Confronting the opioid crisis: Practical pain management and strategies: AOA 2018 critical issues symposium

The United States is in the midst of an opioid crisis. Clinicians have been part of the problem because of overprescribing of narcotics for perioperative pain management. Clinicians need to understand the pathophysiology and science of addiction to improve perioperative management of pain for their patients. Multiple modalities for pain management exist that decrease the use of narcotics. Physical strategies, cognitive strategies, and multimodal medication can all provide improved pain relief and decrease the use of narcotics. National medical societies are developing clinical practice guidelines for pain management that incorporate multimodal strategies and multimodal medication. Changes to policy that improve provider education, access to naloxone, and treatment for addiction can decrease narcotic misuse and the risk of addiction

Relationship between the levels of Serum Thyroid Hormones and the Risk of Breast Cancer

Breast cancer is still one of the leading causes of cancer death in women, but there has been a sustained decline in mortality rates over the last decades the relationship between breast cancer and thyroid diseases is controversial many works have been done in past also. The relation between autoimmune and non-autoimmune thyroid diseases has been investigated in patients with breast cancer and age-matched control individuals without breast or thyroid disease. Determination of serum thyroid hormone and antibody levels was done in 100 breast cancer patients and 75 control individuals. The mean values for thyroid hormones and anti-thyroid peroxidase antibodies were significantly higher in breast cancer patients than in control individuals. Our results indicate an increased prevalence of autoimmune and non-autoimmune thyroid diseases in breast cancer patients. Keywords: breast, cancer, autoimmune thyroid diseases

Transgenesis: An efficient tool in mulberry breeding

Genetic engineering is the most potent biotechnological approach dealing with transfer of specially constructed gene assemblies through various transformation techniques. Tools of recombinant DNA technology facilitated development of transgenic plants.  The plants obtained through genetic engineering contain a gene or genes usually from an unrelated organisms, and are known as transgenic plants. The combined use of recombinant DNA technology, gene transfer methods and tissue culture techniques has  led to the efficient transformation and production of transgenics in a wide variety of crop plants. In fact transgenesis has emerged as a novel tool for carrying out “single gene breeding” or transgenic breeding of crop plants. Identification, isolation and cloning of resistant genes is the prerequisite for development of transgenic plants for disease resistance. Identification of resistance genes on the basis of amino acid sequence, conservation enables plant breeder to monitor resistance gene segregation using  appropriate DNA probe intend of testing progeny for disease resistance and susceptibility. Significant developments in plant  genetic modification have been achieved in the last 15 years. Some of the success include herbicide tolerant corn, cotton,  soyabeen and papaya; virus resistant corn, potato, cotton among others. In mulberry, little work has been carried out at Delhi University (south campus). They have developed drought and salinity tolerent transgenic mulberry through Agrobacterium mediated transformation. The overexpression of HVA1 gene from barley generates tolerence to salinity and water stress in  transgenic mulberry (Morus indica).Keywords: Transgenic plant, mulberry, resistance, salinity

Effect of ethrel and nitrogen on nitrate reductase activity, photosynthesis, biomass and yield of mustard (Brassica juncea L. Czern and Coss)

      The plants of mustard (Brassica juncea L. Czern and Coss; cultivar Alankar) were treated with 200 µL/L ethrel (2-chloro ethyl phosphonic acid) at flowering stage (60 d after sowing) along with basal application of nitrogen 40, 60, and 80 kg N ha-1. Effect of ethrel and nitrogen on leaf area index (LAI), net photosynthetic rate (PN), nitrate reductase (NR) activity and plant dry mass were recorded at 80 and 100 d after sowing. At harvest pods plant-1, 1000 seed mass and seed yield were recorded. Ethrel 200 µL/L x 80 kg N ha-1 treatment enhanced all the characteristics studied during the experiment

Advances in Nematode Identification: A Journey from Fundamentals to Evolutionary Aspects

Nematodes are non-segmented roundworms evenly distributed with various habitats ranging to approximately every ecological extremity. These are the least studied organisms despite being the most diversified group. Nematodes are the most critical equilibrium-maintaining factors, having implications on the yield and health of plants as well as well-being of animals. However, taxonomic knowledge about nematodes is scarce. As a result of the lack of precise taxonomic features, nematode taxonomy remains uncertain. Morphology-based identification has proved inefficacious in identifying and exploring the diversity of nematodes, as there are insufficient morphological variations. Different molecular and new evolving methodologies have been employed to augment morphology-based approaches and bypass these difficulties with varying effectiveness. These identification techniques vary from molecular-based targeting DNA or protein-based targeting amino acid sequences to methods for image processing. High-throughput approaches such as next-generation sequencing have also been added to this league. These alternative approaches have helped to classify nematodes and enhanced the base for increased diversity and phylogeny of nematodes, thus helping to formulate increasingly more nematode bases for use as model organisms to study different hot topics about human well-being. Here, we discuss all the methods of nematode identification as an essential shift from classical morphometric studies to the most important modern-day and molecular approaches for their identification. Classification varies from DNA/protein-based methods to the use of new emerging methods. However, the priority of the method relies on the quality, quantity, and availability of nematode resources and down-streaming applications. This paper reviews all currently offered methods for the detection of nematodes and known/unknown and cryptic or sibling species, emphasizing modern-day methods and budding molecular techniques

Efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of acute pain after orthopedic trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma and the Orthopedic Trauma Association

