Regular Saline Research Articles

Pre-expanded Local Flaps: Optimal Choice for Repairing Defects Following Extensive Benign Tumor Resection in the Head and Face.

Treating extensive benign tumors of the head and face presents a longstanding challenge, necessitating efficacy at the lesion site, and postoperative esthetic considerations for the donor area. This study aims to explore the clinical outcomes of pre-expanded local flap reconstruction for extensive benign tumors of the head and face post resection. From March 2018 to March 2023, a total of 18 patients with extensive benign tumors of the head and face were admitted, including 13 cases of nevus, 2 cases of hemangioma, 2 cases of neurofibroma, and 1 case of verruca. Based on the location and size of the lesions, suitable local areas were selected for tissue expansion, and expanders were implanted for regular saline injections over 8 to 16 weeks. After reaching the desired expansion, resection of the head and facial tumors and local flap reconstruction were performed. Postoperatively, data on patients' information, tumor types, tumor area, expansion volume, postexpander complications, vascular condition after flap transfer, and donor site condition were collected. In this series of 18 patients, benign tumors of the head and face were completely repaired through 1 to 2 stages of tissue expansion surgeries. Postimplantation complications included hematoma in 1 case and infections in 2 cases, with one instance of expander infection leading to surgical failure. However, all other patients achieved adequate expansion, successful flap survival post-transfer, and experienced no other complications. Follow-up over 6 to 24 months showed no recurrence at the lesion sites, with flaps maintaining consistent color, texture, and thickness matching surrounding skin tissue. In addition, donor site healing was excellent, with no obvious surgical scars. Pre-expanded local flap reconstruction is an ideal method for repairing extensive benign tumors of the head and face postresection.

Effects of In Ovo Administration of Freeze-Dried Royal Jelly on Hatchability, Blood Parameters, and Organ Weights of Day-Old Chicks.

Royal jelly renowned for its robust nutritional, functional, and biological properties, is a pivotal product derived from honeybees. The purpose of this investigation was to assess the theory that in ovo injection of freeze-dried royal jelly (FDRJ) solutions at varying concentrations can influence the hatchability, blood properties and hatching characteristics of day-old chicks. A total of 480 eggs (54.81 ± 0.187 g) were allocated into four experimental groups: negative control (NC), without injection, positive control (PC), administered with regular saline, a low FDRJ dose group (9 mg/egg), and a high FDRJ dose group (18 mg/egg). The in ovo injections were administered on Day 18 of incubation, and the experiment was subsequently continued until the incubation period concluded at 21 days. Results revealed that the lower FDRJ dose (9 mg/egg) significantly improved hatchability percentages compared to other treatments. Conversely, the higher FDRJ dose (18 mg/egg) and control groups (NC and PC) resulted in significantly higher chick yield percentages than the lower FDRJ and PC groups. The NC group showed the supreme yolk sac (YS) percentage, whereas the yolk-free body mass (YFBM) percentages displayed an inverse trend. Furthermore, the in ovo FDRJ injection did not affect haematological values or the relative organ weight of day-old chicks. In conclusion, in ovo FDRJ injection demonstrated beneficial effects on hatchability and chick weight, as evidenced by the studied parameters.

Probiotics, tetracycline fibres and chlorhexidine gel's effectiveness in treating chronic periodontitis as a supplement to scaling and root planning.

A periodontal pocket can result into progressive loss of attachment. Many agents are tried to improve periodontal health. Hence this research was done to estimate the effectiveness of Tetracycline fibers; Probiotics and Chlorhexidine gel as a conjunction to scaling and root planning (SRP) in the treatment of chronic periodontitis. In all, 60 patients between the ages of 25 and 35 who had generalized chronic periodontitis and had a probing pocket depth (PPD) of at least 5 mm were enrolled for this study. Four groups of 15 patients each were created from the patients: Group 1: Tetracycline fibres after SRP, Group 2: Chlorhexidine gel, Group 3: Probiotic mouthwash and Group 4: Rinse with regular saline. At baseline, oral prophylaxis was administered to all groups. Gingival index (GI), Plaque index (PI), and probing depth (PD), among other clinical indicators, were evaluated at baseline, two weeks, and four weeks, respectively. All clinical findings, along withPlaque index (PI), Gingival index (GI), and Probing depth at various time intervals, decreased statistically significantly. Tetracycline fibres, Chlorhexidine gel, and probiotic mouthwash are all similarly effective for treating chronic periodontitis, but they are all more effective than SRP alone, according to an intergroup comparison. When it comes to SRP, local medication delivery methods are beneficial in treating periodontitis.

