Standard Saline Research Articles

Efficacy of Endodontic Cryotherapy in Alleviating Post-Treatment Pain after Single-Visit RCT: A Randomized Study

ABSTRACT Aim: This study aims to assess whether endodontic cryotherapy can effectively lower discomfort after a single root canal visit. Material and Method: Thirty-six patients aged 18–32 years requiring single-visit root canal treatment (RCT) were divided into three groups at random, with twelve people in each: group 1 (control group), group 2 (normal saline), and group 3 (cold saline). After root canal therapy was finished, group 1 got no further treatment, group 2 got standard saline irrigation at room temperature, and group 3 got cold saline irrigation at 35.6–41°F. A visual analog scale (VAS) was used to measure pain after 6, 12, 24, and 48 hours after therapy. Result: Preliminary results indicated a marked reduction in pain in group 3 relative to groups 1 and 2 at 6, 12, and 24 hours post-treatment (P < 0.05). At 48 hours, pain levels had significantly diminished across all groups, with group 3 consistently exhibiting the lowest VAS scores. Conclusion: Endodontic cryotherapy using cold saline irrigation shows significant efficacy in reducing post-treatment pain after single-visit RCT when compared to normal saline and no additional intervention. These findings suggest that integrating cryotherapy could be a valuable adjunct in endodontic pain management.

Impedance-Modified Injection Solutions in Endoscopic Removal of Gastrointestinal Lesions: A Randomized Controlled Trial

Background: The efficiency of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) is related to the electrical impedance of the injection solutions. It is therefore possible to postulate that improving impedance may enhance resection rates while minimizing the risks. Objective: To assess the effectiveness and the side effects of impedance-modified injection solutions in the endoscopic resection of gastrointestinal lesions. Methods: This study was a randomized controlled trial of patients with gastrointestinal lesions greater than 20mm in size The patients were randomly assigned to receive standard saline solution or an impedance-modified injection solution during EMR/ESD. The first end-point of the study was the en-bloc resection rate. Other related measures were procedure duration, complication profiles, and histological characteristics. Data were analyzed using SPSS version 27.0 and statistical significance was set at p≤0.05. Results: The impedance-modified group had a statistically higher en-bloc resection rate as compared to the standard saline group at 85 percent against 65 percent respectively, p<0.05 The procedure taking times were less in the impedance-modified group and complication rates are also less though not reaching the statistical difference. Conclusion: The enhancement of EMR/ESD by using impedance-modified injection solutions indicates new direction in endoscopic practice.

Decoupling Fluorous Protein Coatings Yield Heat-Stable and Intrinsically Sterile Bioformulations.

Thermal inactivation is a major bottleneck to the scalable production, storage, and transportation of protein-based reagents and therapies. Failures in temperature control both compromise protein bioactivity and increase the risk of microorganismal contamination. Herein, we report the rational design of fluorochemical additives that promiscuously bind to and coat the surfaces of proteins to enable their stable dispersion within fluorous solvents. By replacing traditional aqueous liquids with fluorinated media, this strategy conformationally rigidifies proteins to preserve their structure and function at extreme temperatures (≥90 °C). We show that fluorous protein formulations resist contamination by bacterial, fungal, and viral pathogens, which require aqueous environments for survival, and display equivalent serum bioavailability to standard saline samples in animal models. Importantly, by designing dispersants that decouple from the protein surface in physiologic solutions, we deliver a fluorochemical formulation that does not alter the pharmacologic function or safety profile of the functionalized protein in vivo. As a result, this nonaqueous protein storage paradigm is poised to open technological opportunities in the design of shelf-stable protein reagents and biopharmaceuticals.

Roles of eyestalk in salinity acclimatization of mud crab (Scylla paramamosain) by transcriptomic analysis