OBJECTIVES: Fracture is a common injury after a traumatic event. The efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) to treat acute pain related to fractures is not well established. METHODS: Clinically relevant questions were determined regarding NSAID use in the setting of trauma-induced fractures with clearly defined patient populations, interventions, comparisons and appropriately selected outcomes (PICO). These questions centered around efficacy (pain control, reduction in opioid use) and safety (non-union, kidney injury). A systematic review including literature search and meta-analysis was performed, and the quality of evidence was graded per the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. The working group reached consensus on the final evidence-based recommendations. RESULTS: A total of 19 studies were identified for analysis. Not all outcomes identified as critically important were reported in all studies, and the outcome of pain control was too heterogenous to perform a meta-analysis. Nine studies reported on non-union (three randomized control trials), six of which reported no association with NSAIDs. The overall incidence of non-union in patients receiving NSAIDs compared with patients not receiving NSAIDs was 2.99% and 2.19% (p=0.04), respectively. Of studies reporting on pain control and reduction of opioids, the use of NSAIDs reduced pain and the need for opioids after traumatic fracture. One study reported on the outcome of acute kidney injury and found no association with NSAID use. CONCLUSIONS: In patients with traumatic fractures, NSAIDs appear to reduce post-trauma pain, reduce the need for opioids and have a small effect on non-union. We conditionally recommend the use of NSAIDs in patients suffering from traumatic fractures as the benefit appears to outweigh the small potential risks

Normative and self-perceived orthodontic treatment need of a Peruvian university population

BACKGROUND: Previous studies on orthodontic treatment need in young adults have shown that up to 50% had malocclusions that needed orthodontic treatment. The aims of this study were to assess the normative and self-perceived need for orthodontic treatment using the Index of Orthodontic Treatment Need (IOTN) and to determine if the treatment need levels were influenced by sex, age and socio-economic status (SES) in a sample of Peruvian young adults. METHODS: 281 first-year students (157 male and 124 female students) with a mean age of 18.1 +/- 1.6 years were randomly selected and evaluated through the Dental Health Component (DHC) and Aesthetic Component (AC) of the IOTN. Structured interview and clinical examination were used to assess the students. Descriptive statistics and Chi-square tests were used for data analysis with statistical significance set at P < 0.05. RESULTS: An intra-examiner reliability of 0.89 was obtained (weighted Kappa). The percentage of students according to SES was 51.2%, 40.6% and 8.2% corresponding to low, medium and high SES respectively. The percentage of students with DHC grades 4–5 was 29.9% whereas the percentage of students with AC grades 8–10 was 1.8%. There were no significant differences in the distribution of normative and self-perceived orthodontic treatment need based on sex, age and SES comparisons. CONCLUSION: Normative orthodontic treatment need was not matched by a similar level of self-perceived treatment need in these young adults. Sex, age and SES were non-significant factors associated with levels of treatment need

Metabolomic Response of Calotropis procera Growing in the Desert to Changes in Water Availability

Water availability is a major limitation for agricultural productivity. Plants growing in severe arid climates such as deserts provide tools for studying plant growth and performance under extreme drought conditions. The perennial species Calotropis procera used in this study is a shrub growing in many arid areas which has an exceptional ability to adapt and be productive in severe arid conditions. We describe the results of studying the metabolomic response of wild C procera plants growing in the desert to a one time water supply. Leaves of C. procera plants were taken at three time points before and 1 hour, 6 hours and 12 hours after watering and subjected to a metabolomics and lipidomics analysis. Analysis of the data reveals that within one hour after watering C. procera has already responded on the metabolic level to the sudden water availability as evidenced by major changes such as increased levels of most amino acids, a decrease in sucrose, raffinose and maltitol, a decrease in storage lipids (triacylglycerols) and an increase in membrane lipids including photosynthetic membranes. These changes still prevail at the 6 hour time point after watering however 12 hours after watering the metabolomics data are essentially indistinguishable from the prewatering state thus demonstrating not only a rapid response to water availability but also a rapid response to loss of water. Taken together these data suggest that the ability of C. procera to survive under the very harsh drought conditions prevailing in the desert might be associated with its rapid adjustments to water availability and losses

A Deletion in Exon 9 of the LIPH Gene Is Responsible for the Rex Hair Coat Phenotype in Rabbits (Oryctolagus cuniculus)

The fur of common rabbits is constituted of 3 types of hair differing in length and diameter while that of rex animals is essentially made up of amazingly soft down-hair. Rex short hair coat phenotypes in rabbits were shown to be controlled by three distinct loci. We focused on the “r1” mutation which segregates at a simple autosomal-recessive locus in our rabbit strains. A positional candidate gene approach was used to identify the rex gene and the corresponding mutation. The gene was primo-localized within a 40 cM region on rabbit chromosome 14 by genome scanning families of 187 rabbits in an experimental mating scheme. Then, fine mapping refined the region to 0.5 cM (Z = 78) by genotyping an additional 359 offspring for 94 microsatellites present or newly generated within the first defined interval. Comparative mapping pointed out a candidate gene in this 700 kb region, namely LIPH (Lipase Member H). In humans, several mutations in this major gene cause alopecia, hair loss phenotypes. The rabbit gene structure was established and a deletion of a single nucleotide was found in LIPH exon 9 of rex rabbits (1362delA). This mutation results in a frameshift and introduces a premature stop codon potentially shortening the protein by 19 amino acids. The association between this deletion and the rex phenotype was complete, as determined by its presence in our rabbit families and among a panel of 60 rex and its absence in all 60 non-rex rabbits. This strongly suggests that this deletion, in a homozygous state, is responsible for the rex phenotype in rabbits