Multifunctional Microgel-Based Cream Hydrogels for Postoperative Abdominal Adhesion Prevention

Postoperative abdominal adhesions are a common problem after surgery and can produce serious complications. Current antiadhesive strategies focus mostly on physical barriers and are unsatisfactory and inefficient. In this study, we designed and synthesized advanced injectable cream-like hydrogels with multiple functionalities, including rapid gelation, self-healing, antioxidation, anti-inflammation, and anti-cell adhesion. The multifunctional hydrogels were facilely formed by the conjugation reaction of epigallocatechin-3-gallate (EGCG) and hyaluronic acid (HA)-based microgels and poly(vinyl alcohol) (PVA) based on the dynamic boronic ester bond. The physicochemical properties of the hydrogels including antioxidative and anti-inflammatory activities were systematically characterized. A mouse cecum-abdominal wall adhesion model was implemented to investigate the efficacy of our microgel-based hydrogels in preventing postoperative abdominal adhesions. The hydrogels, with a high molecular weight HA, significantly decreased the inflammation, oxidative stress, and fibrosis and reduced the abdominal adhesion formation, compared to the commercial Seprafilm group or Injury-only group. Label-free quantitative proteomics analysis demonstrated that S100A8 and S100A9 expressions were associated with adhesion formation; the microgel-containing hydrogels inhibited these expressions. The microgel-containing hydrogels with multifunctionality decreased the formation of postoperative intra-abdominal adhesions in a murine model, demonstrating promise for clinical applications.

Coverage of mass drug administration (MDA) and operational issues in elimination of lymphatic filariasis in selected districts of Jharkhand, India

Background

Despite annual rounds of mass drug administration (MDA) being carried out every year since 2004 to break the transmission of lymphatic filariasis, India has not achieved elimination status in many areas of country. This study was conducted to determine the operational issues in the implementation of MDA for elimination of lymphatic filariasis in selected districts of Jharkhand.

Methods

Two districts of Jharkhand state were selected for present cross-sectional study. Multi-staged cluster sampling was adopted to select study participants. Data were collected with use of prescribed questionnaire of National Vector Borne Disease Control Programme (NVBDCP) from the study participants. Data related to socio-demographic details, coverage and compliance of MDA and operational issues were collected.

Results

Findings of independent assessment show that percentage of MDA coverage and compliance for Hazaribag district was 96.02% and 88.90%, respectively. On the other hand, percentage of MDA coverage and compliance was found to be only 67.06% and 48.44% in Chatra district. Overall drug consumption was significantly associated with age group (p-value = 0.045), educational status (p-value = <0.0001) and socio-economic status (p-value <0.0001) of eligible population. Most common reason for not swallowing the drugs was found to be absence of family members at the time of MDA rounds followed by no visit of house by drug distributors.

Conclusions

Coverage and compliance of MDA was better in Hazaribag district as compared to Chatra district. In order to increase compliance, socio-demographic factors must also be addressed apart from other operational issues.

Effect of ‘Garbhpal Ras’ on Pregnancy Induced Nausea Vomiting (NVP)

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[Treatment and follow-up of retinal tears associated with avulsed overlying retinal vessels (author's transl)]

The present clinical study is based on 17 cases of a specific clinical entity, which is characterised by a retinal break without retinal detachment, the tear being spanned by an avulsed patient retinal vessel invariably adjoining the operculum. The vessel was in the vitreous cavity and formed an arch above the break. All cases began with a sudden decrease or loss of visual acuity due to the rupture of the avulsed vessel and the occurrence of hemorrhages within the vitreous. These hemorrhages recurred in the course of the follow-up of the patients which lasted from 1-8 years. The recurrence of the bleeding was in most instances related to the mobility and the size of the vessel overlying the break. During treatment the cases were divided into two groups, group 1 comprising cases which were subjected only to light-coagulation, whereas in the cases of group 2 scleral buckling was performed in conjunction with cryopexy or light-coagulation. The comparatively best results were achieved in group 2. This condition is rare and amounted to only 1.5% of our total number of cases of retinal tears treated with light-coagulation during the last 8 years.