Injection Of Sulfate Research Articles

Comparison of clinical efficacy of different internal fixation methods in older adult patients with osteoporotic fractures of proximal humerus

ObjectiveTo compare the efficacy of three treatment methods for older adult patients with osteoporotic proximal humerus fractures: proximal humerus locking plate (PHILOS) combined with calcium sulfate injection, PHILOS plate alone, and artificial hemi-shoulder joint replacement.MethodsThe clinical data of 48 older adult patients with osteoporotic proximal humerus fractures admitted to the Shoulder and Elbow Surgery Department of Zhongshan Hospital Affiliated with Dalian University from February 2018–August 2021 were retrospectively analyzed. The patients comprised 18 males and 30 females, with a mean age of (68.6 ± 5.8) years. The 48 patients were divided into three groups based on their treatment methods: Group A: 16 patients treated with PHILOS plate combined with calcium sulfate injection. Group B: 16 patients treated with the PHILOS plate alone. Group C: 16 patients treated with artificial hemi-shoulder joint replacement. Key parameters such as operation time, blood loss, incision length, operation cost, and shoulder joint motion at the final follow-up were recorded and compared. Shoulder joint function was evaluated using the American Shoulder and Elbow Surgeons (ASES) score, Visual Analogue Scale (VAS) for pain, University of California Shoulder Joint Score (UCLA), and Brief Shoulder Function Test (SST).ResultsThere were no statistically significant differences in the preoperative general data between the three groups (P > 0.05), indicating comparability. There was no significant difference in operation time, blood loss, and incision length among Groups A, B, and C (P > 0.05). However, Group C had significantly higher operation costs compared to the other two groups (P < 0.05). At the final follow-up, there were no significant differences in shoulder flexion and rotation among the three groups (P > 0.05). However, a statistically significant difference in abduction was observed between Group A and Group C (P < 0.05). No significant differences were found in ASES, VAS, UCLA, and SST scores among the three groups at the last follow-up (P > 0.05).Complications occurred in 1 patient (Group A), 3 patients (Group B), and 4 patients (Group C), showing a statistically significant difference among the groups (P < 0.05).ConclusionAll three surgical methods are effective in treating older adult osteoporotic proximal humerus fractures, as they significantly alleviate pain and restore joint function. However, the use of a PHILOS plate combined with calcium sulfate injection (Group A) is particularly effective, demonstrating reliable clinical efficacy with fewer complications.

Transforaminal lumbar epidural injection of dexmedetomidine versus magnesium sulfate combined with dexamethasone for lower limb radicular pain management: a randomized, clinical trial.

Epidural steroid injections are frequently used to treat chronic radicular pain of a discogenic origin; however, their efficacy remains limited. Magnesium sulfate and dexmedetomidine are emerging adjuvants with the potential to enhance the effectiveness and prolong the therapeutic duration of steroid injections. In this randomized, double-blind study, 90 patients with unilateral lower limb radiculopathy due to lumbar disc prolapse who did not respond to conservative treatment for 12 weeks were assigned to three groups. The control group received dexamethasone (4 mg), lidocaine 2% (40 mg), and saline. The magnesium group received magnesium sulfate (200 mg) with dexamethasone and lidocaine. The dexmedetomidine group received dexmedetomidine (50 mcg), dexamethasone, lidocaine, and saline. Pain intensity was assessed using the visual analog scale at 1 week and 1, 3, and 6 months post-treatment. Secondary outcomes included the Modified Oswestry Disability Index (MODI), analgesic consumption, and procedure-related complications. Both magnesium and dexmedetomidine significantly reduced pain, disability, and analgesic consumption for up to 3 months. By 6 months, the magnesium group demonstrated significant improvement in pain scores and MODI and a decline in ibuprofen use compared to the control and dexmedetomidine groups. Magnesium significantly reduced pain intensity, disability, and analgesic consumption over a 6-month observation period.

Impacts of Copper Deficiency on Oxidative Stress and Immune Function in Mouse Spleen.

