Anaesthesia-related morbidity associated with recumbent, low-field magnetic resonance imaging of horses

CASE HISTORY

Medical records from 2009 to 2021 from a private equine referral hospital in Rochester, NH, USA were analysed for cases that underwent general anaesthesia for low-field MRI of the distal limb. These were used to determine peri-anaesthetic morbidity and mortality.

CLINICAL FINDINGS AND OUTCOME

Two hundred and forty-three anaesthetic episodes were recorded in horses undergoing low-field MRI. The peri-anaesthetic complication rate prior to discharge was 6.2% (15/243). No patients experienced a fatal complication. Ninety two of the 243 patients had multiple sites imaged, 90/243 received pre-anaesthetic dantrolene, 134/243 received intra-anaesthetic dobutamine, and 15/243 were positioned in dorsal recumbency. Complications included: abdominal discomfort ("colic"; 9/243), myopathy (4/243), hyphaema (1/243) and carpal fracture (1/243). At the time of discharge, 14/15 complications had resolved. Of 135 horses for which data were available 55 became hypotensive during the procedure (lowest mean arterial pressure < 65 mmHg). Median body weight was 553 (min 363, max 771) kg. Horses were anaesthetised for a median of 150 (min 45, max 210) minutes. There was no evidence of an association between higher body weight (p = 0.051) or longer duration of anaesthesia (p = 0.421) and development of an anaesthetic complication. For categorical variables (dantrolene administration pre-anaesthesia, dobutamine administration during anaesthesia, hypotension (mean < 65 mmHg) during anaesthesia, dorsal vs. lateral recumbency, and imaging of single vs. multiple sites), the 95% CI for the OR included 1, indicating a lack of effect of the variable on the odds of complication.

CLINICAL RELEVANCE

The cases included in this series suggest that low-field MRI under general anaesthesia is a viable option for diagnostic imaging in otherwise healthy horses. Complications occur, but most resolve before discharge.

From field to table: Ensuring food safety by reducing pesticide residues in food

The present review addresses the significance of lowering pesticide residue levels in food items because of their harmful impacts on human health, wildlife populations, and the environment. It draws attention to the possible health risks-acute and chronic poisoning, cancer, unfavorable effects on reproduction, and harm to the brain or immunological systems-that come with pesticide exposure. Numerous traditional and cutting-edge methods, such as washing, blanching, peeling, thermal treatments, alkaline electrolyzed water washing, cold plasma, ultrasonic cleaning, ozone treatment, and enzymatic treatment, have been proposed to reduce pesticide residues in food products. It highlights the necessity of a paradigm change in crop protection and agri-food production on a global scale. It offers opportunities to guarantee food safety through the mitigation of pesticide residues in food. The review concludes that the first step in reducing worries about the negative effects of pesticides is to implement regulatory measures to regulate their use. In order to lower the exposure to dietary pesticides, the present review also emphasizes the significance of precision agricultural practices and integrated pest management techniques. The advanced approaches covered in this review present viable options along with traditional methods and possess the potential to lower pesticide residues in food items without sacrificing quality. It can be concluded from the present review that a paradigm shift towards sustainable agriculture and food production is essential to minimize pesticide residues in food, safeguarding human health, wildlife populations, and the environment. Furthermore, there is a need to refine the conventional methods of pesticide removal from food items along with the development of modern techniques.

Effect of foliar applied zinc sulphate on phenotypic variability, association and heritability of yield and zinc biofortification related traits of wheat genotypes

Wheat is an important food crop worldwide, providing substantial calories and nourishment. Genetic variability in wheat germplasm is crucial for the development of cultivars with desirable features. This two years study (2020-21 and 2021-22) was conducted to evaluate 13 diverse wheat genotypes factorially combined with foliar-applied zinc sulphate (0, 0.4, 0.6%) arranged in a triplicate randomized complete block design. Boxplot analysis revealed the significant (P < 0.01) phenotypic variation of wheat germplasm for all the studied traits, but maximum variation was observed for yield and Zn biofortification-related traits. Correlation and path analysis revealed a significant (P < 0.01) association among yield and biofortification-related traits. Zinc uptake showed maximum strength of association (r = 0.96, p < 0.01) with grain Zn concentration. The Biplot analysis showed the graphical representation of wheat accessions based on similar characteristics and then assort into distinct groups. Broadsense heritability (Hbs) was calculated to determine the proportion of variation transmitted to future generations. The high value of Hbs for yield and Zn biofortification-related traits indicates that these traits are governed by the additive type of gene action and can be fixed in early segregating generations. In crux, this study validated the genetic variability in existing wheat genotypes for yield and Zn biofortification-related traits and may be helpful to devise an efficient breeding program for wheat Zn biofortification.

