Management of parturient with triplet pregnancy and placenta percreta: Importance of multi-disciplinary approach

Obstetric conditions like placenta percreta and multiple pregnancies can be extremely challenging as they pose a high risk for both the mother and infants. In placenta percreta, placental villi penetrate through the wall of uterus into the surrounding organs including the bladder and carry a risk of massive maternal bleeding. Multiple pregnancies have greater complication rate than that in singleton pregnancy. Successful management of such challenges are best done by a multidisciplinary teamwork, where all members of a perinatal team are involved in decision making and management. We report the successful management of a triplet gestation associated with placenta percreta

Identify cmy-2 Incompatibility Groups in Salmonella Multidrug Resistance Plasmids

Many Gram negative bacteria including Salmonella enterica species exhibit evolving multi-drug resistance coded for on their chromosome and on mobile genetic elements. Salmonella species carrying multi-drug resistance plasmids can potentially disperse the cmy-2 gene conferring β- lactam resistance to new Salmonella species as well as to other enteric bacteria commonly found in the human and animal gut. Objective: This study seeks to identify the numbers and incompatibility types of plasmids carried by six different Salmonella clinical isolates. Design: Raw whole genome and DNA fragment (contig) sequence secondary data analyses were conducted using the Center for Genomic Epidemiology (Lyngby, Denmark) open source internet databases plasmid Multilocus Sequence Typing (pMLST) and Resistance Finder (ResFinder). Method: Nucleic acid sequences were separated into files, labeled by contig, and uploaded to the consensus databases for analysis against known Salmonella resistance genes and plasmid types. Results were returned in table format and identified specific resistance, susceptibility, and incompatibility groups present with greater than 90% homology between known and analyzed DNA sequences. Results: Results of this analysis show that these bacterial strains carry plasmids which confer multi-drug resistance and that multiple incompatibility groups are present across some but not all analyzed Salmonella strains. Conclusions: The researchers continue to analyze the data and have not yet formed conclusions as to their significance. This study will advance our understanding about how bacteria develop multiple antibiotic resistances and could ultimately help design more effective drugs with greater potential to combat and prevent bacterial diseases

Ultrathin uniform platinum nanowires via a facile route using an inverse hexagonal surfactant phase template

We present an attractive method for the fabrication of long, straight, highly crystalline, ultrathin platinum nanowires. The fabrication is simply achieved using an inverse hexagonal (HII) lyotropic liquid crystal phase of the commercial surfactant phytantriol as a template. A platinum precursor dissolved within the cylindrical aqueous channels of the liquid crystal phase is chemically reduced by galvanic displacement using stainless steel. We demonstrate the production of nanowires using the HII phase in the phytantriol/water system which we obtain either by heating to 55 °C or at room temperature by the addition of a hydrophobic liquid, 9-cis-tricosene, to relieve packing frustration. The two sets of conditions produced high aspect nanowires with diameters of 2.5 and 1.7 nm, respectively, at least hundreds of nanometers in length, matching the size of the aqueous channels in which they grow. This versatile approach can be extended to produce highly uniform nanowires from a range of metals

The analgesic efficacy of ultrasound-guided transversus abdominis plane block vs. local anesthetic infiltration technique in major gynecologic surgery: A randomized controlled trial

Background and aim: Transversus abdominis plane (TAP) block and local anesthetic infiltration (LAI) technique are used as part of the multimodal analgesic regimen after abdominal surgery. Postoperative opioid consumption and analgesic efficacy was compared using TAP and LAI techniques in patients undergoing gynecologic surgery in a randomized, controlled clinical trial.Material and methods: Total of 135 patients scheduled for major gynecological surgeries were allocated into three groups: group T received bilateral TAP block with bupivacaine 0.25%; group I received LAI with 0.25% bupivacaine with epinephrine 5 μ/mL in the peritoneum and abdominal wall, and group C was control group. Anesthesia and postoperative analgesia were standardized. Outcome measures were cumulative and rescue tramadol consumption, numerical rating score (NRS) for pain and side effects in post-anesthesia care unit (PACU) at 4, 8, 12 hours postoperatively.Results: Tramadol consumption, need for rescue analgesia, and NRS for pain between three groups at 4, 8, and 12 hours postoperatively had no statistically significant difference (P \u3c 0.05). In PACU, median tramadol consumption used for rescue analgesia between group T (15 (15-30)) and group C (30 (15-45)) (P = 0.035), and between group T (15 (15-30)) and group I (30 (15-52)) was statistically significant (P = 0.034). In PACU, the percentage of patients having NRS \u3e4 on movement in group C (72%) compared to group T (46.5%) and group I (46.5%) was significant (P = 0.034). No statistically significant difference was observed in the incidence of side effects among study groups (P \u3e 0.05).Conclusion: Except for the immediate postoperative period, neither TAP block nor LAI had added benefit to the multimodal analgesia regimen in patients undergoing gynecological surgeries

