Comparison of Target-Controlled Infusion vs. Manual Infusion of Propofol on Postoperative Recovery in Gynecological Endoscopic Procedures: An Open-Label Randomized Controlled Trial

Background: TIVA with propofol using a manually controlled infusion technique may cause delayed recovery or awareness due to overdosing or underdosing of an anaesthetic. However, TCI can optimally deliver anaesthetic by adjusting the infusion rates based on the pharmacokinetic profile of propofol. This study aimed to compare the recovery time after termination of propofol infusion in TCI with that of the manual infusion technique in patients undergoing gynaecological endoscopic procedures. Methods: In this randomized trial, 100 female patients (18–65 years, American Society of Anesthesiologists (ASA - I/II) undergoing gynaecological endoscopic procedures were assigned to Manual or TCI propofol infusion. The Manual group (n=50) received propofol using the Bristol formula, while the TCI group (n=50) received a pump targeting 4 mcg/ml (Marsh model). Recovery time, total propofol dose, and post-induction MAP changes were measured with target BIS value of 40–60. Results: The demographic data were comparable between the groups. The recovery time was faster with the TCI group (478.4±52.76 seconds) than the manual group (505.8±65.15 seconds) (p=0.0229). No significant difference was observed in total propofol consumption (p=0.199), with mean values of 14.47±1.24 mg/kg/hr in Group T and 14.12±1.46 mg/kg/hr in Group M. Patients in manual infusion group had better haemodynamic parameters than TCI group with less fall in mean arterial pressure post-induction. A significant difference was found in the percentage change in MAP (p=0.0003), with Group T showing a mean change of 9.18±2.6% and Group M 11.2±2.8%. Conclusion: TCI offers significantly shorter recovery time and better post-induction haemodynamic parameters than manual propofol infusion in patients undergoing gynaecological endoscopic procedures

Unlocking Exosome-Based Theragnostic Signatures:Deciphering Secrets of Ovarian Cancer Metastasis

Ovarian cancer (OC) is a common gynecological cancer worldwide. Unfortunately, the lack of early detection methods translates into a substantial cohort of women grappling with the pressing health crisis. The discovery of extracellular vesicles (EVs) (their major subpopulation exosomes, microvesicles, and apoptotic bodies) has provided new insights into the understanding of cancer. Exosomes, a subpopulation of EVs, play a crucial role in cellular communication and reflect the cellular status under both healthy and pathological conditions. Tumor-derived exosomes (TEXs) dynamically influence ovarian cancer progression by regulating uncontrolled cell growth, immune suppression, angiogenesis, metastasis, and the development of drug and therapeutic resistance. In the field of OC diagnostics, TEXs offer potential biomarkers in various body fluids. On the other hand, exosomes have also shown promising abilities to cure ovarian cancer. In this review, we address the interlink between exosomes and ovarian cancer and explore their theragnostic signature. Finally, we highlight future directions of exosome-based ovarian cancer research.</p

Properties of an alkali-thermo stable xylanase from Geobacillus thermodenitrificans A333 and applicability in xylooligosaccharides generation

An extracellular thermo-alkali-stable and cellulase-free xylanase from Geobacillus thermodenitrificans A333 was purified to homogeneity by ion exchange and size exclusion chromatography. Its molecular mass was 44 kDa as estimated in native and denaturing conditions by gel filtration and SDS-PAGE analysis, respectively. The xylanase (GtXyn) exhibited maximum activity at 70 °C and pH 7.5. It was stable over broad ranges of temperature and pH retaining 88 % of activity at 60 °C and up to 97 % in the pH range 7.5–10.0 after 24 h. Moreover, the enzyme was active up to 3.0 M sodium chloride concentration, exhibiting at that value 70 % residual activity after 1 h. The presence of other metal ions did not affect the activity with the sole exceptions of K+ that showed a stimulating effect, and Fe2+, Co2+ and Hg2+, which inhibited the enzyme. The xylanase was activated by non-ionic surfactants and was stable in organic solvents remaining fully active over 24 h of incubation in 40 % ethanol at 25 °C. Furthermore, the enzyme was resistant to most of the neutral and alkaline proteases tested. The enzyme was active only on xylan, showing no marked preference towards xylans from different origins. The hydrolysis of beechwood xylan and agriculture-based biomass materials yielded xylooligosaccharides with a polymerization degree ranging from 2 to 6 units and xylobiose and xylotriose as main products. These properties indicate G. thermodenitrificans A333 xylanase as a promising candidate for several biotechnological applications, such as xylooligosaccharides preparation

VKORC1 Pharmacogenetics and Pharmacoproteomics in Patients on Warfarin Anticoagulant Therapy: Transthyretin Precursor as a Potential Biomarker

Recognizing specific protein changes in response to drug administration in humans has the potential for the development of personalized medicine. Such changes can be identified by pharmacoproteomics approach based on proteomic technologies. It can also be helpful in matching a particular target-based therapy to a particular marker in a subgroup of patients, in addition to the profile of genetic polymorphism. Warfarin is a commonly prescribed oral anticoagulant in patients with prosthetic valve disease, venous thromboembolism and stroke.We used a combined pharmacogenetics and iTRAQ-coupled LC-MS/MS pharmacoproteomics approach to analyze plasma protein profiles of 53 patients, and identified significantly upregulated level of transthyretin precursor in patients receiving low dose of warfarin but not in those on high dose of warfarin. In addition, real-time RT-PCR, western blotting, human IL-6 ELISA assay were done for the results validation.This combined pharmacogenomics and pharmacoproteomics approach may be applied for other target-based therapies, in matching a particular marker in a subgroup of patients, in addition to the profile of genetic polymorphism

Isolated left ventricular non-compaction in association with ventricular tachycardia

A 32-year-old young male was found to have non-sustained, repetitive, monomorphic ventricular tachycardia of right bundle branch morphology during routine pre-anaesthetic evaluation for orthopaedic surgery. Echocardiography and left ventricular angiogram were suggestive of isolated non-compaction of left ventricular apex with systolic dysfunction. He was successfully managed with anti-arrhythmic drugs and had an uneventful 9-month follow-up. The index case is an unusual association of asymptomatic, non-sustained ventricular tachycardia with isolated ventricular non-compaction

Wavelet adaptive quantization based color image segmentation

Image segmentation is an important pre-processing step towards higher level tasks such as object recognition, computer vision or image compression. Most of the existing segmentation algorithms deal with grayscale images only. But in the modern world, color images are extensively used in many situations. A new approach for color image segmentation is presented in this paper. There are many ways to deal with image segmentation problem and in these techniques; a particular class of algorithms traces their origin from region-based methods. These algorithms group homogeneous pixels, which are connected to primitive regions. They are easy to implement and are promising. Therefore, here one of the most efficient region-based segmentation algorithms is explained. The color image is quantized adaptively, using a wavelet transform. Then the region growing process is adopted. As preprocess, before actual region merging, small regions are eliminated by merging them with neighbor regions depending upon color similarity. After this, homogeneous regions are merged to get segmented output.</jats:p