The Protective Role of Nigela Sativa Volatile Oil on Antioxidant and Oxidative Stress Enzymes

Hepatotoxicity is the outcome of a paracetamol overdose.In this study, 40 adult male rats, weighing 180–260 gm and aged between 9 and 13 weeks, were given doses of Nigela sativa oil and their liver enzymes were examined to see how paracetamol affected them. The rats were kept in an environment at a temperature of 25 Co in an animal house. ,There were four groups of rats, and food was provided for them. (G). (G1) The only injections given to the control group are food and regular saline (0.9% of the time). (G2) 200 mg/kg of N. sativa and (G3) 400 mg/kg of paracetamol Addition of 400 mg/kg body weight of paracetamol. supplying 300 mg/kg B.W. of N. sativa to (G4)400 milligrams/kg B.W. of aspirin. Rat G2, GPT 87.80 IUL, and GOT hepatic enzyme concentration (129.32 IUL) all exhibit significant increases in comparison to the control. Furthermore, the levels of the liver GSH enzyme in rats (G2 )1.24 IUL shown a substantial increase, whereas G3 ( GOT ) 91.9 IUL, (GPT )76.70 IUL, and group (G4) GOT 109.88 IUL and enzyme (GPT ) 55.66 IUL exhibited significant declines as compared with control. While MDA enzyme in rats G2 (0.259 IUL) shows a major increase in comparison to the control, rats G3 (0.139 IUL) and G4 (0.112) show a noticeable decrease in comparison to G2. While body weight indicates that G2's outcomes are significantly lower than those of the other three groups. Groups G3 (2.55 gm) and G4 (2.7 gm) demonstrated a significant rise in liver weight compared to controls and G2, whereas groups G2 (24.23 gm) demonstrated a significant increase in liver weight compared to controls and group G2. Male rats in groups G2 (1.7 gm) demonstrated a significant drop in liver weight compared to controls.

A simplified herbal decoction attenuates myocardial infarction by regulating macrophage metabolic reprogramming and phenotypic differentiation via modulation of the HIF-1α/PDK1 axis

BackgroundMyocardial infarction (MI) poses a global public health challenge, often associated with elevated mortality rates and a grim prognosis. A crucial aspect of the inflammatory injury and healing process post-MI involves the dynamic differentiation of macrophages. A promising strategy to alleviate myocardial damage after MI is by modulating the inflammatory response and orchestrating the shift from pro-inflammatory (M1) to anti-inflammatory (M2) macrophages, aiming to achieve a reduced M1/M2 ratio. Nuanxinkang (NXK), a simplified herbal decoction, has demonstrated noteworthy cardioprotective, inflammation-regulating, and myocardial energy metabolism-regulating properties.MethodsIn this study, we constructed an MI model by ligating coronary arteries to investigate the efficacy of NXK in improving ventricular remodeling and cardiac function. Mice were administered NXK (1.65 g/kg/d) or an equivalent volume of regular saline via gavage for 28 consecutive days, commencing the day after surgery. Then, we conducted echocardiography to assess the cardiac function, Masson staining to illustrate the extent of myocardial fibrosis, TUNEL staining to reveal myocardial apoptosis, and flow cytometry to analyze the polarization of M1 and M2 macrophages in the hearts. Besides, a lipopolysaccharide (LPS)-induced pro-inflammatory macrophage (M1) polarization model was implemented in RAW264.7 cells to elucidate the underlying mechanism of NXK in regulating macrophage polarization. RAW264.7 cells were pre-treated with or without NXK-containing serum. Oxidative stress was detected by MitoSox staining, followed by Seahorse energy metabolism assay to evaluate alterations in mitochondrial metabolic patterns and ATP production. Both In vivo and in vitro, HIF-1α and PDK1 were detected by fluorescent quantitative PCR and Western blotting.ResultsIn vivo, MI mice exhibited a decline in cardiac function, adverse ventricular remodeling, and an increase in glycolysis, coupled with M1-dominant polarization mediated by the HIF-1α/PDK1 axis. Notably, robust responses were evident with high-dose NXK treatment (1.65 g/kg/day), leading to a significant enhancement in cardiac function, inhibition of cardiac remodeling, and partial suppression of macrophage glycolysis and the inflammatory phenotype in MI mice. This effect was achieved through the modulation of the HIF-1α/PDK1 axis. In vitro, elevated levels of mitochondrial ROS production and glycolysis were observed in LPS-induced macrophages. Conversely, treatment with NXK notably reduced the oxidative stress damage induced by LPS and enhanced oxidative phosphorylation (OXPHOS). Furthermore, NXK demonstrated the ability to modify the energy metabolism and inflammatory characteristics of macrophages by modulating the HIF-1α/PDK1 axis. The influence of NXK on this axis was partially counteracted by the HIF-1α agonist DMOG. And NXK downregulated PDK1 expression, curtailed glycolysis, and reversed LPS-induced M1 polarization in macrophages, similar to the PDK1 inhibitor DCA.ConclusionIn conclusion, NXK protects against MI-induced cardiac remodeling by inducing metabolic reprogramming and phenotypic differentiation of macrophages, achieved through the modulation of the HIF-1α/PDK1 axis. This provides a novel and promising strategy for the treatment of MI.

