Ameliorative potential of stem bromelain on lead-induced toxicity in Wistar rats

The present study investigates the protective efficacy of stem bromelain against lead-induced toxicity in male Wistar rats. There were six experimental groups; Group I was negative control, Group II was administered only 20 mg/kg of stem bromelain. Group III and V were orally exposed to 30 mg/kg/day and 60 mg/kg/day of lead acetate, respectively. Group IV and Group VI were exposed to both low and high dose of lead acetate, respectively, and treated with 20 mg/kg stem bromelain. The experimental period was 21 days. The end points evaluated were, lead accumulation in kidney, liver and spleen, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activity, serum malonaldehyde (MDA) cholesterol and triglycerides levels. Co-administration of stem bromelain with lead markedly reduced the lead accumulation in the kidney and spleen. The treatment of stem bromelain also reduced the serum MDA levels in the group exposed to lower dose of lead and serum triglyceride level in the group exposed to higher dose of lead. The lead-induced modulated levels of serum ALT and AST were also alleviated by bromelain treatment. Our key findings suggest a chelating potential of stem bromelain for combating lead toxicity and oxidative stress. Bromelain represents a novel approach to the treatment of metal toxicity and metabolic disorders with a limited therapeutic window

A comparative study of general anesthesia versus combined spinal–epidural anesthesia on the fetus in cesarean section

Background: Obstetric anesthesia guidelines recommend regional over general anesthesia for most caesarean sections to decrease the risk for both fetus and mother. Aim of the work: To determine the effects of combined spinal epidural anesthesia and general anesthesia on the newborns and the mother undergoing elective cesarean section. Subjects: A total of 60 consecutive women with uncomplicated singleton pregnancies at term and scheduled to undergo elective cesarean section at Kasr Al-Aini obstetric hospital participated in this prospective study. The women were divided into 2 groups (each 30), a general anesthesia group (A) and combined spinal–epidural anesthesia group (B). Methods: Umbilical artery blood gas analysis and Apgar scores were assessed at 1 and 5 min after delivery in the newborn while systolic and diastolic blood pressure, heart rate, oxygen saturation and (capnography in general anesthesia) were measured preoperative and after 5, 10 and 15 min of induction of anesthesia in the mothers. In addition, the time from induction of anesthesia till delivery of the fetus and duration in operative room were measured. Results: Apgar score recorded statistically significant differences between the 2 groups at 1 min and 5 min, where with combined spinal–epidural anesthesia the Apgar score readings were higher than with general anesthesia. HCO3 readings showed a statistically significant difference between the 2 groups after 1 and 5 min, where the newborns in general anesthesia group had a statistically significant lower HCO3 compared to the newborns in combined spinal–epidural group. Patients in general anesthesia group were significantly more tachycardic compared to patients in combined spinal–epidural group. Conclusion: Combined spinal–epidural anesthesia is safer on the newborn than general anesthesia regarding the APGAR scores and acid–base balance

Quantification of the <em>Lamin A/C</em> Transcript Variants in Cancer Cell Lines by Targeted Absolute Quantitative Proteomics and Correlation with mRNA Expression

Lamin A/C proteins have key roles in nuclear structural integrity and chromosomal stability. Lamin A/C cumulative protein expression of all variants is reported by semi-quantitative Western blotting. To date, there have not been specific antibodies for the individual Lamin A/C transcript variants. We developed a mass spectrometric approach for the quantification of Lamin A/C transcript variants. A signature peptide for each specific splice variant of Lamin A/C was selected. A LC–MS/MS assay based on the selected signature peptides and their labeled internal standards was established to measure the expression of Lamin A/C transcript variant concentrations. The method validation was carried out according to Food and Drug Administration (FDA) guidelines. The expression levels of the Lamin A/C transcript variants were measured in samples derived from MCF7 and U937 cell lines. RT-qPCR assay was also used to quantitate and compare the mRNA expression of splice variants of Lamin A/C. The established and validated method showed a great linearity, sensitivity, and precision. The different expressed Lamin A/C variants in different cell lines were measured and their levels were in concordance with qRT-PCR results. The developed method is reproducible, reliable, and sensitive for measuring different Lamin A/C transcript variants in different cell lines

Unilateral erector spinae plane block versus intravenous morphine for postoperative analgesia after Percutaneous nephrolithotomy. A randomized controlled trial