Copper is an essential trace element crucial for enzyme synthesis and metabolism. Adequate copper levels are beneficial for maintaining the normal immune function of the spleen. Copper deficiency disrupts the metabolic processes within the spleen and impairs its immune function. This research examines the impact of copper deficiency on the spleen and the potential recovery following copper supplementation. Weaned mice underwent a 4-week copper-deficient diet, succeeded by 1-week of copper repletion via intraperitoneal copper sulfate injection. Histological examination was used to assess pathological changes in the spleen. Biochemical assays were performed to measure oxidative stress levels in the spleen. ELISA, qPCR, and Western blot were employed to examine alterations in inflammatory markers, immune indicators, and oxidative regulatory factors across various levels. Copper deficiency caused histological damage to the spleen, altered the expression of oxidative stress regulatory pathways (Nrf2, Keap1, and HO-1), and affected the expression of key inflammatory enzymes (iNOS, COX2) and transcription factor NF-κB, leading to oxidative damage. This was reflected by decreased levels of SOD, GSH, and T-AOC, along with increased levels of CAT and MDA. The levels of inflammatory cytokines IL-1β, TNF-α, IL-6, and IL-8 were notably increased. Copper supplementation significantly improved these changes. Copper deficiency leads to spleen tissue damage in mice, affecting the Nrf2 regulatory pathway and inducing oxidative damage. Subsequent copper supplementation with copper sulfate effectively ameliorates the damage caused by copper deficiency.

Consistent presence of cutaneous artery angiosome of the caudal gluteal artery suggests the usefulness of a caudal gluteal axial pattern flap in dogs.

The purpose of this study was to define the angiosome of a cutaneous artery arising from the caudal gluteal artery and identify landmarks for its use as an axial pattern flap. This was an experimental anatomic study done between July 2019 and July 2021 with a retrospective review of CT scans. Twenty postcontrast CT scans in client-owned dogs, unrelated to this study, were evaluated for identification of a potential angiosome over the hip region. Additionally, 6 cadavers received injections of barium sulphate into the internal iliac arteries. The skin over the cadaver hindlimbs was evaluated for cutaneous angiosomes via contrast radiography. The direct cutaneous artery of the caudal gluteal artery was present in 20/20 CT scans. The artery traveled through the fat to hypodermis in a dorsal to ventral direction and the path of the artery had mild variation of its location relative to the greater trochanter between patients. Externally, the direct cutaneous artery traveled from the tail base to the greater trochanter region in all cadavers. The angiosome of the artery extended along the hypodermis to at least the proximal fourth of the femur. The cutaneous angiosome of the caudal gluteal artery was present in all dogs evaluated in the study. The cutaneous artery from the caudal gluteal artery may be useful in clinical reconstruction of wounds on the tail, perineum, and sacral region as a caudal gluteal axial pattern flap.

Lavender improves sleep through olfactory perception and GABAergic neurons of the central amygdala

Ethnopharmacological relevanceThe use of lavender as sleep aid or hypnotic agent can be traced back as early as ancient Romans and Greeks. Yet, objective experimental data on whether and how lavender enhances sleep duration or/and sleep quality remain lacking. Aim of the studyWe aimed to characterize the sleep-wake regulating effects of lavender in the mouse and to demonstrate the brain targets and neural circuits involved. Materials and methodsA self-made precise odor delivery system combined with chronic polysomnographic recordings was employed to assess the sleep-wake effects of inhalation with lavender essential oil (LEO, extracted from lavender) and its different constituents during the light and dark phases in free-moving C57BL/6J mice. Neuroviral labeling, in situ hybridization and pharmacogenetics were combined to identify the neural circuits and targets involved. Finally, an insomniac model of DL-4-Chlorophenylalanine (PCPA)-treated mice was established to examine the sleep-inducing potential of LEO. ResultsWe found that inhalation of LEO with a concentration at 25.0% during the light (inactive) phase significantly shortened the latency to non-rapid eye movement (NREM) sleep, increased the total amount of NREM sleep at the expense of wakefulness (W), and enhanced cortical EEG slow wave activities, notably delta power spectra density. We further identified linalool, d-limonene, 1,8-cineole, linalyl acetate and terpinene-4-ol as the major effective sleep-promoting monomer components. Importantly, we found that LEO no longer produced any of the above sleep-promoting effect following either nasal injection of zinc sulfate which interrupts the olfactory pathway, or pharmacogenetics silencing of central amygdala GABAergic neurons. Finally, LEO reestablished NREM sleep with short latency in PCPA-treated insomniac mice, effects comparable with those induced by a potent sedative diazepam. ConclusionsWe have characterized the quantitative and qualitative sleep-promoting effects of LEO and its effective components via the olfactory pathway and central amygdala GABA neuronal targets. The hypnotic property of LEO is reinforced by its ability to restore sleep in insomnia. Our study thus establishes a neurobiological basis for aromatherapy of sleep disorders using lavender.