Salinity acclimatization refers to the physiological and behavioral adjustments made by crustaceans to adapt to varying salinity environments. The eyestalk, a neuroendocrine organ in crustaceans, plays a crucial role in salinity acclimatization. To elucidate the molecular mechanisms underlying eyestalk involvement in mud crab (Scylla paramamosain) acclimatization, we employed RNA-seq technology to analyze transcriptomic changes in the eyestalk under low (5 ppt) and standard (23 ppt) salinity conditions. This analysis revealed 5431 differentially expressed genes (DEGs), with 2372 upregulated and 3059 downregulated. Notably, these DEGs were enriched in crucial biological pathways like metabolism, osmoregulation, and signal transduction. To validate the RNA-seq data, we further analyzed 15 DEGs of interest using qRT-PCR. Our results suggest a multifaceted role for the eyestalk: maintaining energy homeostasis, regulating hormone synthesis and release, PKA activity, and downstream signaling, and ensuring proper ion and osmotic balance. Furthermore, our findings indicate that the crustacean hyperglycemic hormone (CHH) may function as a key regulator, modulating carbonic anhydrase expression through the activation of the PKA signaling pathway, thereby influencing cellular osmoregulation, and associated metabolic processes. Overall, our study provides valuable insights into unraveling the molecular mechanisms of mud crab acclimatization to low salinity environments.

Histopathological Changes in a Rat Model of Diabetic Neuropathy

This study was done to investigate the histopathological Changes in a Rat Model of Diabetic Neuropathy. The 24 male rats used in this investigation were split into two groups of 12 animals. The first group (G1), which consisted of healthy individuals, was given standard saline. Normal saline was administered after G2 (STZ group) received STZ at a dosage of 60 mg/kg. After rats were starved overnight, a single intraperitoneal injection of 60 mg/kg of freshly produced STZ was given to induce diabetes. (0.1 M, pH 4.5) Sodium Citrate Buffer was used to dissolve STZ. On the third day after the injection of STZ, a digital glucometer was used to measure the blood glucose levels of 12-hour fasting rats; hyperglycemia was defined as values greater than 250 mg/dl. In order to assess neuropathic pain, cold allodynia was calculated by counting the number of times the foot withdrew in response to cold stimuli applied to the back of the hand. The sciatic nerve was carefully removed after the sacrifice (after 2 months) and preserved in 10% formalin for histopathological study. Normal blood glucose levels were maintained in the control rats throughout the study. However, G2 exhibited much greater FBG levels than healthy animals. In the 2-month study, the G2 maintained FBG levels above 250 mg/dl. The score for severity of STZ on sciatic nerves showed a significant difference between treated group as compared with G1. No paw reactions were seen when intact animals were subjected to plantar surface acetone. The experimental groups did not show any notable reactions to acetone on the tenth day after the diagnosis of diabetes. On days 20, 30, 40, 50 and 60 after diabetes confirmation, there were significant differences in paw withdrawal frequency between the G1 and G2 (p<0.001). Within the control group, nerve fibres were found to be regularly arranged and there was no evidence of axonal swelling. However, in the G2 group, nerve fibres were found to be significantly disorganised, and there was a notable increase in the number of Schwann cells in the sciatic nerves, suggesting damage, in comparison to the control group. In conclusion, potentially via antinociceptive, antihyperglycemic, antioxidant, and neuro-regeneration boosting pathways in STZ-induced diabetic peripheral disease.

Phloroglucinol ameliorated methylglyoxal induced harmful effects in rats.

Glycation is among the underlying mechanisms attributed to ageing and associated morbidities. There is no drug available to combat this deleterious phenomenon. The present study aimed to explore phloroglucinol (PHL) for its anti-glycation potential at preclinical level. The rats were treated with methylglyoxal (MGO, 17.25 mg/kg, i.p. for 14 days) to induce glvcative stress. The treatment groups received additional administration of test drug (PHL; 0.25mg/kg, 0.5mg/kg, and 1mg/kg) or standard aminoguanidine (AG, 50 mg/kg) or saline (control, 5ml/kg). During 14 days, the weight and food intake was noted. Afterwards, the cognitive function was evaluated using Morris Water Maze (MWM) while hepatic and renal functions were assessed through liver function test (bilirubin, alkaline phosphatase, SGPT, and SGOT) and creatinine respectively, using chemical analyzer. The carboxymethyllysine (CML) levels were quantified in the blood using ELISA technique. Histopathological study was performed on the brain, liver, and kidney using H&E staining. Additionally, the qPCR was used to quantify the expression of TNF-α, RAGE and BACE-1 (brain), RAGE, TNF-α, and glyoxalase-I (liver) and RAGE, TNF-α, and VEGF (kidney), while glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was used as a reference housekeeping gene. The data regarding weight and food intake did not reveal significant alterations. In MWM, the MGO treatment caused significant increase in the time to reach target quadrant, while decrease in the time spent in target quadrant and number of crossings through platform position. All these effects were inhibited by both AG and PHL. The navigation maps also exhibit that the retention of spatial memory. Additionally, the MGO-induced alteration in hepatic and renal function indicators was ameliorated by both AG and PHL treatments. The plasma CML levels were found to be elevated following MGO treatment, while the concomitant administration of AG and PHL has resisted this raise. Histopathological assessment revealed no specific pathology in liver kidney and brain tissues. The qPCR data revealed enhanced expression of all genes, especially TNF-α and BACE, which were found to be reduced following both AG and PHL treatments. PHL prevented the brain, hepatic, and renal impairments caused by MGO induced glycative stress. Hence, the PHL, a clinically used anti-spasmodic drug, presents itself as a potential candidate to be repurposed as anti-glycation drug.

