Green facile synthesis of Ag-doped ZnO nanoparticles from Gymnema sylvestre leaf extract and investigation of their Antibacterial activity

The unique characteristics of the green synthesis pathway have opened the way for a new field of scientific investigation. The current study used green chemistry methodologies to produce pure zinc oxide (ZnO) (G1) and silver doped zinc oxide (Ag doped ZnO) (G2) nanoparticles (NPs) using Gymnema sylvestre (G. sylvestre) leaf extract as a reducing as well as capping agent. XRD, FESEM, EDAX, and FT-IR investigations were used to investigate the structural characterization of G1 and G2 NPs. The UV–Vis and PL analyses were used to examine the optical characteristics. The results clearly reveal that the leaf extract is the best possible stabilizing agent for the manufacture of G1 and G2 NPs, and that the generated nanoparticles operate as potent microbial agents, inhibiting the growth of a variety of dangerous microbes. Due to their eco–friendly and non–toxic compatibility, the prepared G1 and G2 NPs can be employed for therapeutic and other purposes

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