Regional impacts of solar radiation modification on surface temperature and precipitation in Mainland Southeast Asia and the adjacent oceans.

Solar radiation modification (SRM) has been proposed to temporarily reduce anthropogenic warming. This study presents an assessment of the regional impacts of SRM via solar dimming and stratospheric aerosol injection (SAI) on temperature and precipitation over 0°-30° N and 90° E-110° E, covering Mainland Southeast Asia and adjacent oceans. Using data from the Geoengineering Model Intercomparison Project Phase 6 (GeoMIP6), we examine regional impacts of SRM using three SRM experiments: (1) G6Sulfur, which reduces radiative forcing from the high-emission SSP5-8.5 scenario to the moderate-emission SSP2-4.5 scenario by injecting sulfate aerosols; (2) G6Solar, which similarly reduces radiative forcing from the high-emission to moderate-emission scenarios but by uniformly reducing the solar constant; and (3) G1ext, which reduces radiative forcing from a quadrupled carbon dioxide concentration to pre-industrial levels by uniform solar constant reduction. Our findings show that higher greenhouse gas emissions increase overall precipitation, along with tendencies to have extreme rainfall events and more dry episodes in between. While SRM can partially cool down the surface temperature warming caused by increased greenhouse gas emissions, its effects on precipitation are complex: Solar dimming in G6Solar and G1ext tends to reduce overall precipitation, and tropical sulfate injection in G6Sulfur could lead to further drying in the tropics because of the stratospheric warming associated with the injected aerosols. Different SRM strategies might result in different responses on precipitation.

Comparison of Transforaminal Magnesium Sulfate with Steroid Injection in the Management of ‎Radicular Back Pain: A Randomized Double-Blinded Clinical Trial Study

Background: This study compares the effects of transforaminal magnesium sulfate injection versus other methods for managing radicular back pain, highlighting its potential for improved pain relief and functional outcomes. Methods: This randomized, double-blind clinical trial involved 30 patients with radicular back pain who were randomly assigned to receive either transforaminal magnesium sulfate or triamcinolone injection. Primary outcomes were pain intensity and functional disability, assessed using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), respectively. These were evaluated at five time points: Before the injection, 2 weeks, 1 month, 3 months, and 6 months after the injection. Secondary outcomes included drug-related adverse events within the six-month follow-up period. Results: Baseline characteristics were not significantly different between the two study groups. Compared to pre-injection measures, post-injection pain intensity and functional disability were significantly reduced in both groups at all time points (P < 0.001). At all postoperative evaluations, pain intensity and functional disability were lower in the magnesium sulfate group compared to the steroid group (P < 0.001). No drug-related side effects were recorded in either group. Conclusions: For patients with radicular back pain, transforaminal magnesium sulfate injection appears to be an effective and safe alternative to transforaminal steroid injection.

Preliminary investigations of microbiologically influenced corrosion of 304 stainless steel by anaerobic Clostridioides difficile biofilm

Clostridioides difficile is a pathogenic anaerobe that potentially causes microbiologically influenced corrosion (MIC). Coupons of 304 stainless steel (SS) were incubated with C. difficile in deoxygenated brain heart infusion supplement medium. After a 7-d incubation, C. difficile biofilms were observed on the 304 SS coupon surfaces. The sessile cell count on 304 SS coupons were (1.9 ± 0.5) × 107 cells/cm2. It was found that this high-grade SS did not suffer measurable corrosion weight loss and pitting. X65 carbon steel was used to verify C. difficile bio-corrosivity. A 7-d weight loss of 0.9 ± 0.2 mg/cm2 was found on X65 coupons with the same incubation condition, which manifested as uniform corrosion. 13%Cr steel, also known as 420 SS which is a low-grade SS that is prone to pitting, was used to verify pitting by C. difficile. A 15.2 μm pit was observed after 26 d of incubation. Electrochemical tests were conducted in a 10 mL biofilm/MIC test kit. The electrochemical analysis of electron mediator injection indicated that MIC of 304 SS by C. difficile belongs to extracellular electron transfer-MIC. A 100 ppm (w/w) tetrakis (hydroxymethyl)phosphonium sulfate (a green biocide) injection test proved that it is a suitable disinfectant for C. difficile.