Deviation of Root Canal Curvature Using Three Types of Rotary Instruments: An In Vitro Study

One of the essential requirements for a successful endodontic treatment is efficient cleaning and shaping. Since its introduction, the nickel-titanium rotary system has gained popularity due to its elasticity and suppleness in the creation of curved root canals. To assess the deviation in root canal curvature in severely curved root canals following three different rotary file system preparations. Thirty-six human permanent mandibular first molars were chosen and stored in regular saline after being newly extracted with the curve mesial root. To standardize length at 13 mm, the mesial roots were separated from the tooth and the crown was removed. The three groups of teeth were A, B, and C. Groups A, B, and C were equipped with rotary variable taper instruments, reciprocating variable taper instruments, and rotary constant taper control memory instruments, respectively, in their mesio buccal canals. The instruments were never pressed apically; instead, they were employed in the canal with a constant, gentle passive movement. With frequent and copious irrigation using 5.25% sodium hypochlorite solution and 17% ethylene diamine tetra acetic acid, all canals were shaped and cleansed. To assess the curvature deviation, periapical radiographs were taken both before and after preparation. By using the Schneider method to measure the pre- and post-instrument canal curvatures, the deviation was found. The Wilcoxon test was employed for numerous pairwise comparisons across distinct groups, and the Kruskal-Wallis test was used to conduct statistical analysis among three groups. The p-value of less than 0.05 was deemed statistically significant. Compared to groups A and B, group C had the least variation of canal curvature. The current study concludes that a 4% rotating constant taper control memory instrument works better than a rotary variable taper instrument or a reciprocating variable taper instrument for shaping a curved canal.

Effect of silver colloid dressing over conventional dressings in diabetic foot ulcer: A prospective study.

Topical silver treatments and silver dressings are increasingly being utilized for the local treatment of wounds; nevertheless, the evidence for their usefulness is unclear. The aim of this study was to investigate the impact of conventional dressings and silver colloid dressing on diabetic foot ulcers (DFU) with and without compression therapy. This prospective, double-blind experiment included 50 patients with non-ischemic DFUs, split into two groups of 25 patients each. The study was conducted for a period of six months. The primary endpoint was to evaluate the entire epithelialization (total healing) of all ulcers on the study leg. The ulcer area significantly decreased in the colloidal silver group (67.77 ± 17.82%) compared to the conventional saline group (21.70 ± 23.52%). When compared to the conventional group, the colloidal silver group required considerably fewer days to reach the endpoint (23.15 ± 8.15 days vs. 48.35 ± 18.07 days), and by day 14, ulcer area reduction (from 100%) was greater (48% in the silver group vs. 89.69% in the conventional group). In managing DFUs, unstructured hydrogel wound dressings using silver colloids based on ionic silver are more effective than regular saline dressings since they heal wounds more quickly in fewer days while also drastically reducing ulcer areas over time.

Treatment with Umbilical Cord Blood Platelet Lysate Gel Improves Healing of Diabetic Foot Ulcer.

