NEPHROPROTECTIVE ACTIVITY OF PLUMERIA RUBRA AGAINST CISPLATIN INDUCED NEPHROTOXICITY IN EXPERIMENTAL RATS

Objective: The current study was designed to evaluate the protective effect of standardized hydroalcoholic extract of Plumeria rubra (HAEPR) against cisplatin-induced nephrotoxicity in Wistar rats.  Methods: HAEPR was administered orally at 3 dose levels (100,200,400 mg/kg). Vitamin E (250 mg/kg) was used as a Standard nephroprotective agent. The kidney function test (estimation of serum creatinine, albumin, blood urea nitrogen) oxidative stress study (estimation of superoxide dismutase, malondialdehyde activity) and histological examination of kidneys was conducted. Results: The efficacy of HAEPR was compared with Cisplatin (CP) treated group. Serum creatinine and BUN was significantly (p<0.01) elevated in CP-treated group compared to the control group. HAEPR (100,200 mg/kg) and Vitamin E (250 mg/kg) significantly (p<0.01) decreased the serum creatinine and BUN levels. CP treated group exhibited significant (p<0.01) decrease in albumin when compared to control. Significant (p<0.01) increase in the serum albumin level was found in HAEPR (100,200 mg/kg) and Vitamin E (250 mg/kg) compared to CP group. Significant (p<0.01) decrease in the activity of SOD was observed in the CP group as compared to control. HAEPR (100 and 200 mg/kg) and Vitamin E (250 mg/kg) significantly (p<0.01) increased SOD levels. HAEPR (400 mg/kg) significantly (p<0.05) increased SOD levels. HAEPR (100,200,400 mg/kg) significantly (p<0.01) decreased MDA levels as compared to CP group. Histopathological examination of the kidneys showed that HAEPR markedly ameliorated Cisplatin-induced renal tubular necrosis. An extract was found effective at all doses, although low dose (100 mg/kg) was found to be more effective and comparable with the standard group (Vitamin E 250 mg/kg).  Conclusion: Present investigation revealed that HAEPR resulted in attenuation of Cisplatin-induced renal damage in rats

The natural history of curve behavior after brace removal in adolescent idiopathic scoliosis: A literature review

PURPOSE: Brace treatment is the most common nonoperative treatment to prevent curve progression in adolescent idiopathic scoliosis (AIS). The goal of this review and analysis is to characterize curve behavior after completion of brace treatment and to identify factors that may facilitate the estimation of long-term curve progression. METHOD: A review of the English language literature was completed using the MEDLINE (PUBMED) database of publications after 1990 until September 2020. Studies were included if they detailed a minimum of 1 year post-brace removal follow-up of AIS patients. Data retrieved from the articles included Cobb angle measurements of the major curves at in-brace, weaning, and follow-up visit(s) for all patients described and for subset populations. RESULTS: From 75 articles, 18 relevant studies describing a follow-up period of 1-25 years following brace removal were included in the analyses. The reviewed literature demonstrates that curves continue to progress after brace treatment is completed with three main phases of progression: (i) immediate (upon brace removal) where a mean curve progression of 7° occurs; (ii) short term (within five years of brace removal) where a relatively high progression rate is evident (0.8°/year); and (iii) long term (more than five years after brace removal) where the progression rate slows (0.2°/year). The magnitude and rate of curve progression is mainly dependent on the degree of curve at weaning as curves weaned at \u3c 25° progress substantially less than curves weaned at ≥ 25° at 25 years. CONCLUSION: Curves continue to progress after brace removal and the rate and magnitude of progression are associated with the curve size at weaning, with larger curves typically exhibiting more rapid and severe progression. This analysis provides physicians and patients the ability to estimate long-term curve size based on the curve size at the time of weaning. LEVEL OF EVIDENCE: IV

Decreased Type I Interferon Production by Plasmacytoid Dendritic Cells Contributes to Severe Dengue

The clinical presentation of dengue virus (DENV) infection is variable. Severe complications mainly result from exacerbated immune responses. Type I interferons (IFN-I) are important in antiviral responses and form a crucial link between innate and adaptive immunity. Their contribution to host defense during DENV infection remains under-studied, as direct quantification of IFN-I is challenging. We combined ultra-sensitive single-molecule array (Simoa) digital ELISA with IFN-I gene expression to elucidate the role of IFN-I in a well-characterized cohort of hospitalized Cambodian children undergoing acute DENV infection. Higher concentrations of type I IFN proteins were observed in blood of DENV patients, compared to healthy donors, and correlated with viral load. Stratifying patients for disease severity, we found a decreased expression of IFN-I in patients with a more severe clinical outcome, such as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS). This was seen in parallel to a correlation between low IFNα protein concentrations and decreased platelet counts. Type I IFNs concentrations were correlated to frequencies of plasmacytoid DCs, not DENV-infected myloid DCs and correlated inversely with neutralizing anti-DENV antibody titers. Hence, type I IFN produced in the acute phase of infection is associated with less severe outcome of dengue disease

