Role of Stem Cells in Orthopaedic Surgery: Theoretical Survey

This study aims at analyzing the Stem cell application is a burgeoning field of medicine that is likely to influence the future of orthopaedic surgery. Stem cells are associated with great promise and great controversy. For the orthopaedic surgeon, stem cells may change the way that orthopaedic surgery is practiced and the overall approach of the treatment of musculoskeletal disease. Stem cells may change the field of orthopaedics from a field dominated by surgical replacements and reconstructions to a field of regeneration and prevention. This review will introduce the basic concepts of stem cells pertinent to the orthopaedic surgeon and proceed with a more in depth discussion of current developments in the study of stem cells in orthopaedic surgery. Keywords: Stem cell, orthopaedic, surgery

Treatment of Hypertensive Crisis Using Beta Blockers Vs Diuretics: Review

Current review aiming to evaluate and the advantage and disadvantage and also to discuss the differences in use and combination therapy of beta blockers VS diuretics in the treatment of hypertensive crisis.  Literature were search on topic concerning the treatment of hypertensive crisis, using biomedical databases; PubMed, and Embase, up to August, 2017.  Patients with hypertensive crises could call for immediate reduction in raised high blood pressure to stop and also detain modern end-organ damage. The best scientific setup in which to attain this blood pressure control remains in the intensive care unit, with making use of titratable intravenous hypotensive agents. Beta-blocker- based therapy, numerous possible randomized trials have recorded that diuretic-based treatment is efficient in reducing morbidity and also mortality in hypertensive patients. The advantages of diuretic therapy have actually been shown to be more significant in the senior compared to in younger patients. The result of diuretics is especially articulated when it comes to decrease of the risk of stroke and also somewhat less excellent with regard to the reduction of the danger of coronary heart disease. Keywords: Hypertension, Diuretics Therapy, Beta Blocker, Hypertensive Crisis

The Importance of Preventive Medicine in Family Practice: A Review of Current Guidelines and Recommendations

Prevention is seen as a critical topic in family practice. Primordial prevention, primary prevention, secondary prevention, tertiary prevention, and quaternary prevention are all part of this strategy to disease prevention. To avoid the formation and development of risk factors, primary prevention focuses on addressing the fundamental causes and social determinants of disease. Primary prevention is the practice of preventing illnesses before they arise via the use of treatments such as immunizations and health education. Secondary prevention focuses on illness identification and intervention as early as possible to avoid disease development. Tertiary prevention addresses illness outcomes by restoring health and offering rehabilitation. Finally, quaternary prevention seeks to safeguard patients against needless medical treatments and the harm caused by over-medicating. Risks frequently rise in tandem with frailty and comorbidities. In contrast, advantages frequently drop as life expectancy increases. Preventive management strategies should consider the patient's viewpoint and be mutually agreed upon. Healthcare providers must prioritize the deployment of preventive care services, even when clinical treatments are required, in order to overcome preventive care hurdles. Healthcare practitioners may play a critical role in illness prevention and contribute to family well-being by investing in preventive care and executing these measures

Chlorhexidine versus Povidone-Iodine for the prevention of ‎Surgical Site ‎Infections: A review.‎

BackgroundSurgical Site Infections (SSIs) are the third most frequently reported health care-associated ‎infection‎ and it remain a major clinical problem despite improvements in prevention, as they ‎are associated with ‎significant mortality and morbidity. Prevention strategies for SSIs are based ‎on reducing the risk of infection by bacteria, So many antiseptic agents are ‎used, the most ‎common one are Chlorhexidine and Povidone-Iodine.‎AimsTo discuss the ‎findings of RCTs that compare Chlorhexidine versus Povidone-Iodine in the prevention of ‎Surgical ‎Site ‎Infections (SSIs).‎Methods This systematic review was carried out, including PubMed, Google Scholar, and EBSCO that ‎examining randomized trials of Chlorhexidine and Povidone-Iodine to summarize the major ‎RCT that compare Chlorhexidine versus Povidone-Iodine in the prevention of Surgical Site ‎Infections (SSIs).‎Results The review included six randomized studies that compare between Chlorhexidine and Povidone-‎Iodine for the prevention of SSIs. The findings showed that many studies prefer using ‎Chlorhexidine over Povidine-Iodine to reduce SSIs, few studies prefer using PVI as antiseptic ‎and other studies reported that there is no significant difference between both. ConclusionMajority of results prefer using Chlorhexidine than Povidone-Iodine‎ as antiseptics but ‎there were few findings prefer ‎PVI and other studies reported that there was no significant ‎difference between using them as ‎antiseptics.