Postoperative myocardial injury in a patient with left ureteric stone and asymptomatic COVID-19 disease

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified on 8thDecember 2019 in Wuhan, Hubei, China, and has since spread globally to become an emergency of international concern. Patients infected with SARS-CoV-2 may be asymptomatic or present with symptoms ranging from mild clinical manifestations: such as fever, cough, and sore throat to moderate and severe form of the disease such as pneumonia and acute respiratory distress syndrome (ARDS). In some patients, SARS-CoV-2 can affect the heart and cause myocardial injury which is evidenced either by electrocardiographic (ECG) changes or by a rise in serum troponin level. Patients with myocardial involvement are generally at risk of developing severe illness and tend to have a poor outcome. We hereby present a case of a hypertensive male patient with undiagnosed, asymptomatic COVID-19, who underwent an emergency urologic procedure for ureteric calculi. He eventually sustained a postoperative myocardial injury resulting in his demise. This case highlights the importance of detailed preoperative assessment and anticipation of complications during this global pandemic

Assessment of total phenolic and flavonoid contents of selected fruits and vegetables

686-693This work was conceptualized with the goal to investigate different fruits and vegetables for their comparative investigation of total phenolic and total flavonoid contents. The total phenolic content of 9 fruits and 12 vegetables used in the current study was determined by Folin-Ciocalteau assay. In addition, total flavonoid content was identified through catechin and aluminum colorimetric analysis. The ratio among the phenolic and flavonoid contents of fruits and vegetables extracts were also analyzed. Our results showed that methanolic extract of Citrullus lanatus had higher contents of phenolics and flavonoids (215±1.24 mg GAE/100 g and 73±0.81 mg CE/100 g) than other fruits. Moreover, maturity process of fruits from unripened to fully ripened stage showed significant increase in the total phenolic and flavonoid contents. Fruits under study had shown flavonoids/phenolics ratio of 0.32, which indicates that these fruits contained about 32% of flavonoid contents. Among vegetables, the greatest value of phenolic contents was observed in Capsicum annuum (213±1.24 mg GAE/100 g), and total flavonoid content in Raphanus sativus (45±1.24 mg CE/100 g). Vegetables showed lower ratios of flavonoids/phenolics (0.11-0.2) indicating lesser total flavonoid content (11-20%) as compared with fruits. The obtained results indicate that fruits and vegetables could be attributed to a potential source of natural phenolics and flavonoids in the pharmaceutical and food industry. Moreover, the antioxidant activities of these selected fruits and vegetables should also be determined in order to explore their beneficial effects against the prevention and management of disorders caused by oxidative stress

Assessment of total phenolic and flavonoid contents of selected fruits and vegetables

This work was conceptualized with the goal to investigate different fruits and vegetables for their comparative investigation of total phenolic and total flavonoid contents. The total phenolic content of 9 fruits and 12 vegetables used in the current study was determined by Folin-Ciocalteau assay. In addition, total flavonoid content was identified through catechin and aluminum colorimetric analysis. The ratio among the phenolic and flavonoid contents of fruits and vegetables extracts were also analyzed. Our results showed that methanolic extract of Citrullus lanatus had higher contents of phenolics and flavonoids (215±1.24 mg GAE/100 g and 73±0.81 mg CE/100 g) than other fruits. Moreover, maturity process of fruits from unripened to fully ripened stage showed significant increase in the total phenolic and flavonoid contents. Fruits under study had shown flavonoids/phenolics ratio of 0.32, which indicates that these fruits contained about 32% of flavonoid contents. Among vegetables, the greatest value of phenolic contents was observed in Capsicum annuum (213±1.24 mg GAE/100 g), and total flavonoid content in Raphanus sativus (45±1.24 mg CE/100 g). Vegetables showed lower ratios of flavonoids/phenolics (0.11-0.2) indicating lesser total flavonoid content (11-20%) as compared with fruits. The obtained results indicate that fruits and vegetables could be attributed to a potential source of natural phenolics and flavonoids in the pharmaceutical and food industry. Moreover, the antioxidant activities of these selected fruits and vegetables should also be determined in order to explore their beneficial effects against the prevention and management of disorders caused by oxidative stress