Pain is an everyday challenge during all surgeries and it is a chief postoperative complication, so pain management is a corner stone in anesthetic practice. Percutaneous nephrolithotomy PCNL surgeries are usually associated with acute postoperative pain. Ultrasound guided nerve block is considered a recent technique for pain management. it provides better visualization of the nerves and reduces the risk for complications e.g. unintended injury to adjacent structures. Erector spinae plane (ESP) block is a novel method of delivering postoperative analgesia after PCNL surgery, technique involves injecting local anaesthetic into the interfascial plane between the erector spinae muscle and the transverse processes.and is therefore devoid of major adverse effects like pneumothorax, spinal cord trauma, and hypotension that can occur with other types of blocks like thoracic paravertebral block (TPVB). The goal of this research was to determine the analgesic efficacy and safety of ultrasound-guided ESP. block done at T8 transverse process level in patients undergoing PCNL surgeries for intraoperative and postoperative analgesia

Unilateral Erector Spinae Plane Block Versus Intravenous Morphine for Postoperative Analgesia After Percutaneous Nephrolithotomy. A Randomized Controlled Trial

Pain is an everyday challenge during all surgeries and it is a chief postoperative complication, so pain management is a corner stone in anesthetic practice. Percutaneous nephrolithotomy PCNL surgeries are usually associated with acute postoperative pain. Ultrasound guided nerve block is considered a recent technique for pain management. it provides better visualization of the nerves and reduces the risk for complications e.g. unintended injury to adjacent structures. Erector spinae plane (ESP) block is a novel method of delivering postoperative analgesia after PCNL surgery, technique involves injecting local anaesthetic into the interfascial plane between the erector spinae muscle and the transverse processes.and is therefore devoid of major adverse effects like pneumothorax, spinal cord trauma, and hypotension that can occur with other types of blocks like thoracic paravertebral block (TPVB). The goal of this research was to determine the analgesic efficacy and safety of ultrasound-guided ESP. block done at T8 transverse process level in patients undergoing PCNL surgeries for intraoperative and postoperative analgesia

Nutritional Status of Short Stature Children under Growth Hormone Therapy

Background: Childhood stunting is one of our community's most prevalent public health nutrition problems. Many factors may lead to the development of stunning. Growth hormones and diet might play a role in the treatment. This study aims to investigate the effect of nutritional status on the growth rate among children with short stature who underwent growth hormone therapy the previous year. Methods: A one-year retrospective, cross-sectional study was carried out among 4-10-year-old children with stunting. Laboratory tests, anthropometric measurements, and dietary intake were measured at the start of the research and one year after the application of growth hormone therapy. Results: A significantly higher growth rate was observed among males than females (P = 0.040). Also, males had significantly higher calorie intake (P). This study found that the patients had a less than 8.5% difference in energy intake vs. total energy requirement. There is a significant association between food consumption from two food groups (milk and meat) (P = 0.04 and 0.021, respectively. Conclusion: Diet plays a significant role in the improvement of growth velocity

The consumption of dietary supplements in Saudi Arabia during the COVID-19 pandemic: A cross-sectional study

Background and Objectives: People frequently utilize dietary supplements (DS), notably during the COVID-19 epidemic, despite the lack of data supporting their usefulness and safety in enhancing general health. This study aimed to measure the consumption of DS in Saudi Arabia during COVID-19. Previous studies focused on using dietary supplements for preventing or reducing mental health. Materials and Methods: A cross-sectional study was conducted with 1572 participants aged 18–65, from all-over Saudi Arabia who were invited to complete a self-administered questionnaire to measure the consumption of supplements during the pandemic lockdown period. Also, it investigates the factor that effect supplements consumption. Results: Around 63% of the participants did not change their consumption patterns during the pandemic, while 16% consumed more and 21.4% consumed fewer supplements during the pandemic. The most commonly used supplements were iron; calcium, especially among pregnant women; omega-3, especially in people older than 65 years; and vitamin D. Females (81%; P < 0.002); age (94.7%; P < 0.002); married people (84%; P < 0.001); those with a higher educational level (83.9%; P = 0.02); those with a higher monthly income (86.1%; P = 0.006); and pregnant women (100%; P < 0.007) reported the highest rates of consumption. Conclusion: Dietary supplements have recently become popular in Saudi Arabia, but large differences remain between Saudis in their consumption of supplements. Additional research should be conducted to examine the level of knowledge of dietary supplements among Saudi population

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit