Platelet rich plasma following hysteroscopic adhesolysis: a randomized clinical trial

Background: Intrauterine adhesions (IUAs) is an uncommon condition that occurs after endometrial trauma, still it affects many women seeking fertility. Hystroscopic adhesolysis is the standard management procedure for IUAs, yet many concerns arise about the incidence of recurrence. This study evaluates the efficacy of Platelet rich plasma in decreasing adhesion recurrence following hystroscopic adhesolysis of severe intrauterine adhesions.Methods: A prospective randomized clinical trial held in the Endoscopy Unit of Ain Shams University Hospital, Cairo, Egypt. 160 women with grade-III intrauterine adhesions, according to American Fertility Society criteria, were randomized to either receiving 5ml platelet rich plasma injection into the uterine wall in the most affected parts of the endometrium and lining the uterine cavity by 5ml platelet rich plasma gel followed by intrauterine insertion of folley’s catheter balloon left for two weeks (study group), or only insertion of folley’s catheter balloon for two weeks with injection of placebo solution and using placebo gel (control group). Second look office hysteroscopy was performed 3 months post-operative to assess the grade of intrauterine adhesions. The primary outcome was the incidence of recurrence of intrauterine adhesions. Secondary outcomes were the post-operative improvement of menstrual duration and flow, and pregnancy rate within 1 year post-adhesolysis.Results: 70/81(86.4%) patients showed grade-I adhesions, 8/81 (9.9%) grade-II and 3/81 (3.7%) remained grade-III in the study group compared to 42/78 (53.8%) grade-I, 21/78 (26.9%) grade II and 15/78 (19.2%) grade-III in the control group (p<0.001).Conclusions: Platelet rich plasma shows better improvement of adhesion score, menses duration and menses amount following hystroscopic dissection of severe intrauterine adhesions

An Investigation into Mechanical Properties of Ductile Cast Iron with Different Heat Treatment Processes

The mechanical properties as well as microstructure of the ductile cast iron (DCI) are most likely affected by heat treatments. In&nbsp;this work, the mechanical properties of different heat treated of DCI alloy were investigated. Two heat treatment (HT) processes were conducted for DCI; austempering and quenching followed by lower tempering. The melted alloy of DCI was poured in Y-block, from&nbsp;which the specimens of the mechanical tests were prepared. Experimental tests were carried out to investigate the effect of these HT processes on the mechanical properties. A comparison between mechanical properties due to HT and as cast DCI are presented and discussed. The results showed that there is a difference in microstructure, homogeneity, wear rate and compression of DCI based on the conducted heat treatment

Treatment of Bronchiolitis Using Nebulized Hypertonic Saline in Asthma-Prone and Non-Asthma-Prone Patients

Background: In bronchiolitis, children under the age of two experience cough, dyspnea and wheezing, following a viral upper respiratory infection. Frequently recurrent bronchiolitis in infants with atopic background is the best example of asthma-prone viral-induced wheeze. In bronchiolitis management, inhaled hypertonic saline is the subject of debate among pediatricians and researchers. Nebulized hypertonic saline acts by increasing fluidity of airway surface liquid. Bronchospasm is a theoretical risk for inhaled hypertonic saline when used without adjunctive bronchodilators. Objective: To compare the response to nebulized hypertonic saline plus B 2 agonists, with nebulized isotonic saline plus B 2 agonists, in asthma-prone and non-asthma-prone bronchiolitis patients. Patients and methods: This study was a randomized double blind controlled trial, which was carried out at Pulmonology Unit, Pediatric Department, Zagazig University Children Hospital. The study was conducted on 104 infants with acute viral bronchiolitis of mild to moderate severity. They were divided into two groups 52 in each group. Group 1: Asthma-prone patients and group 2, which included non-asthma-prone patients. Patients were randomly assigned to receive inhalation of 0.3 mg/kg salbutamol added to 5 ml of either normal saline 0.9% or hypertonic saline 3%. Within each group the number of patients receiving hypertonic or isotonic saline inhalation was equal to 26. Results: Nebulized hypertonic saline salbutamol mixture resulted in better improvement of the studied asthmaprone and non-asthma prone bronchiolitis patients. Hypertonic saline decreased case severity and days of hospital stay. Conclusion: Nebulized hypertonic saline shortened the days of hospital admission and improved the respiratory distress in mild to moderate bronchiolitis. Nebulized hypertonic saline is equally effective in asthmaprone and non-asthma-prone patients and its beneficial effect outweighs its theoretical broncho-constrictive effect

In vitro evaluation of electroporated gold nanoparticles and extremely-low frequency electromagnetic field anticancer activity against Hep-2 laryngeal cancer cells

Introduction. The extremely-low frequency electromagnetic field (ELFEMF) has been proposed for use in cancer therapy since it was found that magnetic waves interfere with many biological processes. Gold nanoparticles (Au-NPs) have been widely used for drug delivery during cancer in vitro studies due to their low cytotoxity and high biocompatibility. The electroporation of cancer cells in a presence of Au-NPs (EP Au-NPs) can induce cell apoptosis, alterations of cell cycle profile and morphological changes. The impact of ELFEMF and EP Au-NPs on morphology, cell cycle and activation of apoptosis-associated genes on Hep-2 laryngeal cancer cell line has not been studied yet. Materials and methods. ELFEMF on Hep-2 cells were carried out using four different conditions: 25/50 mT at 15/30 min, while Au-NPs were used as direct contact (DC) or with electroporation (EP, 10 pulses at 200V, equal time intervals of 4 sec). MTT assay was used to check the toxicity of DC Au-NPs. Expression of CASP3, P53, BAX and BCL2 genes was quantified using qPCR. Cell cycle was analyzed by flow cytometry. Hematoxylin and eosin (HE) staining was used to observe cell morphology. Results. Calculated IC50 of DC Au-NPs 24.36 μM (4.79 μg/ml) and such concentration was used for further DC and EP AuNPs experiments. The up-regulation of pro-apoptotic genes (CASP3, P53, BAX) and decreased expression of BCL2, respectively, was observed for all analyzed conditions with the highest differences for EP AuNPs and ELFEMF 50 mT/30 min in comparison to control cells. The highest content of cells arrested in G2/M phase was observed in ELFEMF-treated cells for 30 min both at 25 or 50 mT, while the cells treated with EP AuNPs or ELFEMF 50 mT/15 min showed highest ratios of apoptotic cells. HE staining of electroporated cells and cells exposed to ELFEMF’s low and higher frequencies for different times showed nuclear pleomorphic cells. Numerous apoptotic bodies were observed in the irregular cell membrane of neoplastic and necrotic cells with mixed euchromatin and heterochromatin. Conclusions. Our observations indicate that treatment of Hep-2 laryngeal cancer cells with ELFEMF for 30 min at 25–50 mT and EP Au-NPs can cause cell damage inducing apoptosis and cell cycle arrest

Hepatorenal Effects of Diclofenac and Ciprofloxacin in Rats

The toxic effect of diclofenac (DCF) sodium and Ciprofloxacin (CIP) on gene expression of cytochrome  P450 oxidase (CYPs) and the histology of liver and kidney of male albino rat has been evaluated in this study. DCF and CIP were chosen since they are inhibitors for specific CYP enzymes. Thirty-five adult male albino rats were divided into 7 groups of 5 animals each (A, B, C, D, E, F and G) and were treated orally with drugs for 21 consecutive days. Group A served as the control while B and C were treated with 5.3, 10.6 mg/kg body weight (bw) DCF sodium and groups D and E were treated with 40 and 80 mg/kg bw CIP, respectively. Groups F and G were treated with a mixture of the low and the high doses of both drugs, respectively. Both drugs significantly downregulated the mRNA expression of CYP1a2, CYP3a4 and CYP2c9. They caused hepatorenal histological changes. In the liver, massive fibrosis, necrosis, inflammatory cell infiltration with hemorrhages and hydrophilic degeneration have been observed. A massive tissue injury with glomerular and tubular damages due to sever necrosis, degeneration of concomitant inflammatory cells and blood vessels congestion have been shown in renal tissues. Although DCF and CIP are still used as therapeutic drugs, their use should be limited as their chronic administration induces a toxic effect on human health

