Is intraoperative bleeding control useful after tourniquet release in arthroscopic anterior cruciate ligament reconstruction?

BackgroundArthroscopic anterior cruciate ligament (ACL) reconstruction is a common orthopedic surgery, and rehabilitation is very important to achieve successful postoperative results. Postoperative hemarthrosis causes pain and limitation of movement, which prolongs the rehabilitation period. For these reasons, various strategies are used to reduce hemarthrosis in patients undergoing ACL reconstruction. This study aimed to evaluate the effect of bleeding control after releasing the tourniquet in ACL reconstruction surgery on the amount of hemarthrosis and pain in the postoperative period.MethodologyA total of 60 patients who underwent arthroscopic single-bundle ACL reconstruction were enrolled in this prospective randomized control study. Bleeding control with the radiofrequency (RF) probe after releasing the tourniquet was done at the end of the arthroscopic ACL reconstruction in 30 patients (coagulation group) while bleeding control was not done for the other 30 patients (control group). Both groups were compared in terms of the degree of hemarthrosis using the Coupens and Yates classification in the early postoperative period and the degree of pain using the Visual Analog Scale (VAS) score and postoperative complications.ResultsIn both groups, isolated ACL reconstruction was performed in 10 patients, additional partial meniscectomy in three patients, and additional arthroscopic meniscus repair in 17 patients. There was no statistically significant difference between the coagulation and control groups in terms of VAS (p > 0.05) and the degree of hemarthrosis (p > 0.05). Although the duration of tourniquet application was similar in both groups (p = 0.78), the duration of anesthesia was significantly longer in the coagulation group (p = 0.001). There was no significant difference between the groups in terms of postoperative complications.ConclusionsBleeding control with the RF probe after tourniquet release does not yield superior outcomes. More research with larger populations is needed to confirm these findings

IN VITRO EFFICACY OF VITEX AGNUS-CASTUS EXTRACTS AGAINST TRICHOMONAS VAGINALIS: A POTENTIAL THERAPEUTIC APPROACH

Aim and objectives: Trichomonas vaginalis is the most prevalent nonviral sexually transmitted infection globally. The current treatment, 5-nitroimidazole derivatives has raised concerns as a result of drug reliance, allergies, and drug resistance, driving efforts to identify alternative therapies. The Vitex species recognized for their pharmacological attributes including anti-inflammatory, antibacterial, antifungal, and antimicrobial properties are promising candidates for further investigation.  Methods: In this study, the potential of Vitex agnus-castus extracts against T. vaginalis was explored. The water, ethanol, and 60% aqueous ethanol extracts from both leaves and fruits were examined for their effects on metronidazole (MET)-resistant (TV 50143) and sensitive strains (TV-78). Cytotoxicity was evaluated on L929 mouse fibroblast cells to determine the minimum lethal dose for each extract under aerobic and anaerobic conditions.  Results: Antitrichomonial activity, cytotoxic activity and Selectivity Index (SI) values revealed distinct efficacy profiles. Leaf water extract displayed a balanced selectivity profile, while leaf 60% ethanol extract showed moderate to high selectivity. The fruit 60% ethanol extract exhibited significantly elevated selectivity with SI values of 2 and 1 under aerobic and anaerobic conditions, respectively, for the MET-sensitive reference strain, and 3 and 5, respectively, for the MET-resistant reference strain.  Conclusion: These findings underscore the potential of the fruit 60% ethanol extract as a promising candidate for future drug development. Further investigations into its mechanisms and optimization are warranted to enhance its efficacy against T. vaginalis.                   Peer Review History: Received 13 May 2024;   Reviewed 15 July 2024; Accepted 21 August; Available online 15 September 2024 Academic Editor: Dr. Amany Mohamed Alboghdadly, Ibn Sina National College for Medical Studies in Jeddah, Saudi Arabia, [email protected]  Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewers: Prof. Ali Gamal Ahmed Al-kaf, Sana'a university, Yemen, [email protected] Dr. Marwa A. A. Fayed, University of Sadat City, Egypt, [email protected] Dr. Sangeetha Arullappan, Universiti Tunku Abdul Rahman, Malaysia, [email protected]

