Clinical benefits of preemptive oral clonidine versus oral tramadol for abdominal hysterectomy conducted under subarachnoid block with 0.5% hyperbaric bupivacaine: a comparative evaluation

Background: Neuraxial techniques possess many benefits for elective abdominal hysterectomy due to profound surgical anesthesia and muscle relaxation. The present study was aimed to compare the clinical benefits of pre-emptive oral clonidine with oral tramadol for abdominal hysterectomy conducted under subarachnoid block with 0.5% hyperbaric bupivacaine.Methods: Sixty adult female patients of American Society of Anaesthesiologists (ASA) physical status I and II, aged 42 to 65 years, were randomized into two groups of 30 patients each to receive either oral clonidine, 100 µg (Group C) or oral tramadol 50 mg tramadol (Group T), 90 min before initiation of subarachnoid block with 3.5 mL of 0.5% hyperbaric bupivacaine. Intraoperative hemodynamic changes, duration of analgesia and incidence of shivering were recorded as primary end points. Drug related effects of pruritus, sedation, nausea, vomiting, and respiratory depression were recorded as secondary outcomes.Results: The onset of sensory and motor block was comparable between the groups but the time to two dermatome regression were prolonged in patients of Group C with statistical significant difference (p=0.05). Duration of analgesia was also enhanced in patients of Group C (268.27±12.18 min versus 223.15±14.31 min in Group T) with statistically highly significant difference (p=0.000). The incidence of shivering was lower in the patients of clonidine group. The heart rate was lower in patients of clonidine throughout intraoperative period and no incidence of bradycardia, hypotension or sedation occurred in any patient.Conclusions: Both drugs showed clinical benefits as pre-emptive oral medication for abdominal hysterectomy conducted under subarachnoid block but oral clonidine (100 µg) proved to be more beneficial

Identification of novel biomarkers in chronic immune thrombocytopenia (ITP) by microarray-based serum protein profiling

The pathological mechanisms underlying the development of immune thrombocytopenia (ITP) are unclear and its diagnosis remains a process of exclusion. Currently, there are no known specific biomarkers for ITP to support differential diagnosis and treatment decisions. Profiling of serum proteins may be valuable for identifying such biomarkers. Sera from 46 patients with primary chronic ITP and 34 healthy blood donors were analysed using a microarray of 755 antibodies. We identified 161 differentially expressed proteins. In addition to oncoproteins and tumour-suppressor proteins, including apoptosis regulator BCL2, breast cancer type 1 susceptibility protein (BRCA1), Fanconi anaemia complementation group C (FANCC) and vascular endothelial growth factor A (VEGFA), we detected six anti-nuclear autoantibodies in a subset of ITP patients: anti-PCNA, anti-SmD, anti-Ro/SSA60, anti-Ro/SSA52, anti-La/SSB and anti-RNPC antibodies. This finding may provide a rational explanation for the association of ITP with malignancies and other autoimmune diseases. While RUNX1mRNA expression in the peripheral blood mononuclear cells (PBMC) of patients was significantly downregulated, an accumulation of RUNX1 protein was observed in the platelets of ITP patients. This may indicate dysregulation of RUNX1 expression in PBMC and megakaryocytes and may lead to an imbalanced immune response and impaired thrombopoiesis. In conclusion, we provide novel insights into the pathogenic mechanisms of ITP that warrant further exploration

Effect of Cold- and Hot-Break Heat Treatments on the Physicochemical Characteristics of Currant Tomato (Solanum pimpinellifolium) Pulp and Paste

Currant tomato (Solanum pimpinellifolium), an underutilized wild species of modern tomato, was investigated to determine the physicochemical properties and understand the effect of cold- and hot-break heat treatments on physicochemical characteristics. Moreover, a new Arrhenius-type equation was used to model the temperature-dependent viscosity of currant tomato pulp and paste. The currant tomato’s porosity, surface area, and lycopene content were 40.96 ± 0.84%, 663.86 ± 65.09 mm2, and 9.79 ± 1.88 mg/100 g, respectively. Cold- and hot-break heat treatments had a significant (p < 0.05) effect on tomato pulp and paste color change (0.09 to 0.26; 0.19 to 1.96), viscosity (0.06 to 0.02 Pa.s; 0.85 to 0.37 Pa.s), and lycopene content (9.70 to 9.07 mg/100 g; 9.60 to 9.37 mg/100 g), respectively. An Arrhenius-type equation described the temperature-dependent viscosity of currant tomato pulp and paste with activation energy (Ea) ranging from 7.54 to 11.72 kJ/mol and 8.62 to 8.97 kJ/mol, respectively. Principal component analysis (PCA) revealed a total of variance 99.93% in tomato pulp and paste as affected by the cold- and hot-break heat treatments. Overall, the findings may provide knowledge for design graders and process optimization to develop currant tomato-based products