The effectiveness of botulinum toxin injection for reducing hypertrophic scar after cleft lip surgery

Introduction: The most frequent complication after cleft lip surgery is HTS. This condition leads to lip asymmetry as the scar contracts, leading to a shortened lip and nasal deformity on the affected side, impaired speech development, and psychological stress. Botulinum toxin injection is known as HTS treatment. Therefore, this systematic review aims to postoperatively establish the physical outcome of cleft lip scar in patients injected with botulinum toxin. Method : The systematic review was conducted based on the PRISMA guidelines and PICO criteria. The experimental group was patients given botulinum toxin injections, and the control group was a placebo group. The results were based on the physical effects. This study was assessed with Cochrane risk-of-bias assessment tools. Five studies met the criteria. Results: Physical outcomes were significantly improved using the Vancouver Scar Scale criteria, while two studies explained no significant difference in the scar scale. The consistent results were from the scar width measurement. The experimental group's scar was narrower than that of the control group. Two studies added a visual analog scale with better results in the experimental groups. Compared with standard saline injection, botulinum toxin injection has a better outcome. This result was aligned with the results found in several previous studies. Conclusions: Botulinum toxin can promote wound healing pre or postoperatively and has narrower effects than in control groups. This study showed that overall physical outcome improved in botulinum injection for the cleft lip’s surgical scars. However, there is still a need for broader-scale studies on this topic for more reliable results.

Growing Salicornia europaea L. with Saline Hydroponic or Aquaculture Wastewater

Among halophyte plants, Salicornia species (also known as glasswort or sea asparagus) are increasingly grown in open fields and greenhouses for edible or non-edible purposes. Their salinity tolerance makes it possible to irrigate Salicornia plants with saline waters and even seawater, which cannot be used by other crop species. In this work, S. europaea (L.) was cultivated in pots under the typical climatic conditions of the fall season in the Mediterranean region and irrigated with non-saline standard nutrient solution (SNS) or saline wastewater discharged from a greenhouse semi-closed hydroponic (substrate) culture of tomato or a saltwater recirculating aquaculture system (RAS) with Gilthead sea bream (Spaurus aurata L., which was used as such or after dilution (50:50) with SNS. Plant growth was not significantly affected by the composition of irrigation water, while higher antioxidant capacity (measured using the DPPH assay) and concentration of photosynthetic pigments, phenols, flavonoids, and ascorbic acid were found in the shoots of SNS plants than in those of plants irrigated with wastewater. The level of lipid peroxidation and H2O2 production significantly increased in the SNS plants, which also showed higher activity of superoxide dismutase and lower activity of catalase. These results suggest that S. europaea can be cultivated using wastewater with moderate to high salinity discharged from greenhouse hydroponic crops or RASs, and that salt is not strictly required for the growth of this species. Using non-saline nutrient solution can result in moderate oxidative stress that improves the shoot quality of S. europaea.

Fatty acid production and associated gene pathways are altered by increased salinity and dimethyl sulfoxide treatments during cryopreservation of Symbiodinium pilosum (Symbiodiniaceae)