This study was conducted to examine the hypothesis that umbilical cord blood platelet lysate (UCB-PL) gel has a significant impact on the healing rate of DFU. Μethods: In this open-labeled, randomized controlled trial, 110 patients were randomized to treatment with UCB-PL gel (UCB-PL group, n = 52) every three days for one month or dressing with normal saline (control group, n = 58). All participants were followed up for 20 weeks post treatment. Ulcer surface area was assessed with the imitoMeasure application at two, four, and six weeks, and two, four and six months. This study's main outcome was the reduction in ulcer size over the six-month study period. The mean ulcer area at baseline was 4.1 cm2 in the UCB-PL group and 1.7 cm2 in the control group. At six months post treatment, patients on the UCB-PL treatment displayed a significant reduction in ulcer size compared to baseline 0.12 (0-8.16) in contrast to a more modest change in the control group 1.05 (0-24.7). The ulcer area was decreased at the end of the study in 40 patients (97.6%) in the UCB-PL group and 27 (73%) in the control group (Fisher's p = 0.002). The application of UCB-PL gel in DFU resulted in a significant reduction in ulcer size compared to regular saline dressing.

Effects of Thymoquinone Nanoparticles on Paracetamol-Induced Nephrotoxicity by Mitigating Oxidative Stress and Inflammation in Rats

Abstract A common and efficient analgesic-antipyretic medication for a variety of syndromes is paracetamol (PAR). The use of PAR was associated with acute kidney injury and other side effects, and its hazardous effects were influenced by oxidative stress and inflammation. Black seed oil’s primary active ingredient, thymoquinone (TQ), has anti-inflammatory, immunomodulatory, and antioxidant properties. A few animal models for drug-induced nephrotoxicity described promising outcomes of its renoprotective action. The main goal of this work was to evaluate TQ nanoparticles’ (TQNP) powerful renoprotective properties in a rat model of nephrotoxicity caused by PAR. Three groups of eight rats each were assigned; group one (the control group, CON) was given gavaged normal saline. Group 2 (PAR group, PAR) received 600 mg/kg of gavaged PAR diluted in regular saline. One hour after PAR delivery, group 3 (the TQNP group) received TQNP 0.5 mg/kg via oral administration. In rat kidney tissues, PAR resulted in renal damage, a rise in blood urea nitrogen (BUN), creatinine, cystatin C (CYC), myeloperoxidase, protein carbonyl (PC), malondialdehyde (MDA), and a decrease in nitric oxide and cellular antioxidants. In rats given PAR, TQNP effectively reduced renal damage, lowered serum levels of creatinine, BUN, and CYC, and improved oxidative stress (MDA, MYO, and PC) and inflammatory markers (TNFα and IFN-γ). TQNP treatment resulted in modestly dilated/congested blood vessels in the renal tissues of PAR. The TQNP’s renoprotective action is an effective preventative against PAR-induced nephrotoxicity, primarily by enhancing cellular defense mechanisms and reducing inflammatory and oxidative indicators in a rat model. However, additional research and clinical trials should be needed for testing in future studies.

Evaluation bone healing agents: radiological presentative on lidocaine and diclofenac in rabbits

This study aimed to assess the impact of intraosseous injections of 2% lidocaine hydrochloride and 3.75% Diclofenac on bone regeneration. Forty-five adult male rabbits of a local breed were used to create a 3.5mm hole in the proximal third of the medial aspect of the tibia using an electric drill, with continuous isotonic regular saline irrigation to prevent thermal necrosis. The rabbits were randomly divided into three groups of fifteen each (n=15): a control group without any treatment, Group 1 (Lidocaine HCl), which received a daily dose of 2% lidocaine HCl (2 mg/kg body weight) for five days post-operation (P.O.), and Group 2 (Diclofenac), which received 3.75% Diclofenac (20 mg/kg body weight). Radiographic evaluations were conducted at the end of the 7th, 14th, and 21st days P.O. The findings demonstrated accelerated bone regeneration and development in Group 1 compared to Group 2 and the control group. In conclusion, intraosseous injection of 2% Lidocaine HCl (2mg/kg B.W.) showed a stimulatory effect on bone healing, with osteogenic tissue and trabecular bone formation being visible in radiographic images at the end of the first week, indicating a more effective outcome compared to the Diclofenac and control groups.

The effectiveness of different immunotherapies in the treatment of condyloma acuminatum: a network meta-analysis of randomized clinical trials.