Biological activity and chemical composition of essential oils from the leaves of Myrtus communis L

Common myrtle (Myrtus communis L., Myrtaceae) is an evergreen shrub. The genus Myrtus includes flowering plants and was previously thought to be represented by approximately 16 taxa in the areas of the Middle East and Asia [1]. It has been used for medicinal, food and spice purposes since ancient times. The essential oil is used as an antiseptic, disinfectant, analgesic, and anti-inflammatory agent [2,3].                In the present work, M. communis leaf essential oil was obtained by hydrodistillation using a Clevenger apparatus. The essential oil was analyzed by both GC-FID and GC-MS. α-Pinene (43.1%) and linalool (18.8%) were found to be the main constituents. The oil was evaluated for its toxicity (Caenorhabditis elegans), antileishmanial and antimicrobial activities. The IC50 value was 2.5 mg/mL against Leishmania tropica promastigotes. The following MIC values were determined: Staphylococcus aureus ATCC 6538 : 20 mg/mL; Streptococcus pyogenes ATCC 13615 : 5 mg/mL; Candida albicans ATCC 90028 : 10 mg/mL; and Escherichia coli NRRL B-3008 : 1.25 mg/mL. To the best of our knowledge, this is the first report on the in vivo selectivity of M. communis leaf essential oil against Leishmania tropica

Unpleasant Souvenir: Imported Plasmodium falciparum Malaria in Türkiye

Objective: Each year, approximately 125 million people visit malaria-endemic countries. This study aimed to investigate the clinical characteristics of imported Plasmodium falciparum malaria infections in Türkiye. Methods: The study included patients diagnosed with P. falciparum malaria between 1996 and 2022. A retrospective evaluation was conducted on whole blood samples and/or blood smears, as well as detailed medical histories, clinical manifestations, and laboratory findings. A total of 131 imported cases of P. falciparum were included in the study. Results: Among the patients, 121 were male. Of these, 101 had traveled to Africa, while 30 had visited Asia. Among the patients, 109 were returned travelers, and 22 were refugees/migrants. Early trophozoites were observed in all patients, while gametocytes were detected in 30 patients. Cerebral malaria developed in 15 patients, resulting in the death of two individuals. Additionally, 10 patients received preventive chemoprophylaxis. Conclusion: Turkey is situated on migration routes that connect two continents to Europe, where more than 95% of the global malaria burden exists. The importation of malaria through returned travelers poses a risk of malaria reintroduction in our country, given the presence of suitable vectors, climate conditions, and environmental factors. Importantly, 30 patients (22.9%) exhibited gametocyte forms of P. falciparum, which have the potential to infect Anopheles species, thus establishing a basis for local malaria transmission

Evaluation of the Reproduction on Blood and Chocolate Agars of Leishmania Isolates Obtained from Turkey