Stimulant induced Dermatological and Vascular Complications in patients with ADHD: A literature review

Introduction

Methylphenidate and amphetamine are the two most widely used stimulants in managing Attention Deficit Hyperactivity Disorder (ADHD)¹. Reynaud’s phenomenon (RP) is a reversible distal vasoconstriction presenting with various dermatological symptoms. RP can secondarily develop after certain medications as well².

Objectives

The review was undertaken to synthesize the incidence of RP within ADHD population treated with stimulants, and any causal relation of RP and stimulant-use.

Methods

PubMed, Psych-Info and Google Scholar were searched using these keywords: skin change, Raynaud, stimulants and methylphenidate. All relevant study types were included. Results were synthesized narratively.

Results

Initial search yielded 240 articles with 5 articles fulfilling our inclusion criteria. One was retrospective case-controlled study while remaining 4 were case reports. Six cases were identified with an age of 12-19 years, who presented with RP after being treated with methylphenidate-or-dextroamphetamine. In one case, multiple clinical signs of RP were seen with cold distal fingers, transient color changes and even frank ulceration^3–6. In two cases, it was seen that RP was dose-dependent with stimulant use and got resolved after decreasing the dosage respectively. In case-control study, 32 cases with RP and 32 controls were enrolled. The results showed a statistically significant association (χ² =5, p=0.01) between RP and past-or-current stimulant usage.⁷

Conclusions

The literature review suggests weak evidence of the association between RP and stimulant use but no evidence of any causal link. Further studies are needed to identify characters that can predict this adverse effect in vulnerable ADHD individuals.

Disclosure

No significant relationships.

Frequency of Different Ocular Conditions Leading to Ocular Morbidity in Pediatric Age Group at Dow University Hospital

Purpose:  To determine the frequency of different ocular conditions leading to ocular morbidity in a tertiary care hospital. Study Design:  Descriptive cross sectional study. Place and Duration of Study:  Study was done in Dow University of medical sciences, from May 2018 to October 2018. Methods:  A total of 278 patients presenting in the eye out-patient department were included. Patients with unaided visual acuity of 6/6 in both eye and no ocular abnormality were excluded from the study. Children with congenital syndromes like Down’s syndrome, etc. leading to eye diseases were also excluded. All children underwent complete ocular examination. Data was analyzed by using SPSS version 22. Frequency and percentages were computed for gender and different ocular diseases e.g., myopia, hypermetropia, strabismus, Vernal Kerato-conjunctivitis, astigmatism, red eye, subconjunctival hemorrhage etc. Post-stratification chi-square test was applied with p-value ≤ 0.05. Results:  Out of 278 participants of the study, there were 154 (55.4%) males and 124 (44.6%) females. Average age of the patients was 11.15 ± 3.44 years. Myopia and red eyes were the major causes of pediatric ocular morbidity i.e. 33.81% and 26.6% respectively. Comparison between two age groups showed that Myopia was higher in children with 11 to 15 years. Myopia and astigmatism were more common in females while sub-conjunctival hemorrhage was more in males. Conclusion:  Refractive errors are the commonest cause of childhood visual impairment in our setup. Correcting these preventable diseases can have a positive impact on the performance of children at school. Key Words:  Visual acuity, Pediatric, Myopia, Hypermetropia, Kerato-conjunctivitis.

Analgesia after ACL reconstruction: Hamstring donor-site injection versus intra-articular local anaesthetic injection

BACKGROUND

The purpose of this study was to compare hamstring donor-site injection versus intra-articular injection of a local anaesthetic for analgesia after anterior cruciate ligament (ACL) reconstruction.

HYPOTHESIS

The two methods provide similar pain relief.

MATERIAL AND METHODS

158 consecutive patients undergoing ACL hamstring tendon graft reconstruction (semi-tendinosus/gracilis [STG] or four-stranded semi-tendinosus [ST4]) during two periods in 2015 were included. Peripheral nerve block was not performed. At the end of surgery, 20mL of ropivacaine 7.5mg/mL was injected, intra-articularly during the early period (n=79) and into the hamstring donor site during the second period (n=79). Post-operative pain was evaluated subjectively by the patients using a visual analogue scale (VAS). We recorded patient demographics, concomitant surgical procedures, VAS pain scores, rescue analgesic use, time to discharge, and patient satisfaction. VAS pain score, side effects, and patient satisfaction were also recorded during a phone interview on the day after surgery (D1).