The treatment of condyloma acuminatum (CA), especially the very persistent and recurrent CA, is currently the focus of our research. Immunotherapies have recently been shown to be well-tolerated and effective in treating warts, particularly refractory warts. However, there is still a lack of corresponding evidence-based medical evidence on the effectiveness of different immunotherapies in treating warts. The difference between network meta-analysis and meta-analysis is that network meta-analysis can be used to compare multiple treatments by combining direct and indirect evidence to assess the interrelationship between all treatments. We intend to compare the efficacy of different treatments for CA using a network meta-analysis. PubMed, Cochrane Library and Embase from inception to June 1st, 2023 were searched using a computer. All articles on immunotherapies for CA were included. Stata MP17.0 software was used for data analyses. A total of 8 randomly-controlled trials involving 493 patients were included. Result showed that all treatment measures had a significant efficacy compared with the regular saline group (BCG (bacillus Calmette-Guérin vaccine) OR = 96.00, 95%CI: 10.35-890.58; MMR (measle, mumps and rubella vaccine) OR = 29.69, 95%CI: 7.47-118.04; Candida antigens OR = 27.34, 95%CI: 8.64-86.52; PPDs (purified protein derivatives) OR = 23.33, 95%CI: 6.75-80.60; VD3 OR = 21.36, 95%CI: 4.34-105.16 and purified protein derivatives (general) OR = 13.14, 95%CI: 3.38-51.12). The area under the curve (SUCRA) ranking results showed that the bacillus Calmette-Guérin vaccine had the highest total efficiency, which was 88.2%, with the rest in the order of measle, mumps and rubella vaccine, which was 68.9%, Candida antigens, which was 63.6%, purified protein derivatives, which was 52.9%, vitamin D3, which was 49.0%, purified protein derivatives (general), which was 27.4%, and saline, which was 0%. In summary, we found that the bacillus Calmette-Guérin vaccine was superior to other treatments in terms of efficacy according to the SUCRA value.

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.

Microbiological Detection of Pathogenic Bacteria in Diabetic Foot Ulcers of Type 1 and 2 Diabetic Mellitus Patients

Globally, diabetes mellitus (DM) is a serious health issue. Diabetic neuropathy, the most prevalent micro-vascular consequence of diabetes, raises the chance of developing foot ulcers. Different aerobic bacteria, including Gram positive cocci, Staphylococcus aureus, and (beta-haemolytic) Streptococcus are some of the pathogens that can colonize DFUs. Coagulation-negative Staphylococcus (CNS), Corynebacterium, Enterococcus, and Cutibacteria are frequently found in ulcer cultures in clinical practice; however they are typically regarded as colonizing rather than harmful bacteria. Anaerobes are detected in a smaller minority of DFIs and have been associated to altered innate and adaptive immune responses in the hyperglycemic milieu. Gram-negative bacteria account for about one third of DFIs. About 70 participants in all, including 29 individuals with type 1 diabetes and 41 patients with type 2 diabetes who have diabetic foot ulcers. Scarping of ulcers takes place after regular saline wound cleansing to eliminate surface pollutants, and then exudate is sampled. Pus, or discharges from the base of the ulcer, are then submitted to the laboratory as quickly as possible using an aseptic approach. Then, the bacteria were inoculated onto various culture media, such as MacConkey and Blood agar as enrichment media, and incubated aerobically at 37°C for 24 hours to isolate aerobic bacteria. The following day, the bacteria were checked for growth, and a pure colony was then prepared. According to morphological, microscopic, and particular cards of the automated VITEK2 system, isolated bacteria were identified.

Pros and Cons of Air-Dried and Conventional Wet-Fixed Pap Smears: An Institutional Study

Introduction: Wet-fixed smear study routinely used to identify several pre-cancerous and cancerous tumours. By contrasting cellular preservation and staining quality in rehydration smears with wet-fixed smears, the current study aims to establish the effects of rehydration on air-dried smears. Materials and Methods: One hundred paired samples are compared. Wet fixing was done in the first place. Air-dried samples are rehydrated for 30 s with regular saline and then placed in 95% ethanol for 30 min. Both smears will undergo screening, evaluation and grading for numerous cytomorphological factors after Pap staining. The 2014 Bethesda system was used to report the cervical smear results. Results: When evaluated for numerous cellular properties, statistically significant similarities can be seen between two groups, one with wet-fixed smears and the other with rehydrated air-dried smears. The results of the cytological diagnosis comparison between the two groups can be shown in the agreement. Rehydrated air-dried smear interpretation and staining quality are significantly superior to traditional wet smears. Conclusions: Rehydration air-dried techniques can be used instead of traditional wet fixation methods and are as effective when used alone or with traditional wet-fixed smears.