A New Approach for One-step Synthesis of Perovskite:fullerene Bulk Heterojunction Using Surfactant Free Microemulsion in Slot Die Method

Organometallic halide perovskite based solar cells are considered as the foundation of future photovoltaic technology. In these types of solar cells, it has been emphasized that the bulk heterojunction active layer architecture may show superior performance than the bilayer active layer architecture due to the increase in the interfacial area by intermixing both donor and acceptor phases in the bulk heterojunction. Organometallic halide perovskite with suitable acceptor in bulk heterojunction architecture can be a promising active layer in perovskite solar cells. Conventionally, the perovskite and acceptor are mixed together in a single solvent before thin film formation. Though this offers a one-step synthesis way, limited solubility of perovskite and acceptor in single solvent puts major constraint on the formation of bulk heterojunction through one-step solution processable method. This paper describes a new way of one-step synthesis of bulk heterojunction using surfactant free microemulsion in slot die method, which removes the constraint of limited solubility of the two phases in a single solvent. Emulsion of DMSO (solvent for CH3NH3PbI3) and cyclohexane (solvent for PCBM) stabilized with acetone was used for making perovskite:fullerene bulk heterojunction. Solvent evaporation dynamics has been simulated to get deeper understanding of emulsion solidification leading to bulk heterojunction formation. Structural and optical studies support the formation of bulk heterojunction for efficient charge separation at donor:acceptor interfaces. A perovskite solar cell employing this bulk heterojunction has also been reported

Delayed referral to specialist centre increases morbidity in patients with bile duct injury (BDI) after laparoscopic cholecystectomy (LC)

Background: There is still a debate regarding the optimal management of bile duct injury following cholecystectomy. Our aim was to ascertain if delayed referral influenced clinical outcomes for patients with BDI treated in our institution. Materials and methods: We interrogated a prospectively maintained database, including all patients with BDI (Bismuth and Strasberg classifications) post LC managed in our unit from 2000-2014. Referrals were arbitrarily defined as early (<96 hours from the injury) and delayed (>96 hours). Results: 68 patients with BDI were managed. Patient demographics, referral time, level of injury and morbidity data was collected. 50 patients (77%) required a surgical bile duct reconstruction. The Early referral Group included 33 patients (52.4%) and Delayed referral group 30 (47.6%). The patients referred late had a significantly high incidence of right hepatic artery injury (23% vs. 3%) and the overall number of complications (0.0001). The average number of surgical interventions (2.5 vs 1.8, p<0.05) and invasive procedures (4 vs. 2.5, p< 0.05) per patient was high in the late referral group. There was significant difference in the interval between BDI-to-reconstruction (median 3 vs. median 88 days, p< 0.05) and referral-to-hospital discharge (median 9 vs. median days 59, p< 0.05). On multivariate analysis only delayed referral (OR 7.58, 95% CI 2.1-26.6) and Strasberg-E injuries (OR 4.86, 95% CI 1.1-20.9) were significant. Conclusion: A late referral was associated with a higher incidence of post-treatment complications, greater need for invasive procedures and a longer recovery period. These observations support the need for early patient transfer to a tertiary institution following BDI

The effect of Spirulina sauce, as a functional food, on cardiometabolic risk factors, oxidative stress biomarkers, glycemic profile, and liver enzymes in nonalcoholic fatty liver disease patients:A randomized double-blinded clinical trial

