Feeding Overlap Investigations between Hypophthalmichthys Molitrix and Cyprinus Carpio from Punjab, Pakistan

Freshwater ichthyofauna is facing intensive stress as a result of urbanization and growing industries in Pakistan. The alien fish species are considered one of the major challenges due to their deleterious effects. Feeding habit analysis is a basic tool to evaluate the ecological stress on fish species residing in different habitats. The present study was designed to disclose the feeding overlap between Cyprinus carpio (Common Carp) and Hypophthalmichthys molitrix (Silver Carp) from Head Marala (river Chenab) and Mangla Dam (river Jhelum). For this purpose, 20 samples i-e 10 from each site of each fish species out of total 40 were captured from March to May 2022 and analyzed at the Department of Zoology, University of Sialkot through gut content analyses. Results indicated that there was a significant feeding overlap with Schoener index values of 0.65 and 0.89 at Head Marala and Mangla Dam respectively between two exotic fish species. It is observed that the aquatic ecosystem of Pakistan is being depleted, where highly generalist feeder invasive fishes have interspecific feeding overlap. It is recommended that the management of the freshwater ecosystem and resident ichthyofauna should be treated as a top priority; otherwise, these may embrace an inevitable and incalculable loss. This functional baseline data will help the land managers and aquaculturists to conserve the freshwater ecosystem of Pakistan

Antioxidant, Cytotoxic, and Antimicrobial Potential of Silver Nanoparticles Synthesized using Tradescantia pallida Extract

Silver nanoparticles have received much attention, due to their wide range of biological applications as an alternative therapy for disease conditions utilizing the nanobiotechnology domain for synthesis. The current study was performed to examine the antioxidant, anticancer, antibacterial, and antifungal potential of biosynthesized silver nanoparticles (TpAgNPs) using plant extract. The TpAgNPs were produced by reacting the Tradescantia pallida extract and AgNO3 solution in nine various concentration ratios subjected to bioactivities profiling. According to the current findings, plant extract comprising phenolics, flavonoids, and especially anthocyanins played a critical role in the production of TpAgNPs. UV–visible spectroscopy also validated the TpAgNP formation in the peak range of 401–441 nm. Further, the silver ion stabilization by phytochemicals, face-centered cubic structure, crystal size, and spherical morphology of TpAgNPs were analyzed by FTIR, XRD, and SEM. Among all TpAgNPs, the biosynthesized TpAgNP6 with a medium concentration ratio (5:10) and the plant extract had effective antioxidant potentials of 77.2 ± 1.0% and 45.1 ± 0.5% free radical scavenging activity, respectively. The cytotoxic activity of TpAgNP6 in comparison to plant extract for the rhabdomyosarcoma cell line was significantly the lowest with IC50 values of 81.5 ± 1.9 and 90.59 ± 1.6 μg/ml and cell viability % of 24.3 ± 1.62 and 27.4 ± 1.05, respectively. The antibacterial and antifungal results of TpAgNPs revealed significant improvement in comparison to plant extract, i.e., minimum inhibition concentration (MIC) 64 μg/ml against Gram-negative Pseudomonas aeruginosa while, in the case of antifungal assay, TpAgNP6 was active against Candida parapsilosis. These TpAgNPs play a crucial role in determining the therapeutic potential of T. pallida due to their biological efficacy

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: Multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P \u3c 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (β coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

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 years; 78.2% included were male with a median age of 37 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

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

An Overview of the Antibacterial Implications of Lansium domesticum

Lansium domesticum belongs to the family Meliaceae and is admired for its fruit in southern Asia. The family Meliaceae is known as novel bioactive compounds that are usually used in folk remedy as a drug for the treatment of diarrhea. The leaf and bark mixture of L. domesticum cv. duku exhibited antibacterial activity towards Bacillus subtile, Staphylococcus aureus, and Echerichia coli. Phytochemical screening of fruit waste of L. domesticum showed the presence of 3β -hydroxyonocera-8, 21α -hydroxyonocera-8, 14-dien-21-one and 14-dien-3-one, lansic acid. The seeds contain tetranortriterpenoids. The bark contains active compounds namely onoceradienedione, lansiolic acid A, iso-onoceratriene and 3-keto lansiolic acid. The methanolic extract of the bark of L. domesticum cv kokossan showed major antibacterial efficacy against Escherichia coli and. Bacillus subtilis The ethyl acetate extract exhibited an antibacterial efficacy with an inhibit zone respectively of 14 and 12.5 mm towards E. coli and B. cereus. Silver nanoparticles have a future in an antimicrobial role. The silver nanoparticles of L. domesticum are spherical in shape with a size from10-30 nm

An Overview of the Antibacterial Implications of Lansium domesticum

Lansium domesticum belongs to the family Meliaceae and is admired for its fruit in southern Asia. The family Meliaceae is known as novel bioactive compounds that are usually used in folk remedy as a drug for the treatment of diarrhea. The leaf and bark mixture of L. domesticum cv. duku exhibited antibacterial activity towards Bacillus subtile, Staphylococcus aureus, and Echerichia coli. Phytochemical screening of fruit waste of L. domesticum showed the presence of 3β -hydroxyonocera-8, 21α -hydroxyonocera-8, 14-dien-21-one and 14-dien-3-one, lansic acid. The seeds contain tetranortriterpenoids. The bark contains active compounds namely onoceradienedione, lansiolic acid A, iso-onoceratriene and 3-keto lansiolic acid. The methanolic extract of the bark of L. domesticum cv kokossan showed major antibacterial efficacy against Escherichia coli and. Bacillus subtilis The ethyl acetate extract exhibited an antibacterial efficacy with an inhibit zone respectively of 14 and 12.5 mm towards E. coli and B. cereus. Silver nanoparticles have a future in an antimicrobial role. The silver nanoparticles of L. domesticum are spherical in shape with a size from10-30 nm

N-(2,4-Dichlorophenyl)-1,3-thiazol-2-amine

In the title molecule, C9H6Cl2N2S, the mean planes of the benzene and thiazole rings make a dihedral angle of 54.18 (8)°. In the crystal, molecules are joined into dimers with an R22(8) ring motif by pairs of N—H...N hydrogen bonds. These dimers are linked by C—H...Cl interactions into layers parallel to (011). The thiazole rings form columns along the c-axis direction, with a centroid–centroid separation of 3.8581 (9) Å, indicating π–π interactions. An intramolecular C—H...S contact also occurs