Régulation de l'expression hépatique de récepteur LSR (lipolys stimulated lipoprotein receptor): rôles de l'acide docosahexaénoïque et du récepteur PPARa (peroxisome proliferator-activated receptor alpha)

Lipolysis stimulated lipoprotein receptor (LSR) plays an important role in the clearance of ApoB/ApoE containing triglyceride-rich lipoproteins during postprandial phase. In this study, we demonstrated that in vitro treatment of mouse hepatoma cells, Hepa 1-6, with docosahexaenoic acid (DHA) led to an increase in LSR protein levels as well as its activity. Furthermore, the mice placed on the diet supplemented with DHA showed an increase in hepatic LSR protein. However, the mRNA levels remained unchanged in both in vitro and in vivo studies, suggesting that DHA enrichment may result in changes in LSR microenvironment that could affect its anchorage at the surface of cell membrane. Specific peroxisome proliferator response elements were identified in the upstream region of human, mouse and rat lsr gene by in silico analysis. We therefore sought to determine the role of the transcription factor, peroxisome proliferator-activated receptor (PPAR[alpha]), in LSR regulation. In vitro pharmacological studies using PPAR[alpha]-selective agonist and antagonist agents demonstrated that PPAR[alpha] is indeed involved in the transcriptional regulation of LSR expression. Furthermore, qPCR array analysis revealed the downregulation of PPAR[alpha] and various genes involved in hepatic lipid metabolism in LSR+/- mice on standard and high-fat diets. In conclusion, these studies show that the hepatic LSR activity is controlled by dietary factors that can activate various pathways involved in regulating lipid homeostasis, therefore representing LSR as a potential target for either nutritional or therapeutic strategies towards the prevention or treatment of dyslipidemiaLe récepteur LSR est un acteur important du métabolisme hépatique, puisqu'il joue un rôle dans la clairance des lipoprotéines à ApoB/ApoE riches en triglycérides durant la période postprandiale. Dans cette étude, nous avons montré qu'un traitement in vitro par DHA peut augmenter les niveaux de protéine et d'activité LSR dans les cellules d'hépatome de souris Hepa 1-6. En toute cohérence, un régime supplémenté en DHA a conduit à élever les niveaux de protéine LSR hépatique chez la souris. Mais aucune de ces deux études n'a montré de changement au niveau des ARNm. Ceci suggère que l'enrichissement en DHA influe positivement sur le microenvironnement de LSR et son ancrage à la surface de la cellule. Nous avons ensuite étudié le rôle du récepteur PPAR[alpha] dans la régulation du gène lsr. Une analyse in silico nous a permis d'identifier des éléments PPRE dans la région 5' régulatrice du gène humain et de ses homologues de souris et de rat. Des traitements pharmacologiques par des agoniste et antagoniste spécifiques de PPAR[alpha] ont montré que ce récepteur est impliqué dans la régulation transcriptionnelle de l'expression du LSR dans les cellules Hepa 1 6. Enfin, une analyse transcriptomique a révélé une diminution de l'expression de PPAR[alpha] et d'autres gènes impliqués dans le métabolisme lipidique hépatique chez la souris LSR+/- sous régime standard ou riche en graisses. En conclusion, toutes ces études indiquent que l'activité LSR hépatique est sous le contrôle de facteurs nutritionnels capables d'activer divers mécanismes de régulation, faisant du LSR une cible d'intérêt potentiel pour des stratégies nutritionnelles ou thérapeutiques destinées à prévenir ou traiter les dyslipidémie