OBJECTIVE: This study sought to investigate the effect of Spirulina on cardiometabolic risk factors, oxidative stress biomarkers, glycemic profile, and liver enzymes in nonalcoholic fatty liver disease (NAFLD) patients. METHODS: This randomized, double‐blind clinical trial was performed on 46 NAFLD patients. Subjects were allocated to consume either Spirulina sauce or placebo, each 20 g/day for 8 weeks. Fatty liver grade, liver enzymes, anthropometric parameters, blood pressure, and serum lipids, glucose, insulin, malondialdehyde, and antioxidant capacity were assessed pre‐ and postintervention. RESULTS: Fatty liver grade was significantly different between the two groups. A significant change for ALT (alanine aminotransferase) and AST (aspartate aminotransferase) was seen between the two groups (p = .03 and .02, respectively), while ALP (alkaline phosphatase) serum levels were not significantly different within or between groups. Pertaining to glycemic profile, all variables, except HOMA‐IR, were not significantly different within or between groups. Finally, statistically significant changes were seen in both MDA (malondialdehyde) and TAC (total antioxidant capacity) among the groups (p = .04 and <.001, respectively). CONCLUSIONS: Spirulina may improve fatty liver grade by modifying liver enzymes, oxidative stress, and some lipid profiles; however, there was effect of Spirulina on anthropometric characteristics and blood pressure

Effectiveness of Nursing Interventions on Physical and Psychological Outcome among Cancer Patients Undergoing Chemotherapy

Background: Cancer patient's undergoing chemotherapy experiences a variety of side effects which has influence on prognosis of illness, activity of daily living and the quality of life. There is a need of nursing care interventions for management and prevention of problem among cancer patients. Aim & Objectives: The present study aimed to assess the effectiveness of nursing interventions on physical and psychological outcome among cancer patients undergoing chemotherapy. Material and Methods: A true experimental study, post test only design with control group approach was conducted among 130 cancer patients undergoing chemotherapy at oncology ward of Pravara Rural Hospital, Loni (Bk), Ahmednagar, Maharashtra. Cancer patients who are 18 years old or older were selected with systematic random sampling method. Pre tested semi structured interview schedule was used to gather data. The assessment of health status before start of chemotherapy was carried out, followed by the nursing interventions was implemented based on patient needs and problems, and the post test was conducted after the period of interventions. The collected data was tabulated and analyzed using appropriate statistical methods wherever required. Results: The results revealed that the cancer patients experienced a wide range of physical and psychological problems prior to chemotherapy treatment. Cancer patients who received nursing interventions had improved post test mean scores on chemotherapy symptoms, pain and fatigue; emotional well being, anxiety and depression than the patients who received routine care, notably it was statistically significant at p<0.05 level. A significant association was observed between physical, psychological outcome variables and the socio demographic characteristics like sex, site of cancer, stage of cancer, duration of cancer, metastasis of cancer and the regimen of chemotherapy at p<0.05 level. Conclusion: This study demonstrated that the nursing interventions were well accepted by cancer patients and has significant effect towards the improvement of physical and psychological outcomes of cancer patients undergoing chemotherapy

Elastic Intramedullary Nailing of Pediatric Both-Bone Forearm Fractures.

Elastic intramedullary nailing of both-bone pediatric forearm fractures is used to treat unstable fractures that fail conservative management with closed reduction and casting, open injuries, or injuries with neurovascular compromise. Small incisions are used to enter the medullary canal of the distal end of the radius and proximal part of the ulna, avoiding injury to the adjacent physis. The elastic nail is advanced to the fracture site under fluoroscopic guidance. The fracture is reduced with traction and manipulation, and the nail is passed across the fracture site to stabilize the forearm. Closed reduction and casting is the mainstay of treatment in most pediatric forearm fractures. If conservative treatment fails, these fractures can be surgically managed with elastic intramedullary nails or with plate and screw fixation. Elastic intramedullary nailing of pediatric forearm fractures provides a minimally invasive alternative to treat unstable fractures that fail closed reduction and casting. It has been shown to be a reliable method of achieving anatomic union with excellent function of the injured upper extremity in most patients with very few complications related to the surgery1-3. We advise patients that in &gt;90% of children treated with this technique, we achieve anatomic union with excellent wrist and elbow function. Usually, the nails can be removed 6 to 12 months after the procedure. Complications related to infection, nonunion, malunion, compartment syndrome, and neurovascular compromise are rare1-3. Position the patient and fluoroscopy machine to allow easy access to the elbow and wrist throughout the procedure.Use a sharp-pointed awl to access the medullary canal without injuring the adjacent physes of the distal end of the radius or proximal part of the ulna.Contour the radial implant to allow easy passage and to establish the anatomic radial bow.Traction and direct manual pressure can be used to reduce the fractured fragments to allow passage of the implants across the fracture site.A small open reduction of the fracture site should be performed after ≥3 failed attempts at obtaining a closed reduction.The nails should be cut so that they can be buried subcutaneously but easily accessed for later removal without injuring the adjacent physes