Amaç: Bu çalışma, Türkiye’den elde edilen Leishmania spp. izolatlarının kanlı agar ve çikolata agardaki koloni oluşumlarının izlenmesi ve farklılıklarının karşılaştırılması, tek bir hücreden oluşan koloni elde edilerek gerektiğinde genetik çalışmalarda kullanılması amacıyla planlanmıştır. Yöntem: Çalışmamızda kullanılan kanlı agar ve çikolata agarın gerekli ön hazırlık aşamaları yapıldıktan sonra steril petri kaplarına dökülmesi ile besiyerleri hazırlanmıştır. Kullanılan Leishmania spp. izolatları üniversitemiz bünyesinde bulunan Parazit Bankası’ndan sağlanmıştır. Leishmania spp izolatlarının, ITS1 ve hsp70 bölgesine özgü primer ve problar kullanılarak genotiplendirilmesi yapılmıştır. Türlere göre ayrılan izolatların NNN besiyerinde kültürü yapılmış ve üreyen promastigotlar RPMI 1640 sıvı besiyerlerine aktarılarak logaritmik faza girmeleri beklenmiştir. Logaritmik faza giren promastigotların çikolata agar ve kanlı agara ekimleri yapılmış ve 25°C’lik etüve kaldırılarak gün aşırı takip edilmiştir. Bulgular: Etüvden çıkarılarak incelenen plaklarda inkübasyonun 7. gününde çikolata agarda herhangi bir koloni oluşumu gözlenmezken, kanlı agarda Leishmania tropica, Leishmania infantum ve Leishmania donovani de koloni büyüklüklerinin ortalama 0.9 mm olduğu, Leishmania major’de ise ortalama 0.8 mm olduğu saptanmıştır. Plaklara yapılan ekimin 28. gününde ise çikolata agarda L. tropica, L. major, L. infantum ve L. donovani’deki ortalama koloni büyüklükleri sırasıyla 1.0 mm, 0.9 mm, 1.0 mm ve 0.8 mm olarak gözlemlenirken, kanlı agardaki koloni büyüklükleri sırasıyla 3.1 mm, 3.1 mm, 3.3 mm ve 3.0 mm olduğu belirlenmiştir. Sonuç: Plaklara yapılan ekimlerin takibi sonucunda tüm suşların 7., 14., 21. ve 28. günlerdeki koloni oluşumlarının kanlı agarda daha hızlı olduğu saptanmıştır. Kanlı agarın Leishmania spp. ile ilgili yapılması planlanan genetik çalışmalar ve diğer çalışmalarda kullanılmasının uygun olabileceği sonucuna varılmıştır.Objective: This study was planned with the aim of comparing the reproduction differences of Leishmania isolates, obtained from Turkey, on chocolate and blood agars, colony growth views on agar plates and to attain colonies from single cell to utilize for genetic studies. Method: After preparation of blood agar and chocolate agar used in our study, the media were prepared by pouring into sterile petri dishes. The Leishmania isolates, used, were obtained from the ParasiteBank, located within our university. Genotyping was done by using primers and probes specific to ITS1 and hsp70. The isolates, separated according to species, were cultured in NNN medium and promastigotes were transferred to RPMI-1640 and were expected to enter into logarithmic-phase. Promastigotes entering logarithmic-phase were inoculated on chocolate and blood agar. Plates were transferred to 25°C and were controlled every other day. Results: No growth was observed on chocolate agar on 7th day of incubation on plates, while colony size of Leishmania tropica, Leishmania infantum and Leishmania donovani were found to have an average of 0.9 mm and mean colony size of Leishmania major was 0.8 mm on blood agar, On 28th day of cultivation, average colony size of L. tropica, L. major, L. infantum and L. donovani on chocolate agar was observed as 1.0 mm, 0.9 mm, 1.0 mm and 0.8 mm, respectively, while colony size on blood agar was determined as 3.1 mm, 3.1 mm, 3.3 mm and 3.0 mm, respectively. Conclusion: On 7,14,21,28th days, colony size of all the strains were found to be better and their growth were faster on blood agar. It has been concluded that blood agar may be suitable for reproduction of Leishmania for genetic and other studies planned

In Vitro and In Silico Evaluations of the Antileishmanial Activities of New Benzimidazole-Triazole Derivatives

Benzimidazole and triazole rings are important pharmacophores, known to exhibit various pharmacological activities in drug discovery. In this study, it was purposed to synthesize new benzimidazole-triazole derivatives and evaluate their antileishmanial activities. The targeted compounds (5a–5h) were obtained after five chemical reaction steps. The structures of the compounds were confirmed by spectral data. The possible in vitro antileishmanial activities of the synthesized compounds were evaluated against the Leishmania tropica strain. Further, molecular docking and dynamics were performed to identify the probable mechanism of activity of the test compounds. The findings revealed that compounds 5a, 5d, 5e, 5f, and 5h inhibited the growth of Leishmania tropica to various extents and had significant anti-leishmanial activities, even if some orders were higher than the reference drug Amphotericin B. On the other hand, compounds 5b, 5c, and 5g were found to be ineffective. Additionally, the results of in silico studies have presented the existence of some interactions between the compounds and the active site of sterol 14-alpha-demethylase, a biosynthetic enzyme that plays a critical role in the growth of the parasite. Therefore, it can be suggested that if the results obtained from this study are confirmed with in vivo findings, it may be possible to obtain some new anti-leishmanial drug candidates