randomised, double-blind trial was carried out to test the hypotheses (a) that initial spinal labour analgesia is prolonged by administering clonidine and neostigmine epidurally whilst (b) the hourly local anaesthetic consumption is reduced. Methods Seventy labouring patients received spinal analgesia with ropivacaine and sufentanil. Fifteen minutes after spinal injection, 10 mL of study solution was administered epidurally. The study solution was plain saline or neostigmine 500 μg combined with clonidine 75 μg. Outcome parameters were duration of spinal analgesia, local anaesthetic consumption and number of patients delivering without additional epidural analgesia. Results Epidural clonidine and neostigmine significantly prolonged initial analgesia: 144 (105–163) min vs. 95 (70–120) min in the placebo group and reduced hourly ropivacaine consumption: 7.5 (3.0–11.9) mg vs. 12.7 (9.6–16.9) mg. More patients in the experimental group delivered before the first request for additional analgesia (9 vs. 2). Conclusion Epidural administration of neostigmine 500 μg and clonidine 75 μg, following the intrathecal injection of ropivacaine and sufentanil, prolongs analgesia and reduces hourly ropivacaine consumption.

Comparison of Lidocaine 1% and Normal Saline in Paracervical Anesthesia for Decreasing of Pain in Curettage

The objective of this study was to compare the efficiency oflidocaine with that of plain saline for paracervical pain relief during fractional curettage. The double-blind randomized clinical trial was performed on 150 patients presenting from 2004 to 2005 for curettage. The patients were assigned randomly in two groups to receive lidocaine 1% or normal saline. Number of patients at each group was 75 women. The pain intensity was assessed in four stages: (1) after speculum insertion, (2) during cervical dilatation, (3) during curettage and (4) 30 min after curettage completion. The pain intensity was graded as 0 to 100 according to the Likert Scale. The Mean +/- SD of pain intensity after speculum insertion, during dilatation, during curettage and 30 min after curettage in lidocaine group were 11.33 +/- 9.70, 24.93 +/- 15.36, 37.00 +/- 17.35, 6.47 +/- 6.42 and in normal saline group were 11.73 +/- 9.81, 28.20 +/- 13.19, 49.47 +/- 21.55 and 7.33 +/- 6.22, respectively. There was no significant difference between pain intensity after speculum insertion, during dilatation and during 30 min after curettage but there was a significant difference in pain intensity during curettage between lidocaine 1% group and normal saline group (p < 0.05). Normal saline is as effective as lidocaine 1% in low pain in curettage (distention of nerve capsule) but when increase pain in curettage (third time point), lidocaine 1% is more effective than normal saline. Nerve capsule distention is not the only factor for pain control in paracervical block and analgesic agent is still an important factor.