Effect of porous media heterogeneity and FeS re-generation for multiple cycles on arsenic immobilization under in-situ conditions

Arsenic (As) contamination in groundwater is a well-established concern. Several studies have explored the possibility of immobilizing arsenite [As (III)] in-situ within the aquifer. Recent studies show a uniform distribution of ferrous sulfate (FeS) synthesized within homogenous porous media and demonstrated promising performance in immobilizing As(III). Upscaling from bench-scale to field-scale systems involves the integration of physical and chemical heterogeneities. Thus, the distribution of reducing agent (i.e., FeS), subsequent capturing of As(III) in the upscaled heterogeneous porous media system is a complex and uncertain phenomenon. Therefore, this study focuses on assessing the performance of FeS when synthesized for multiple cycles under constant flow and constant head conditions for immobilization of As(III) through a heterogeneous porous media system. A 3-D heterogenous porous media system is first simulated using a sequential indicator simulator model (SISIM). Then, the same heterogeneous media is prepared in the laboratory by packing three different-sized sand within a 3-D tank (0.67 m × 0.40 m × 0.40 m) which is subdivided into a total of 150 grids (0.096 m × 0.08 m × 0.08 m). FeS is synthesized in-situ by sequential injection of sodium sulfide (Na2S) and ferrous sulfate (FeSO4‧6H2O), as detailed in the previous study. The outcome of the study suggests that flow within the model subsurface porous media is non-uniform and follows an inter-connected preferential flow path. The progression of in-situ synthesized FeS is faster in the areas of higher hydraulic conductivity. The immobilization of As (88%) is promising by FeS synthesized within heterogeneous porous media. An overall reduction of porosity (7.7%) and hydraulic conductivity (68.3%) are observed, which is more predominant along the preferential flow path where deposition of FeS is significantly higher. To maintain constant flow rate, 60% increase in head difference is required. Whereas the flow rate decreases by 47.2% when constant head condition is adopted. Overall, the newly synthesized FeS shows promising performance in immobilizing As(III) within heterogeneous model subsurface porous media; however, there might be some possibility of pore-clogging and bypassing of flow due to deposition and subsequent retention of As, which may impact the As removal efficiency in the longer run.

Anatomy of Liver and Radiographic Study on Hepatic Duct in a South African Ostrich Struthio camelus australis

The South African Ostrich Struthio camelus australis, an acarinate flightless ratite bird, native to the African continent has been introduced in many countries including India in the recent past for meat as well as egg purpose. Although this largest extant bird is gaining popularity globally, the functional anatomy of this majestic giant has received relatively less attention. The liver, the largest gland in the body of an Ostrich (weighing approximately 1.5-2 Kg) is also the heaviest among all the birds. The Ostrich lacks gall bladder and thus, the bile needs to be produced continuously as in the case of certain mammals like horses and elephants. The present study aimed to investigate the gross morphological and radiographic characteristics of the liver of the Ostrich. The liver was divisible into two primary lobes: an undivided right lobe and a divided left lobe. The later consisted of dorso-cranial, intermediate, and ventro-caudal lobes. Notably, the ventro-caudal lobe was observed as the largest, while the intermediate lobe was the smallest. The right lobe, larger than the left, was connected to later by a thick isthmus at its cranial extremity. Using barium sulphate injection and positive contrast radiography, the intrahepatic course of the hepatic duct was visualized, revealing two distinct divisions and tributaries thereof for draining bile from the right and left lobes, respectively. A radiographic study of the intrahepatic course of the hepatic duct revealed a single right intralobar duct and two left intralobar ducts. The distinct isthmus was drained by the branch of the left intralobar duct.