RESULTS

Mean VAS pain scores were not significantly different between the two groups immediately after surgery (D0) or on D1 (D0: intra-articular, 2.08 and donor site, 1.88; Mann-Whitney P=0.6). Neither were the groups significantly different for rescue analgesic use, patient satisfaction, or quadriceps activation.

CONCLUSION

The same local anaesthetic provides similar pain relief when injected intra-articularly or into the hamstring donor site after hamstring tendon ACL reconstruction (STG or ST4).

LEVEL OF EVIDENCE

III, prospective case-control study.

From conception to birth - how endometriosis affects the development of each stage of reproductive life

Increasing evidence suggests that female infertility is associated with endometriosis. Indeed, 40% of women with this disease are infertile. However, a causal relationship has not yet been established, and the possible pathophysiology of infertility in this disease also has not been completely elucidated. In this article, we analyze the mechanisms necessary to achieve a successful live birth in patients with this disease as well as the important steps of fertility, pregnancy and birth that can be impaired in these women. Specifically, we will review new advances in research on folliculogenesis, oocyte quality and sperm quality, egg fertilization, embryo quality, transport through fallopian tube and utero-tubal transport sperm, implantation defects, risk of miscarriage, risk during pregnancy and pre-term delivery. The physiopathology of these alterations and the clinical results of the studies are still very controversial. For these reasons, we can conclude that more research is needed to study the biological pathways of the fertility impairment caused by this disease.

Preferential cell response to anisotropic electro-spun fibrous scaffolds under tension-free conditions

Anisotropic alignment of collagen fibres in musculoskeletal tissues is responsible for the resistance to mechanical loading, whilst in cornea is responsible for transparency. Herein, we evaluated the response of tenocytes, osteoblasts and corneal fibroblasts to the topographies created through electro-spinning and solvent casting. We also evaluated the influence of topography on mechanical properties. At day 14, human osteoblasts seeded on aligned orientated electro-spun mats exhibited the lowest metabolic activity (P < 0.001). At day 5 and at day 7, no significant difference was observed in metabolic activity of human corneal fibroblasts and bovine tenocytes respectively seeded on different scaffold conformations (P > 0.05). Osteoblasts and corneal fibroblasts aligned parallel to the direction of the aligned orientated electro-spun mats, whilst tenocytes aligned perpendicular to the aligned orientated electro-spun mats. Mechanical evaluation demonstrated that aligned orientated electro-spun fibres exhibited significant higher stress at break values than their random aligned counterparts (P < 0.006) and random orientated electro-spun fibres exhibited significant higher strain at break values than the aligned orientated scaffolds (P < 0.006). While maintaining fibre structure, we also developed a co-deposition method of spraying and electro-spinning, which enables the incorporation of microspheres within the three-dimensional structure of the scaffold.

Exploration of skin permeation mechanism of frusemide with proniosomes

The present study explored the transdermal permeation enhancing mechanism of non-ionic surfactant vesicles (proniosomes) of frusemide across rat skin. Fourier Transform Infrared Spectroscopy (FT-IR), Differential Scanning Calorimetry (DSC), activation energy and histological examination were carried out to study the mode of action of the optimized proniosome formulations PGS [Span 40:soyalecithin:cholesterol (4.5:4.5:1)] and PGD [Span 40:dicetylphosphate:cholesterol (4.5:4.5:1)]. The IR spectra showed a prominent decrease in peak areas and heights of CH2 stretchings but did not show shift of these peaks and shift in amide bands. DSC studies also confirmed the IR findings. It was concluded that the proniosomes disrupted the lipid bilayer by extracting the lipids thereby creating pathways for drug penetration. The significant decrease in activation energy for frusemide permeation across rat skin indicated the SC lipid bilayers were significantly disrupted (p<0.05). Histological investigations were carried out. Disruption and extraction of lipid bilayers as distinct voids and empty spaces were visible in the epidermal region. Overall, our findings suggested that proniosomal formulations offer a promising means for non-invasive delivery of frusemide, especially due to their ability to modulate drug transfer and serve as non-toxic permeation enhancers.

Biotechnological production of oil: fatty acid composition of microbial oil

The fatty acid profile and the fatty acid composition of microbial lipids obtained from molds revealed that oil from Aspergillus sydowii, Fusarium oxysporum and F. equisetti had a high percentage of unsaturated fatty acids, particularly oleic acid, and had a similarity to the edible oils, groundnut and palm oil. This study sheds light on the possibilities of exploring the use of these oils as supplement to other edible fats and for other non-edible industrial purposes.