The Symbiodinium genus is ancestral among other Symbiodiniaceae lineages with species that are both symbiotic and free living. Changes in marine ecosystems threaten their existence and crucial ecological roles. Cryopreservation offers an avenue for their long-term storage for future habitat restoration after coral bleaching. In our previous study we demonstrated that high salinity treatments of Symbiodiniaceae isolates led to changes in their fatty acid (FA) profiles and higher cell viabilities after cryopreservation. In this study, we investigated the role of increased salinity on FA production and the genes involved in FA biosynthesis and degradation pathways during the cryopreservation of Symbiodinium pilosum. Overall, there was a twofold increase in mass of FAs produced by S. pilosum after being cultured in medium with increased salinity (54 parts per thousand; ppt). Dimethyl sulfoxide (Me2SO) led to a ninefold increase of FAs in standard salinity (SS) treatment, compared to a fivefold increase in increased salinity (IS) treatments. The mass of the FA classes returned to baseline during recovery. Transcriptomic analyses showed an acyl carrier protein gene was significantly upregulated after Me2SO treatment in the SS cultures. Cytochrome P450 reductase genes were significantly down regulated after Me2SO addition in SS treatment preventing FA degradation. These changes in the expression of FA biosynthesis and degradation genes contributed to more FAs in SS treated isolates. Understanding how increased salinity changes FA production and the roles of specific genes in regulating FA pathways will help improve current freezing protocols for Symbiodiniaceae and other marine microalgae.

Use of autologous platelet-rich plasma for skin graft preservation: an experimental comparative study.

In this experimental study, we aimed to determine whether platelet-rich plasma (PRP) is a suitable preservative for dermo-epidermal grafts. An additional objective was to investigate how long grafts can be stored without biological degradation. We compared pig skin graft preservation using PRP versus saline solution and crystalloid Custodiol®, which is used for hypothermic preservation of organs for transplantation. Grafts (10 × 10 mm) were placed on gauze impregnated with one of the tested solutions, and stored for 3, 7, 11, and 15 days at a constant temperature of 4°C. We evaluated a total of 240 pig skin samples: 120 by histopathology and 120 by fluorescence optical microscopy. Overall, Custodiol® solution appeared to be the best medium for preservation of dermo-epidermal grafts, with beneficial properties manifested on days 7 and 11. Although we expected PRP to be a better preservative than saline, this was not confirmed by our results, as we found no significant difference between these two media. In fact, by day 3, the histopathological results were better with standard saline solution than with PRP. On day 15, with each tested solution, some samples showed histological changes that are incompatible with graft viability. Overall, Custodiol® appears to be the best medium for dermo-epidermal graft preservation. Moreover, the present findings suggest a maximum graft storage time of 11 days in all of the tested solutions. We do not recommend using grafts stored for 15 days, due to isolated signs of graft biodegradation with all solutions.

Dietary taurine effect on intestinal barrier function, colonic microbiota and metabolites in weanling piglets induced by LPS.

Diarrhea in piglets is one of the most important diseases and a significant cause of death in piglets. Preliminary studies have confirmed that taurine reduces the rate and index of diarrhea in piglets induced by LPS. However, there is still a lack of relevant information on the specific target and mechanism of action of taurine. Therefore, we investigated the effects of taurine on the growth and barrier functions of the intestine, microbiota composition, and metabolite composition of piglets induced by LPS. Eighteen male weaned piglets were randomly divided into the CON group (basal diet + standard saline injection), LPS group (basal diet + LPS-intraperitoneal injection), and TAU + LPS group (basal diet + 0.3% taurine + LPS-intraperitoneal injection). The results show that taurine significantly increased the ADG and decreased the F/G (p < 0.05) compared with the group of CON. The group of TAU + LPS significantly improved colonic villous damage (p < 0.05). The expression of ZO-1, Occludin and Claudin-1 genes and proteins were markedly up-regulated (p < 0.05). Based on 16s rRNA sequencing analysis, the relative abundance of Lactobacilluscae and Firmicutes in the colon was significantly higher in the LPS + TAU group compared to the LPS group (p < 0.05). Four metabolites were significantly higher and one metabolite was significantly lower in the TAU + LPS group compared to the LPS group (p < 0.01). The above results show that LPS disrupts intestinal microorganisms and metabolites in weaned piglets and affects intestinal barrier function. Preventive addition of taurine enhances beneficial microbiota, modulates intestinal metabolites, and strengthens the intestinal mechanical barrier. Therefore, taurine can be used as a feed additive to prevent intestinal damage by regulating intestinal microorganisms and metabolites.