Evaluation of intravenous magnesium sulphate on haemodynamic responses to laryngoscopy and tracheal intubation in surgeries of ear, nose and throat

Heart rate, arterial blood pressure, and arrhythmias significantly surge during laryngoscopy and intubation. Anesthesiologists constantly look for ways to minimize these unwanted reactions. Several medicinal interventions have been suggested to mitigate these side effects; intravenous magnesium sulphate injection is one such intervention. Magnesium sulphate is a divalent salt widely recognized for its capacity to lower sympathetic nervous system muscle cell excitability, which lowers blood pressure and causes vasodilation. It is approved as a medicine to treat preeclampsia and control blood pressure. Moreover, there is growing recognition of its benefits on hemodynamic parameters in patients suffering from ischemic infective endocarditis and heart disease. Magnesium is an asset for reducing negative cardiovascular reactions occurring at the time of laryngoscopy and intubation because of its capacity to reduce catecholamine synthesis from adrenergic nerve ends and the adrenal medulla. Intravenous magnesium sulphate will be used in this trial to assess its effect on reducing adverse hemodynamic responses in candidates for elective laryngoscopy and intubation for ENT surgeries.

Dual resistance Janus PDA/patterned PVDF membrane for membrane distillation with early wetting detection using electrochemical impedance spectroscopy

Membrane distillation (MD) is highly efficient in separating and removing water pollutants; however, it is susceptible to membrane wetting and fouling especially when treating low-surface tension pollutants such as oils and surfactants. To address these limitations, we fabricated a Janus polydopamine (PDA)/patterned polyvinylidene fluoride (PVDF) membrane with anti-wetting and anti-fouling properties via non-solvent- and vapor-induced phase separation. In the MD test with a NaCl feed solution with hourly sodium dodecyl sulfate injection, the Janus membrane with the hydrophobic patterned PVDF layer significantly delayed membrane wetting with only a slight trade-off in flux - an 8.6 % decrease in water vapor flux. Also, in the MD test using a NaCl feed solution containing 1000 mg L−1 of canola oil, the hydrophilic PDA layer of the Janus membrane effectively prevented the interaction between oil and the membrane surface. The wetting progression of the Janus membrane was systemically monitored using electrochemical impedance spectroscopy to identify the mechanism of its wetting behaviour and to detect and analyse the different wetting stages (i.e., non-wetting, partial wetting, and full wetting). Therefore, unlike conventional electrical conductivity measurement methods, the wetting front estimated using EIS enabled a more precise wetting detection during the DCMD operation.

Quantitative Applications of ATR-FTIR Spectroscopy with Chemometrics for the Estimation of Amikacin in Amikacin Sulphate Injections

Background: Amikacin belongs to the class of aminoglycoside antibiotics used in the treatment of gram-negative bacterial infections. It is resistant to the aminoglycosides modifying enzymes, making it a clinically effective drug in multidrug-resistant infections. Methods: In this study, a simple Attenuated Total Reflectance-Fourier Transform Infrared Spectroscopy was used for the quantification of amikacin in amikacin sulphate injection. The infrared spectra were generated in the spectral range of 4000–667 cm-1. The calibration curve was computed through TQ Analyst Pro edition software, and the partial least square regression analysis found the linearity in the range of 10-60% w/w. Results: The best calibration results were obtained in the spectral region from 1040 to 1020 cm-1 with a correlation coefficient (r2) of 1.000. The residual mean standard error (RMSEC) value was 0.00235. The percent relative standard deviation (%RSD) values for intra-day and inter-day precision were less than 8.0. The percent relative error (%RE) values were calculated and found in between the range of 0.52 to 5.60. The percent recovery of the amikacin estimation was 113.09 ± 4.27(n=3). Conclusion: This validated method is considered a green method, which is suitable for the routine analysis of amikacin in amikacin sulphate injections.

Percutaneous calcium sulfate injection versus localized scrape bone grafting: clinical effect comparison in titanium elastic nail treatment of pathological fracture of proximal humerus caused by unicameral bone cysts in children.