High-performance liquid chromatography and derivative spectrophotometry for simultaneous determination of pravastatin and fenofibrate in the dosage form

High performance liquid chromatography (HPLC) and second-order derivative spectrophotometry have been used for simultaneous determination of pravastatin (PS) and fenofibrate (FF) in pharmaceutical formulations. HPLC separation was performed on a phenyl HYPERSIL C18 column (125 mm 4.6 mm i.d., 5 m particle diameter) in the isocratic mode using a mobile phase acetonitrile/0.1 % diethyl amine (50:50, V/V, pH 4.5) pumped at a flow rate of 1.0 mL min–1. Measurement was made at 240 nm. Both drugs were well resolved on the stationary phase, with retention times of 2.15 and 5.79 min for PS and FF, respectively. Calibration curves were linear (R = 0.999 for PS and 0.996 for FF) in the concentration range of 5–50 and 20–200 µg mL–1 for PS and FF, respectively. Pravastatin and fenofibrate were quantitated in combined preparations also using the second-order derivative response at 237.6 and 295.1 nm for PS and FF, respectively. Calibration curves were linear, with the correlation coefficient R = 0.999 for pravastatin and fenofibrate, in the concentration range of 5–20 and 3–20 µg mL–1 for PS and FF, respectively. Both methods were fully validated and compared; the results confirmed that they were highly suitable for their intended purpose

Interleukin-10 inhibits osteoclastogenesis by reducing NFATc1 expression and preventing its translocation to the nucleus

BACKGROUND: IL-10 has a potent inhibitory effect on osteoclastogenesis. In vitro and in vivo studies confirm the importance of this cytokine in bone metabolism, for instance IL-10-deficient mice develop the hallmarks of osteoporosis. Although it is known that IL-10 directly inhibits osteoclastogenesis at an early stage, preventing differentiation of osteoclast progenitors to preosteoclasts, the precise mechanism of its action is not yet clear. Several major pathways regulate osteoclastogenesis, with key signalling genes such as p38, TRAF6, NF-κB and NFATc1 well established as playing vital roles. We have looked at gene expression in eleven of these genes using real-time quantitative PCR on RNA extracted from RANKL-treated RAW264.7 monocytes. RESULTS: There was no downregulation by IL-10 of DAP12, FcγRIIB, c-jun, RANK, TRAF6, p38, NF-κB, Gab2, Pim-1, or c-Fos at the mRNA level. However, we found that IL-10 significantly reduces RANKL-induced NFATc1 expression. NFATc1 is transcribed from two alternative promoters in Mus musculus and, interestingly, only the variant transcribed from promoter P1 and beginning with exon 1 was downregulated by IL-10 (isoform 1). In addition, immunofluorescence studies showed that IL-10 reduces NFATc1 levels in RANKL-treated precursors and suppresses nuclear translocation. The inhibitory effect of IL-10 on tartrate-resistant acid phosphatase-positive cell number and NFATc1 mRNA expression was reversed by the protein kinase C agonist phorbol myristate acetate, providing evidence that interleukin-10 disrupts NFATc1 activity through its effect on Ca(2+ )mobilisation. CONCLUSION: IL-10 acts directly on mononuclear precursors to inhibit NFATc1 expression and nuclear translocation, and we provide evidence that the mechanism may involve disruption of Ca(2+ )mobilisation. We detected downregulation only of the NFATc1 isoform 1 transcribed from promoter P1. This is the first report indicating that one of the ways in which IL-10 directly inhibits osteoclastogenesis is by suppressing NFATc1 activity

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020