Some histological effects of Bisphenol-A on some reproductive organs in male adult rabbits (Oryctolagus cuniculus)

Bisphenol-A (BPA) is a broadly used substance in our environment. The current study was established to investigate the potentially toxic effects of BPA in the histology of adult male albino rabbits' reproductive organs. 45 adult male rabbits were subdivided into three groups. Group 1 orally received standard saline solution daily (proposed as a negative control); Group 2 received (0.5 ml/day) of olive oil orally daily (offered as a positive control); and the third Group, 3 rabbits, were treated orally with a dose of 25mg\Kg BW of the BP-A which dissolved in olive oil for 30 days. Tissue specimens from epididymis, testis, seminal vesicles and prostate were collected for histological examination. Blood samples were collected for serum hormone level evaluation. Results showed that BPA caused a significant decrease in testosterone, Luteinizing hormone, Follicle stimulating hormone, and a significant increase in estradiol and prolactin, along with some histopathological alterations in the epithelial and connective tissues of all the organs of studied animals. In conclusion, BPA induced hormonal disturbances in some hormones of the reproductive pituitary axis and histologic and toxic effects on the histology of all reproductive organs. Keywords: Bis-Phenol A; reproductive hormones; testis; epididymis; accessory sex glands; histology.

Identifying low salinity adaptation gene expression in the anterior and posterior gills of the mud crab (Scylla paramamosain) by transcriptomic analysis

In the present study, BGISEQ-500 RNA-Seq technology was adopted to investigate how Scylla paramamosain adapts to salinity tolerance at the molecular level and explores changes in gene expression linked to salinity adaptation following exposure to both low salinity (5 ‰) and standard salinity (23 ‰) conditions. A total of 1100 and 520 differentially expressed genes (DEGs) were identified in the anterior and posterior gills, respectively, and their corresponding expression patterns were visualized in volcano plots and a heatmap. Further analysis highlighted significant enrichment of well-established gene functional categories and signaling pathways, including those what associated with cellular stress response, ion transport, energy metabolism, amino acid metabolism, H2O transport, and physiological stress compensation. We also selected key DEGs within the anterior and posterior gills that encode pivotal stress adaptation and tolerance modulators, including AQP, ABCA1, HSP 10, A35, CAg, NKA, VPA, CAc, and SPS. Interestingly, A35 in the gills might regulate osmolality by binding CHH in response to low salinity stress or serve as a mechanism for energy compensation. Taken together, our findings elucidated the intricate molecular mechanism employed by S. paramamosain for salinity adaptation, which involved distinct gene expression patterns in the anterior and posterior gills. These findings provide the foothold for subsequent investigations into salinity-responsive candidate genes and contribute to a deeper understanding of S. paramamosain's adaptation mechanisms in low-salinity surroundings, which is crucial for the development of low-salinity species cultivation and the establishment of a robust culture model.

In-vitro Anthelmintic Potential of Leaf Extracts of Amaranthus tricolor Linn.

The present study was designed to investigate the anthelmintic potential of Amaranthus tricolor Linn plant of the Amaranthaceae family using acetone, ethyl acetate and ethanol as solvents. The extracts were screened for phytochemical constituents and evaluated for their vermicidal activity against adult Eisenia fetida earthworms. All the extracts contained phytochemicals, but comparatively. The acetone extract showed the presence of most of the phytochemicals, while ethanol extract contained fewer phytochemicals. Various concentrations (10–30 mg/mL) of each extract were studied in the bioassay, observing the time of paralysis and death of the earthworms. Albendazole was used as reference standard and normal saline as a control group. All extracts exhibited dose-dependent anthelmintic activity in both the parameters (paralysis and death) and were showing more potency than the standard drug. The acetone extract (30 mg/mL) exhibited the most promising activity, causing paralysis within 5 minutes and death of worms within 13 minutes. The result suggests that the acetone extract of A. tricolor Linn plant may be useful as an anthelmintic. In the present study, the traditional use of this leafy vegetable as vermicides was proved scientifically and suggests that A. tricolor Linn plant leaves are valuable source of active compounds possessing anthelmintic activity. The preliminary phytochemical evaluation suggests the strong presence of glycosidic and phenolic substances in acetone extract may be responsible for its exceptional vermicidal activity. A further investigation is sought to isolate and develop novel anthelmintic drug present in the plant. The data were verified as statistically significant using one-way ANOVA at 5 % significance level (p &lt; 0.05, n = 3).