A retrospective study was conducted to compare the mid-term clinical efficacy between percutaneous calcium sulfate injection (PCSI) and localized scrape bone grafting (LSBG) in using titanium elastic nails treat humerus pathologic fractures caused by unicameral bone cysts in children. Humerus pathologic fracture patients with unicameral bone cysts in our pediatric orthopedic department from January 2015 to January 2020 were retrospectively analyzed. Patients were divided into two groups, namely the PCSI group and the LSBG group, based on the type of bone grafting material they received. Preoperative assessments were made in both groups using the Cyst Index and Cyst activity. During the perioperative phase, assessments were made regarding operative time, bleeding, postoperative VAS scores, and the frequency of reoperation within 2 years. Clinical outcomes were evaluated using the Capanna scale at the last follow-up, and the occurrence of re-fractures during the follow-up period. A total of 22 patients were included, with a mean follow-up duration of 33.5 ± 5.8 months. No significant differences were found between the two groups in terms of Cyst Index and Cyst activity before the operation. The operative time, bleeding, and postoperative VAS scores in the PCSI group were found to be lower than those in the LSBG group (P < 0.05). The PCSI group also showed a higher frequency of reoperation within 2 years compared to the LSBG group (P < 0.05). However, no significant differences were observed between the two groups in terms of Capanna scale scores at the last follow-up and the incidence of re-fractures during follow-up. Both titanium elastic nails (TEN) combined with PCSI or LSBG were found to be safe and effective treatments for humerus pathologic fractures caused by unicameral bone cysts in children. PCSI is considered as a less invasive option with shorter operative times, less bleeding, and reduced postoperative pain, although it comes with the risk of multiple injections. On the other hand, LSBG is considered as a more invasive option for the treatment of active bone cysts but is associated with a lower recurrence rate.

Influence of inventory management practices on the availability of emergency obstetric drugs in Rwandan public hospitals: a case of Rwanda Southern Province

BackgroundStock-outs of some life-saving drugs, such as emergency obstetric drugs, are evident in many health facilities and have been reported to be the leading cause of maternal mortality and morbidity for women from low and middle income countries (LMICs). For many cases, this situation is associated with poor inventory management practices. The aim of this study was to investigate the influence of inventory management practices on the availability of emergency obstetric drugs in Rwandan public hospitals: case of the Rwanda Southern Province. Moreover, to gain a better grasp of the problem and to suggest possible areas for improvement.MethodsAn institutional-based cross-sectional study was carried out in all ten district hospitals (DHs) providing maternal health care and dispensing emergency obstetric drugs namely; Kigeme DH, Munini DH, Kabutare DH, Kibilizi DH, Gakoma DH, Nyanza DH, Ruhango DH, Gitwe DH, Kabgayi DH and Remera Rukoma DH. Both quantitative and qualitative data were collected and analyzed. Oxytocin injection, Misoprostol tablet and Magnesium sulphate injection as recommended emergency obstetric drugs by WHO, UNFPA and Rwanda Essential Medicines list were included in the study.ResultsThe study revealed that keeping logistics management tools up to date is the backbone of inventory management practices in the availability of medicines and medical supplies. The results showed that hospitals with up-to-date logistics tools for their pharmaceutical management were 33.25 times more likely to have their emergency obstetric drugs in stock at all times compared to those that do not regularly update their logistics tools. The proper use of bin cards and electronic software (e-LMIS) contributed greatly to reducing the stock-out rate of emergency obstetric drugs by 89.9% and reduction of unusable to usable stock ratio by appropriate use of simple techniques such as the Min–Max inventory control model by 79%. Over an 18-month period, misoprostol tablet had the highest average days (32) of stock-outs (5.9%), followed by magnesium sulphate injection with an average of 31 days (5.7%), and oxytocin injection with an average of 13 days (2.4%).ConclusionProper use of pharmaceutical management tools within hospitals premises positively influence the availability of life-saving drugs, such as emergency obstetric drugs. Adequate supply chain staffing in health facilities is the most important key to improving inventory management practices and medicine availability.

Evaluation of one-shot vincristine sulfate combined with surgical excision as a new regimen for treatment of canine transmissible venereal tumor.