Plum-blossom needle tapping enhances the efficacy of ALA photodynamic therapy for facial actinic keratosis in Chinese population: a randomized, multicenter, prospective, and observer-blind study

BackgroundPhotodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) is a reliable treatment for actinic keratosis (AK), but its effect needs to be enhanced in thick lesions. Plum-blossom needle is a traditional Chinese cost-effective instrument for enhancing the transdermal delivery of ALA. However, whether it could improve the efficacy of AK treatment has not yet been investigated. ObjectiveTo compare the efficacy and safety of plum-blossom needle–assisted PDT in facial AK in the Chinese population. MethodsIn this multicenter, prospective study, a total of 142 patients with AKs (grades I–III) were randomized into the plum-blossom needle–assisted PDT group (P-PDT) and control PDT group (C-PDT). In the P-PDT group, each AK lesion was tapped vertically by a plum-blossom needle before the application of 10% ALA cream. In the C-PDT group, each lesion was only wiped with regular saline before ALA cream incubation. Then, 3 hours later, all the lesions were irradiated with light-emitting diode (LED) at a wavelength of 630 nm. PDT was performed once every 2 weeks until all lesion patients achieved complete remission or completed six sessions. The efficacy (lesion response) and safety (pain scale and adverse events) in both groups were evaluated before each treatment and at every follow-up visit at 3-month intervals until 12 months. ResultsIn the P-PDT and C-PDT groups, the clearance rates for all AK lesions after the first treatment were 57.9% and 48.0%, respectively (P < 0.05). For grade I AK lesions, the clearance rates were 56.5% and 50.4%, respectively (P = 0.34). For grade II AK lesions, the clearance rates were 58.0% and 48.9%, respectively (P = 0.1). For grade III AK lesions, the clearance rates were 59.0% and 44.2%, respectively (P < 0.05). Moreover, grade III AK lesions in the P-PDT group required fewer treatment sessions (P < 0.05). There was no significant difference in the pain score between the two groups (P = 0.752). ConclusionPlum-blossom needle tapping may enhance the efficacy of ALA-PDT by facilitating ALA delivery in the treatment of AK.

Paper 16: The Use of Intravenous Tranexamic Acid Does Not Improve Arthroscopic Visualization in Shoulder Surgery: A Randomized Controlled Trial