Antibacterial Potential of Activated Carbon Impregnated with Garlic Extract

Contamination of water resources by pathogenic microorganisms is a major concern worldwide. As an example, hospitals generate effluents with a wide range of chemical and microbiological contaminants. These effluents are generally not treated beforehand due to the high costs and are, therefore, mixed with domestic effluents in regional treatment systems. Thus, actions to maintain water quality include the development of appropriate materials for its sustainable treatment. In this context, this study aims to develop natural antibacterial materials by impregnating aqueous and alcoholic extracts of garlic in activated babassu charcoal to reduce the microbial load of effluents. This material has been tested in a standard saline solution, which simulates the composition of hospital wastewater and allows bacteria to develop. The biomaterials were characterized by Scanning Electron Microscopy, pHPZC assays, Boehm’s method, and microbiological assays. Significant antibacterial activities were verified for the garlic extract-impregnated biomaterials; the activated carbon functionalized with HNO3 and impregnated with aqueous garlic extract inhibited 100% of E. coli growth. This result pointed to garlic extract associated with babassu activated carbon as a green alternative for the pre-treatment of complex effluents, such as hospital effluents.

The role of computed tomography in the detection of traumatic arthrotomies of the elbow: a cadaveric study

Abstract Purpose: To evaluate the use of computed tomography (CT) imaging as a diagnostic tool for elbow arthrotomies using a standardized cadaveric arthrotomy model. Method: Nineteen intact fresh frozen cadaver elbows were CT scanned using 2 mm cuts with sagittal and coronal reformats in the plane of the joint and used as controls. An elbow arthrotomy at the posterocentral arthroscopic portal site was performed in all specimens using a 4.5 millimeter trocar. After arthrotomy, all elbows underwent a second CT scan followed by a standard saline load test (SLT). Images were randomized and reviewed by 2 blinded, independent reviewers. Bimodal scoring was performed for each specimen with regard to the presence of an arthrotomy indicated by presence of air in the joint. Regarding the SLT, saline exiting the arthrotomy wound was considered a positive test. Results: CT scans were found to have 100% sensitivity and 86% specificity for diagnosing elbow arthrotomies. Interrater reliability calculated with Cohen kappa statistic was near perfect at r = 0.89. The SLT had a sensitivity of 79% when 20 mL was injected. A total of 25 mL of saline was required to be injected for a sensitivity greater than 95%. Conclusion: This study demonstrates that CT scan is a reliable and less technically demanding method of diagnosis arthrotomies with high interrater reliability and high sensitivity and with results comparable with SLT. This technique may be useful in centers where trained providers are not readily available to perform SLT. Clinical study is required to validate our results. Level of Evidence: Level II.

Randomized Clinical Trial to Evaluate the Efficacy and Tolerability of Nebulized Hyaluronic Acid and Xylitol Based Solution after Septoturbinoplasty.

Septoplasty and turbinate surgery are among the most frequent surgical procedures to improve nasal obstruction and quality of life. These procedures usually imply the presence of congestion, secretions, and crusting related to the movement of the instruments during surgery. However, the use of nasal lavage may reduce this situation. The addition of Hyaluronic acid or Xylitol offers advantages in these washes. This study was a randomized, double-blind, controlled trial. All patients underwent endoscopic septoplasty with inferior turbinate submucosal resection without posterior nasal packing. SNOT-22, main VAS, NOSE, Modified Lund-Kennedy endoscopic scale, number of crusts and adhesions were quantified before and on the day of the surgery, visit three (seven days), visit four (fourteen days), and visit five (twenty-eight days). Forty-seven patients completed the study, divided into a standard saline arm (group 1, 22 patients) and normal saline plus HA and Xylitol arm (group 2, 27 patients). Both treatment groups improved their quality of life and objective parameters during the four weeks of the study. All patients tolerated the nasal irrigations well, and none discontinued the treatments. The study concludes that nasal washes of Aluneb Isotónico® offer several benefits to patients as a protective and preventative agent.

Role of apoptosis and autophagy in mediating tramadol-induced neurodegeneration in the rat hippocampus.