The purpose of this study was to investigate the effectiveness of surgical excision combined with a single shot of vincristine sulfate for treating transmissible venereal tumor (TVT) in dogs. Fifty-two dogs were divided randomly into two groups (n = 26). Dogs in Group I were treated surgically by debulking the tumorous mass, whereas dogs in Group II were subjected to a combination of surgery and a single injection of vincristine sulfate. Female dogs showed a high prevalence of TVT compared to males (67.3%, n = 35 vs. 32.7%, n = 17), respectively. The German shepherd's breed showed a high prevalence of TVT compared to other breeds. There was a positive association between sex and outcomes. Most occurrences of regret in Group II were reported in females (n = 16, 61.5%) compared to male dogs (n = 10, 38.5%). There was also a positive association between breed and outcome. Most occurrences of regret in Group II were reported in German shepherd dogs (n = 16) compared to Group I (n = 7). In Group I, 15 dogs (57.7%) showed a complete regression, and 11 (42.3%) underwent recurrence. However, in Group II, 21 dogs (80.7%) showed a complete regression, and 5 dogs (19.2 %) underwent recurrence. It appears therefore that the simultaneous use of surgery and administration of a single dose of vincristine sulfate could be considered a combination therapy for TVT as it reduces the risk of recurrence and has a reasonable cost. Recognizing potential risk factors associated with TVT in dogs may be helpful in constructing the best preventive measures.

Novel use of local analgesia prior to intramuscular magnesium sulphate injection compared to mixed local analgesia with magnesium sulphate to reduce pain: a randomised crossover study in patients being managed for eclampsia and preeclampsia.

The World Health Organization (WHO) recommended addition of local anesthetic to reduce the intense pain of intramuscular injection of 50% Magnesium Sulphate (MgSO4) salt solution has been found to be ineffective. We tested whether giving the local anesthetic 5 min before the MgSO4 injection would reduce pain. We conducted a prospective cross-over trial where each participant with pre-eclampsia or eclampsia received sequential and mixed injection methods in random sequence during sequential MgSO4 administrations. Pain and preference were assessed using descriptive words, a numeric pain scale and direct comparison between the two injection methods. Differences were measured using the Wilcoxon signed rank test, risk ratios with 95% confidence intervals and the Chi squared or Fisher's test. The administration techniques were refined based on an initial pilot of 8 participants. We enrolled 49 consented participants and analysed data from 41 post-pilot participants The sequential injection method had a non-significantly lower mean pain score than the mixed injection method (3.1 vs. 3.3, p = 0.44). Severe pain was reported for 3/41 vs. 9/41, p = 0.12. The sequential injection method was perceived to be more painful by 13 (37%) vs. 22 (63%) participants (p = 0.03). The sequential injection was preferred by 21(60%) vs. 14 participants (40%) (p = 0.1). Our results consistently favoured the novel sequential injection method. The lack of statistical significance for most results is not surprising given the small sample size. Given the potential for clinically important benefits to women, a larger study to confirm these results is justified. https://pactr.samrc.ac.za/, Identifier (PACTR202201521544765).

Effect of Intravenous Injection of Magnesium Sulphate on Intraoperative End-Tidal CO2 Level and Postoperative Pain in Laparoscopic Cholecystectomy.

Pain control and stabilizing hemodynamic indices are serious medical challenges, especially in anesthesia. Laparoscopic surgery is increasing in the world, and cholecystectomy surgery is no exception. This study investigated the effect of intravenous (IV) magnesium sulfate injection on intraoperative end-tidal CO2 (ETCO2) levels and postoperative pain in laparoscopic cholecystectomy. This is a clinical trial. The sample size was calculated to be 64 people who were selected among the patients who were candidates for laparoscopic surgery by convenience sampling. They were randomly assigned to intervention and control groups. The intervention group received magnesium sulfate (50 mg/kg) and normal saline (100 mL) within 1 h. The control group only received normal saline (100 mL). Systolic and diastolic blood pressures, ETCO2 level, heart rate, arterial oxygen saturation, pain level, and narcotic analgesics in recovery were measured 2, 6, 12, and 24 h after surgery. The data were analyzed using 1-way analysis of variance (ANOVA) and repeated measures analysis. The mean of systolic blood pressure and ETCO2 during recovery in the intervention group were less than the control group (P = 0.029 and P = 0.015). In the intervention group, analgesic consumption in recovery and 6 h after surgery was less than the control group (P < 0.001). The mean pain score in the intervention group in recovery and 2, 6 (P < 0.001), and 12 h (P = 0.038) after surgery was significantly lower than the control group. Magnesium sulfate can be a suitable and safe supplement to reduce pain after surgery and reduce the use of narcotics. The current conclusion should be investigated on a larger scale of patients, with extended monitoring for postoperative pain over a longer period of time.