Capsaicin ameliorate pulmonary fibrosis via antioxidant Nrf-2/ PPAR- γ pathway activation and inflammatory TGF-β1/ NF-κB/COX II pathway inhibition

Bleomycin is an effective antibiotic with a significant anticancer properties, but its use is limited due to its potential to induce dose-dependent pulmonary fibrosis. Therefore, this study aimed to assess the therapeutic potential of Capsaicin as an additional treatment to enhance patient tolerance to Bleomycin compared to the antifibrotic drug Pirfenidone. Pulmonary fibrosis was induced in rats through by a single intratracheal Bleomycin administration in day zero, followed by either Capsaicin or Pirfenidone treatment for 7 days. After the animals were sacrificed, their lungs were dissected and examined using various stains for macroscopic and histopathological evaluation. Additionally, the study assessed various antioxidant, anti-inflammatory, and antifibrotic parameters were assessed. Rats exposed to Bleomycin exhibited visible signs of fibrosis, histopathological alterations, increased collagen deposition, and elevated mucin content. Bleomycin also led to heightened increased inflammatory cells infiltration in the bronchoalveolar lavage, elevated fibrosis biomarkers such as hydroxyproline, alpha-smooth muscle actin (α-SMA) and transforming growth factor-beta (TGF-β1), increased inflammatory markers including tumor necrosis factor-alpha (TNF-α), interlukine-6 (Il-6), interlukine-1β (Il-1β) nuclear factor-kappa B (NF-κB), and Cyclooxygenase-2 (COX-2), and transforming growth factor-beta (TGF-β1),. Furthermore, it reduced the expression of peroxisome proliferator-activated receptor-gamma (PPAR-γ), increased oxidative stress biomarkers like nitric oxide (NO), malondialdehyde (MDA), myeloperoxidase (MPO) and protein carbonyl. Bleomycin also decreased the expression of nuclear factor erythroid 2–related factor 2 (Nrf-2), reduced glutathione (GSH), total antioxidant capacity, and the activities of catalase and superoxide dismutase (SOD). Treating the animals with Capsaicin and Pirfenidone following Bleomycin exposure resulted in improved lung macroscopic and microscopic characteristics, reduced collagen deposition (collagen I and collagen III) and mucin content, decreased inflammatory cell infiltration, lowered levels of hydroxyproline, α-SMA, and TGF-β1, decreased TNF-α, Il-6, Il-1β, NF-κB, and COX-2, increased PPAR-γ and Nrf-2 expression, and improvement improved in all oxidative stress biomarkers. In summary, Capsaicin demonstrates significant antifibrotic activity against Bleomycin-induced lung injury that may be attributed, at least in part, to the antioxidant and anti-inflammatory activities of Capsaicin mediated by upregulation of PPAR-γ and Nrf-2 expression and decreasing. TGF-β1, NF-κB and COX II proteins concentrations