Objectives: Adequate visual clarity is paramount to performing arthroscopic shoulder surgery safely, efficiently, and effectively. The addition of epinephrine in irrigation fluid, and the intravenous or local administration of tranexamic acid (TXA) have independently been reported to decrease bleeding thereby improving the surgeon’s visualization during arthroscopic shoulder procedures. No study has compared the effect of systemic administered TXA, epinephrine added in the irrigation fluid or the combination of both TXA and epinephrine on visual clarity during shoulder arthroscopy with a placebo group. The purpose of this study is to determine if intravenous TXA is an effective alternative to epinephrine delivered by a pressure-controlled pump in improving arthroscopic shoulder visualization during arthroscopic procedures and whether using both TXA and epinephrine together has an additive effect in improving visualization. Methods: The design of the study was a double-blinded, randomized controlled trial with four 1:1:1:1 parallel groups conducted at one center. Patients aged ≥18 years undergoing arthroscopic shoulder procedures including rotator cuff repair, arthroscopic biceps tenotomy/tenodesis, distal clavicle excision, subacromial decompression and labral repair by five fellowship-trained upper extremity surgeons were randomized into one of four arms: Pressure pump-controlled regular saline irrigation fluid (control), epinephrine (1ml of 1:1000) mixed in irrigation fluid (EPI), 1g intravenous TXA (TXA), and epinephrine and TXA (EPI/TXA). Visualization was rated on a 4-point Likert scale every 15 minutes with 0 indicating ‘poor’ quality and 3 indicating ‘excellent’ quality. The primary outcome measure was the unweighted mean of these ratings. Secondary outcomes included mean arterial blood pressure (MAP), surgery duration, surgery complexity, and adverse events within the first postoperative week. Unweighted means (SD) were calculated for visualization and mean arterial pressure (MAP) for each patient. Study group allocation was represented with epinephrine and tranexamic acid being coded in dichotomous variables (used or not used) for each patient. A step-wise linear regression was performed using visualization as the dependent variable and a series of independent variables considered for inclusion: epinephrine, tranexamic acid, surgery duration, complexity, mean arterial pressure, increase in pump pressure, and volume of irrigation fluid. All statistical tests were considered significant if p&lt;0.05. Results: One-hundred and twenty-eight participants with a mean age (± SD) of 56 (± 11) years were randomized. Figure 1 presents the patient flow through the study. Mean visualization quality for the control, TXA, EPI, and EPI/TXA groups were 2.1 (±0.40), 2.1 (±0.52), 2.6 (±0.37), 2.6 (±0.35), respectively. In a regression model with visual quality as the dependent variable, the presence/absence of EPI was the most significant predictor of visualization quality (R=0.525; p&lt;0.001). TXA presence/absence had no effect, and there was no interaction between TXA and EPI. The addition of MAP and surgery duration strengthened the model (R=0.529; p&lt;0.001). Increased MAP and surgery duration were both associated with decreased visualization quality. When surgery duration was controlled, surgery complexity was not a significant predictor of visualization quality. No adverse events were recorded in any of the groups. Conclusions: Intravenous administration of TXA is not an effective alternative to epinephrine in the irrigation fluid to improve visualization during routine arthroscopic shoulder surgeries although its application is safe. There is no additional improvement in visualization when TXA is used in combination with epinephrine beyond the effect of epinephrine alone. [Figure: see text]

Evaluation of hazards of electronic -cigarette’s liquid refill on testes of mice, complemented by histopathological and chromatographic analysis

ABSTRACT Electronic-cigarettes (e-cigarettes) are devices designed to become an alternative to classic cigarettes. Vaping of e-cigarettes and their recharge liquid have become extremely popular among the adolescents; however, its safety is not well established. Evaluation of the components of e-cigarette liquid and their potential effects on testis of adult male mice. This aim will be fulfilled by histological, ultrastructural, and immunohistochemical analysis of mice testis biopsies. Twenty mice were allocated into two groups of equal size. The control group was given regular saline, whereas the treated group was given e-liquid (contains 3 mg of nicotine/kg of body weight) both groups daily intraperitoneally injected for 3 weeks. Analysis of e-liquid by Gas Chromatography-Mass Spectrometric GC/MS demonstrated nicotine, phenol, vanillin, aldehydes, and pyrethroid insecticide. Evaluation of oxidative stress parameters revealed significant reduction of SOD and GPx. Histological results revealed a significant reduction in the height of seminiferous tubules, sloughing of spermatogenic cells, most cells being dark and pyknotic, and thickening of the interstitium with accumulation of PAS positive exudate. Most spermatogenic cells showed degenerative changes as rarefied cytoplasm, ill-defined electron-dense nuclei, and elongated spermatid showed deformity of ectoplasmic specialization. Immunohistochemical studies revealed a significant increase in caspase-3 positive cells and a significant reduction of area % of E-cadherin. The analysis of an available E-liquid demonstrated potentially harmful chemicals that are not shown in the labeling of the product. E-liquid appears to impair anti-oxidant defense and cause degenerative changes in the body and disruption of blood testes barrier BTB. So, e-cigarettes cannot be regarded as a non-harmful smoking replacement.

An In-Vitro Analysis of Root Fracture Strength Using Single File Systems.