Tramadol (TRA) is an analgesic prescribed for treating mild to moderate pains, the abuse of which has increased in recent years. Chronic tramadol consumption produces neurotoxicity, although the mechanisms are unclear. The present study investigated the involvement of apoptosis and autophagy signaling pathways and the mitochondrial system in TRA-induced neurotoxicity. Sixty adult male Wistar rats were divided into five groups that received standard saline or TRA in doses of 25, 50, 75, 100, or 150mg/kg intraperitoneally for 21 days. On the 22nd day, the Open Field Test (OFT) was conducted. Jun N-Terminal Kinase (JNK), B-cell lymphoma-2 (Bcl-2), Beclin1, and Bcl-2-like protein 4 (Bax) proteins and tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β) were measured in rat hippocampal tissue. TRA at doses 75, 100, and 150mg/kg caused locomotor dysfunction in rats and increased total and phosphorylated forms of JNK and Beclin-1, Bax, and Caspase-3. TRA at the three higher doses also increased the phosphorylated (inactive) form of Bcl-2 level while decreasing the unphosphorylated (active) form of Bcl-2. Similarly, the protein levels of TNF-α and IL-1β were increased dose-dependently. The mitochondrial respiratory chain enzymes were reduced at the three higher doses of TRA. TRA activated apoptosis and autophagy via modulation of TNF-α or IL-1β/JNK/Bcl-2/Beclin1 and Bcl-2/Bax signaling pathways and dysfunction of mitochondrial respiratory chain enzymes.

The Effectiveness of Liposome-Encapsulated Bupivacaine Compared to Standard Bupivacaine for Anesthesia of the Maxilla in Dogs.

Medical and surgical procedures involving the canine maxilla can be painful both during and for several hours post-procedure. The length of this pain may exceed the predicted duration of standard bupivacaine or lidocaine. The goal of this study was to determine the duration and efficacy of sensory blockade of the maxilla produced by liposome-encapsulated bupivacaine (LB), compared to standard bupivacaine (B) or saline (0.9% NaCl) (S), when administered as a modified maxillary nerve block in dogs. Eight maxillae were studied bilaterally from 4 healthy dogs of the same breed and similar age. This prospective, randomized, crossover, blinded study evaluated a modified maxillary nerve block using 1.3% LB at 0.1 mL/kg, 0.5% B, or S at an equivalent volume. An electronic von Frey aesthesiometer (VFA) was used to evaluate mechanical nociceptive thresholds at 4 locations on each hemimaxilla at baseline and at specific intervals up to 72-h post-treatment. Both B and LB treatments resulted in significantly higher VFA thresholds when compared to S. Dogs that received B had VFA thresholds significantly higher than S for 5 to 6 h. Dogs that received LB had thresholds significantly higher than S for 6 to 12 h depending on the site of measurement. No complications were observed. Maxillary nerve block with B provided up to 6 h, and LB 12 h, of sensory blockade depending on the site tested.

Intra-Prostatic Injection of Epinephrine during Transurethral Resection of Prostate Reduces Blood Loss and Need for Blood Transfusions

Aim: To assess the role of Intraprostatic injection of epinephrine intra-operatively in patients undergoing TURP in decreasing blood loss and the need for subsequent blood transfusions. Design: A double-blind, randomized controlled trial. Place and duration of study: The Kidney Centre Postgraduate Training Institute, Karachi, from March till August 2020. Methodology: A total of 40 patients were chosen at random and divided into two groups of equal size. One group got an intra-prostatic injection of epinephrine, whereas the other received a standard saline injection. Both groups were evaluated in terms of prostate volume (ml), resected tissue (gms), surgical resection time (minutes), pre and post-operative Hemoglobin (HB), and Hematocrit (HCT) levels. Intra-operative blood loss was then quantified using the last two variables. Transfusion requirement in both groups was also recorded. Results: Mean +Age of patients in Group A and Group B was 66.30+9.24years and 65.65+7.43years, respectively, with no significant difference between both groups (p=0.808). Median and IQR Prostatic volume in Group A and Group B was 68.0, 15, and 64.0,21, suggesting no statistically significant difference between the two groups (p=0.372). Mean + S.D Loss of HB of patients in Group A and Group B was 1.15 + 0.42 and 1.87+1.04, respectively, with a significant difference between both groups (p=0.007). Mean + S.D of post-op HCT patients in Group A and Group B was 3.16+1.50 and 4.81+2.79, revealing a significant difference between the two groups (p=0.026). No patients in Group A needed blood transfusions, whereas six patients in Group B had blood transfusions, indicating a statistical distinction between the two groups (p=0.001). Conclusion: The use of intra-prostatic injection of epinephrine leads to reduced blood loss and subsequently reduced operative time, irrigation fluid usage, and blood transfusion during TURP. It also allows a greater amount of prostatic tissue to be resected. Keywords: Transurethral resection of Prostate, Epinephrine, Blood transfusion, Hemoglobin, Hematocrit.