Brief isoflurane administration as an adjunct treatment to control organophosphate-induced convulsions and neuropathology.

Organophosphate-based chemical agents (OP), including nerve agents and certain pesticides such as paraoxon, are potent acetylcholinesterase inhibitors that cause severe convulsions and seizures, leading to permanent central nervous system (CNS) damage if not treated promptly. The current treatment regimen for OP poisoning is intramuscular injection of atropine sulfate with an oxime such as pralidoxime (2-PAM) to mitigate cholinergic over-activation of the somatic musculature and autonomic nervous system. This treatment does not provide protection against CNS cholinergic overactivation and therefore convulsions require additional medication. Benzodiazepines are the currently accepted treatment for OP-induced convulsions, but the convulsions become refractory to these GABAA agonists and repeated dosing has diminishing effectiveness. As such, adjunct anticonvulsant treatments are needed to provide improved protection against recurrent and prolonged convulsions and the associated excitotoxic CNS damage that results from them. Previously we have shown that brief, 4-min administration of 3%-5% isoflurane in 100% oxygen has profound anticonvulsant and CNS protective effects when administered 30min after a lethal dose of paraoxon. In this report we provide an extended time course of the effectiveness of 5% isoflurane delivered for 5min, ranging from 60 to 180min after a lethal dose of paraoxon in rats. We observed substantial effectiveness in preventing neuronal loss as shown by Fluoro-Jade B staining when isoflurane was administered 1h after paraoxon, with diminishing effectiveness at 90, 120 and 180min. In vivo magnetic resonance imaging (MRI) derived T2 and mean diffusivity (MD) values showed that 5-min isoflurane administration at a concentration of 5% prevents brain edema and tissue damage when administered 1h after a lethal dose of paraoxon. We also observed reduced astrogliosis as shown by GFAP immunohistochemistry. Studies with continuous EEG monitoring are ongoing to demonstrate effectiveness in animal models of soman poisoning.

Acute Kidney Injury-Induced Circulating TNFR1/2 Elevations Correlate with Persistent Kidney Injury and Progression to Fibrosis.

Elevated levels of circulating tumor necrosis factor receptors 1 and 2 (cTNFR1/2) predict chronic kidney disease (CKD) progression; however, the mechanisms of their release remain unknown. Whether acute kidney injury (AKI) drives cTNFR1/2 elevations and whether they predict disease outcomes after AKI remain unknown. In this study, we used AKI patient serum and urine samples, mouse models of kidney injury (ischemic, obstructive, and toxic), and progression to fibrosis, nephrectomy, and related single-cell RNA-sequencing datasets to experimentally test the role of kidney injury on cTNFR1/2 levels. We show that TNFR1/2 serum and urine levels are highly elevated in all of the mouse models of kidney injury tested, beginning within one hour post injury, and correlate with its severity. Consistent with this, serum and urine TNFR1/2 levels are increased in AKI patients and correlate with the severity of kidney failure. Kidney tissue expression of TNFR1/2 after AKI is only slightly increased and bilateral nephrectomies lead to strong cTNFR1/2 elevations, suggesting the release of these receptors by extrarenal sources. The injection of the uremic toxin indoxyl sulfate in healthy mice induces moderate cTNFR1/2 elevations. Moreover, TNF neutralization does not affect early cTNFR1/2 elevations after AKI. These data suggest that cTNFR1/2 levels in AKI do not reflect injury-induced TNF activity, but rather a rapid response to loss of kidney function and uremia. In contrast to traditional disease biomarkers, such as serum creatinine or BUN, cTNFR1/2 levels remain elevated for weeks after severe kidney injury. At these later timepoints, cTNFR1/2 levels positively correlate with remaining kidney injury. During the AKI-to-CKD transition, elevations of TNFR1/2 kidney expression and of cTNFR2 levels correlate with kidney fibrosis levels. In conclusion, our data demonstrate that kidney injury drives acute increases in cTNFR1/2 serum levels, which negatively correlate with kidney function. Sustained TNFR1/2 elevations after kidney injury during AKI-to-CKD transition reflect persistent tissue injury and progression to kidney fibrosis.