Aim Root canal obturation during endodontic therapy supports the root canal space and helps the extra tooth structure resist fracture.Some believe endodontic-treated teeth are more likely to break than natural teeth. The most common causes of tooth decay are endodontic treatment's extensive tooth structure loss and coronal and radicular dentin drying. Materials and methods Two hundred removed human permanent mandibular first molars were allowed to be stored in isotonic saline solution for a maximum of 72 hours. The collection, storing, sterilizing, and handling of the samples were done per the Occupational Safety and Health Administration (OSHA) and Centers for Disease Control and Prevention(CDC)guidelines. Out of a total of 200 newly removed mandibular first molars, 120 teethwere finally gathered, sterilized, and kept in 1% thymol in normal saline at 30 degrees Celsius. The access cavity was prepared, and the pulp chamber was cleaned and debridedusing an ultrasonic scaler tip while being irrigated with regular saline. A digital radiograph was taken after a 6# K file was placed to the working length in the mesiobuccal canal.Based on their weights, the samples were dispersed equally across the sixgroups (n=20). They looked inside them to ensure that the root morphology was normal and that the canal was open and free of any abnormalities, damage, or fillings. They looked at the curvature of the mesial root and chose samples with a curvature of 20-35 degrees. The mesial roots were dissected, labeled, and put in a different location. Results Overall, the experimental group'sincidence of buccolingual fractures was 55%, making it the most prevalent fracture type. The mesiodistal type of fracture had a 35% incidence rate, which was the second most prevalent. We found that comminuted and transverse fractures occurred in only 15% and 5% of patients, respectively, of all fractures.Both the test and the control groups had a disproportionately high number of buccolingual fractures. When comparing the root fracture loads of the two experimental groups, there was no significant difference (p>0.05) Conclusion Within this study's restrictions and standardization techniques, it can be concluded that the single file system-prepared roots' resistance to fracture was comparable to that of the control group. It is recommended to conduct additional research on these single file systems using different metrics and to assess them in a clinical setting.

Hesperetin-loaded polymeric nanofibers: assessment of bioavailability and neuroprotective effect

Objective The purpose of the study is to assess the bioavailability and neuroprotective effect of hesperetin (Hesp)-loaded nanofibers. Methods Electrospinning was used to create and characterize polyvinyl pyrrolidone-based Hesp-loaded nanofibers. To evaluate the produced nanofibers, preclinical studies were conducted. The study involved five groups of Wistar rats, and the treatments were administered as follows. Group 1 (control) was given regular saline for 14 d. On the 14th day, Group 2 was given scopolamine. Group 3 was given donepezil for 14 d and then scopolamine on the 14th. Group 4 was given Hesp for 14 d and then scopolamine on the 14th. Group 5 was given Hesp-loaded nanofibers for 14 d, followed by scopolamine on the 14th. On the 14th day, rats’ memory was tested using Cook’s pole climbing apparatus and the Morris water maze (MWM). On the 15th day, rats from each group were slaughtered, brain tissues were separated, and biochemical and histological analyses were performed. In addition, in vitro dissolution experiments and pharmacokinetic studies were carried out. Results When compared to the control group, scopolamine-treated rats had considerably longer escape latency times, as well as increased acetylcholinesterase (AChE) activity, lipid peroxidation, degeneration, and inflammation in the hippocampus. These parameters were greatly recovered by donepezil and Hesp-loaded nanofibers that had been pretreated. Because of the greatly improved bioavailability of Hesp, the Hesp-loaded nanofibers significantly protected rats from scopolamine-induced amnesia. Conclusions Hesp-loaded nanofibers have an excellent neuroprotective effect against scopolamine-induced amnesia due to enhanced bioavailability.

Low-concentration Povidone-iodine and Normal Saline as Irrigant on Reducing Postoperative Complications after the Third-molar Surgery: A Comparative Study

This study was conducted to compare the efficacy of using 0.5 mg/mL povidone-iodine solution as an irrigant and coolant in reducing postoperative sequelae like swelling, trismus, and pain with the conventional normal saline irrigation during the surgical removal of the impacted lower third molar. The research was conducted out toward the MES Dental College in Perinthalmanna, Kerala, in the Department of Oral and Maxillofacial Surgery. After mandibular third-molar surgical removal, researchers studied 60 individuals, 30 of whom had normal saline irrigation (group I), and 30 of whom received 0.05% povidone-iodine irrigation (group II). The postoperative discomforts were measured on the second and seventh days after surgery, respectively. After that, the data were analyzed using SPSS. The data analysis considered p-values less than 0.05 to be significant. At the second postoperative visit, patients in the povidone-iodine group reported much less pain, swelling, and reduced mouth opening than those in the normal saline group. But on the seventh postoperative day, there was not much difference between either group. Following the surgical removal of teeth, it was revealed that povidone-iodine solution (0.5 mg/mL) was more effective as irrigation and cooling aid than regular saline solution. Low-concentrated povidone-iodine is a better option in dentistry as irrigant.