Phytochemical Screening and Hepatoprotective Effect of Alhagi maurorum Boiss (Leguminosae) Against Paracetamol-Induced Hepatotoxicity in Rabbits

Purpose: To evaluate the hepatoprotective activity of aqueous-ethanol (30:70 %) extract of Alhagi maurorum Boiss. (Leguminosae) whole plant against paracetamol-induced liver injury in experimental rabbits.Methods: Aqueous-ethanol extract of Alhagi maurorum at doses of 250 mg/kg and 500 mg/kg body weight, p.o., was administered for 7 days in paracetamol (2 gm/kg, s.c.) intoxicated rabbits and compared with silymarine (50 mg/kg, p.o.)-treated rabbits. Biochemical parameters, alkaline phosphatase (ALP), serum glutamic oxalacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) and total bilirubin (TB) levels were recorded to investigate the degree of improvement in the conditions of the rabbits. The liver was removed, washed with normal saline and preserved in 10 % formalin and used in histopathological studies of hepatic architecture by microscopy. Phytochemical screening of the extract was also carried out.Results: The levels of biochemical parameters were increased in paracetamol intoxicated rabbits when compared with the normal group. The extract, at doses of 250 and 500 mg/kg, exhibited significant (p < 0.001) reduction in biochemical parameters (ALP, SGOT, SGPT and TB). Hepatoprotective activity was also confirmed by histopathological findings. Furthermore, the phytochemical profile of the extract revealed the presence of tannins, alkaloids, saponins and flavonoids.Conclusion: These results suggest that Alhagi maurorum extract possesses significant hepatoprotective effect against paracetamol-induced hepatotoxicity and this may be due to the presence of flavonoids and tannins.Keywords: Alhagi maurorum, Hepatoprotective, Paracetamol, Silymarin, Histopatholog

Pharyngitis and sore throat: A review

Pharyngitis is a sore throat caused by inflammation of the back of the throat. It is one of the most common reasons for visits to family physicians. Throat may be scratchy and swallowing can be painful. Usually, a sore throat is the sign of another illness, such as a cold or the flu. In this review article, epidemiology, national perspective, regional perspective, pathogenesis, clinical diagnosis, clinical presentation and causes of pharyngitis was described.Key words: Pharyngitis, sore throat, inflammation

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Wordless intervention for epilepsy in learning disabilities (WIELD):study protocol for a randomized controlled feasibility trial

Epilepsy is the most common neurological problem that affects people with learning disabilities. The high seizure frequency, resistance to treatments, associated skills deficit and co-morbidities make the management of epilepsy particularly challenging for people with learning disabilities. The Books Beyond Words booklet for epilepsy uses images to help people with learning disabilities manage their condition and improve quality of life. Our aim is to conduct a randomized controlled feasibility trial exploring key methodological, design and acceptability issues, in order to subsequently undertake a large-scale randomized controlled trial of the Books Beyond Words booklet for epilepsy

The world trade center 9/11 disaster and progressive collapse of tall buildings

The collapse of the World Trade Center buildings on September 11, 2001 posed questions on the stability of tall buildings in fire. Understanding the collapse of the WTC Towers offers the opportunity to learn useful engineering lessons in order to improve the design of future tall buildings against fire induced collapse. This paper extends previous research on the modelling of the collapse of the WTC Towers on September 11, 2001 using a newly developed ‘‘structures in fire’’ simulation capability in the open source software framework OpenSees. The simulations carried out are validated by comparisons with previous work and against the findings from the NIST investigation, albeit not in the forensic sense. The column ‘‘pull in’’ that triggers the instability of the structure and leads to collapse is explained. The collapse mechanisms of generic composite tall buildings are also examined. This is achieved through carrying out a detailed parametric study varying the relative stiffness of the column and the floors. The two main mechanisms identified in previous research (weak and strong floor) are reproduced and criteria are established on their occurrence. The analyses performed revealed that the collapse mechanism type depended on the bending stiffness ratio and the number of floors subjected to fire and that the most probable type of failure is the strong floor collapse. The knowledge of these mechanisms is of practical use if stakeholders wish to extend the tenability of a tall building structure in a major fire.Professor Jose Torero and the Open-Sees team at PEER, UC Berkele

Effect of bracing systems on the fire-induced progressive collapse of steel structures

This paper investigates the effect of various bracing systems on the fire-induced progressive collapse resistance of steel-framed structures using OpenSees. Two types of bracing systems (vertical and hat bracing) and various fire scenarios (single and multi-compartment fires) are considered. Four collapse mechanisms of steel frames in fire are found through parametric studies. General collapse is characterized by the collapse of the heated bay followed by lateral drift of adjacent cool bays. Global collapse of a whole frame is due to the buckling of ground floor columns. Another two lateral collapse modes (local and global) are caused by catenary action developed in the heated beams under large deflections. Vertical bracing systems have positive effects on increasing the lateral restraint of the frame against local or global drift, while when arranged at edge bays of frames they negatively contribute to the spreading of a local damage to global collapse in the form of sequential buckling of adjacent columns through load-transfer mechanisms. For a more realistic arrangement of vertical bracings inside the frame, the bracing acts as a barrier to restrain the spread of local damage to the rest of the frame. Instead, using hat bracing can effectively optimize the load-transfer path through a more uniform redistribution of loads in columns and enhance the resistance of structures against progressive collapse. It is found that the application of vertical bracing systems alone on the steel frames to resist progressive collapse is proved to be unsafe and a combined vertical and hat bracing system is recommended in practical design

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or ≥ 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care