Transcriptional analysis of Rhazya stricta in response to jasmonic acid

Background: Jasmonic acid (JA) is a signal transducer molecule that plays an important role in plant development and stress response; it can also efficiently stimulate secondary metabolism in plant cells. Results: RNA-Seq technology was applied to identify differentially expressed genes and study the time course of gene expression in Rhazya stricta in response to JA. Of more than 288 million total reads, approximately 27% were mapped to genes in the reference genome. Genes involved during the secondary metabolite pathways were up- or downregulated when treated with JA in R. stricta. Functional annotation and pathway analysis of all up- and downregulated genes identified many biological processes and molecular functions. Jasmonic acid biosynthetic, cell wall organization, and chlorophyll metabolic processes were upregulated at days 2, 6, and 12, respectively. Similarly, the molecular functions of calcium-transporting ATPase activity, ADP binding, and protein kinase activity were also upregulated at days 2, 6, and 12, respectively. Time-dependent transcriptional gene expression analysis showed that JA can induce signaling in the phenylpropanoid and aromatic acid pathways. These pathways are responsible for the production of secondary metabolites, which are essential for the development and environmental defense mechanism of R. stricta during stress conditions. Conclusions: Our results suggested that genes involved in flavonoid biosynthesis and aromatic acid synthesis pathways were upregulated during JA stress. However, monoterpenoid indole alkaloid (MIA) was unaffected by JA treatment. Hence, we can postulate that JA plays an important role in R. stricta during plant development and environmental stress conditions. How to cite: Hajrah, NH, Rabah SO, Alghamdi MK, et al. Transcriptional analysis of Rhazya stricta in response to jasmonic acid. Electron J Biotechnol 2021;50. https://doi.org/10.1016/j.ejbt.2021.01.00

Coronary Artery Bypass grafting (CABG) versus Percutaneous Coronary Intervention (PCI) in the treatment of multivessel coronary disease

BackgroundRevascularization for patients who suffer multivessel coronary artery disease is a common procedure around the world. Taking United about 700,000 patients have multivessel coronary revascularization per year ¼ of these patients are diagnosed with diabetes. AimsTo summarize the current evidence that compare CABG to PCI in multivessel coronary disease‎ in form of ‎cardiac death, stroke, MI and unplanned devascularization.‎Methods This is a systematic review was carried out, including PubMed, Google Scholar, and EBSCO that examining randomized trials of treatment of multivessel coronary disease to summarize the major RCT concerning this topic.Results The review included five randomized studies that compare coronary artery bypass grafting and percutaneous coronary intervention. The findings showed that CABG show better result with less mortality rate.ConclusionThis review concluded that there revascularization in treating coronary artery disease could be conducted either by CABG or PCI, CABG show better result as it cause less death, MI and revascularization rates, but the usage of new additions such as second generation DES, can also improve the safety and efficacy of PCI when added to it

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Comparison of total endoscopic thyroidectomy with conventional open thyroidectomy for treatment of papillary thyroid cancer

BackgroundRecent advance of endoscopic techniques has allowed surgeons to perform thyroidectomy via an incision placement at hidden places which lead to better cosmetic acceptability compared with conventional open thyroidectomy.AimsThis study was conducted to summarize the current evidence that compare open thyroidectomy with endoscopic ‎thyroidectomy in treatment of papillary thyroid cancer‎.‎Methods An electronic literature review, including PubMed, Google Scholar, and EBSCO that examining randomized trials of endoscopic thyroidectomy (ET), conventional open thyroidectomy (COT), and management of papillary thyroid carcinoma was carried out.Results The review included 8 randomized studies that compare total endoscopic thyroidectomy versus conventional open thyroidectomy in treatment of papillary thyroid cancer. The findings showed endoscopic thyroidectomy had statically significant cosmetic appearance, less amount of blood loss and occurrence of transient hypocalcaemia than conventional open thyroidectomy in form of cosmetic outcome, amount lower blood loss.ConclusionThe current review showed that, ET has a better cosmetic outcome and lower blood loss compared with COT. While COT was associated with significantly low operation time, hospital stay, drainage time, amount of drainage fluid and transient recurrent laryngeal nerve (RLN) palsy