Erector spinae plane block versus fascia iliaca block after total hip arthroplasty: a randomized clinical trial comparing analgesic effectiveness and motor block

Background

Ultrasound-guided, supra-inguinal fascia iliaca block (FIB) provides effective analgesia after total hip arthroplasty (THA), but is complicated by high rates of motor block. The erector spinae plane block (ESPB) is a promising motor-sparing technique. In this study, we test the analgesic superiority of FIB over ESPB, while also comparing motor impairment.

Methods

In this randomized, observer-blinded clinical trial, patients scheduled for THA with spinal anesthesia were randomly assigned to receive either ultrasound-guided FIB or ESPB preoperatively. Primary outcome was morphine consumption at 24 hours after surgery. Secondary outcomes were: pain scores; assessment of sensory and motor block; incidence of postoperative nausea and vomiting and other complications; and development of chronic post-surgical pain.

Results

Sixty patients completed the study. There were no statistically-significant differences in morphine consumption at 24 hours (p = 0.68) or pain scores at any time point. FIB produced more reliable sensory block in the femoral nerve (p = 0.001) and lateral femoral cutaneous nerve (p = 0.018) distributions. However, quadriceps motor strength was better preserved in the ESPB group when compared to the FIB group (p = 0.002). No differences were observed for hip adduction motor strength (p = 0.253). No differences between groups were observed in terms of side effects or chronic pain incidence.

Consclusions

ESPB may represent a promising alternative to FIB for postoperative analgesia after THA. ESPB and FIB offer similar opioid-sparing benefits within the first day after surgery, but ESPB results in less quadriceps motor impairment.

Physico-Chemical Properties of Magnetic Dicationic Ionic Liquids with Tetrahaloferrate Anions

A series of imidazolium-based symmetrical and asymmetrical dicationic ionic liquids (DcILs) with alkyl spacers of different length and with [FeCl3 Br]- as counter ion have been synthesized. The synthesized DcILs are characterized by using FTIR and Raman spectroscopy as well as mass spectrometry, along with single-crystal XRD analysis. Physicochemical properties such as solubility, thermal stability and magnetic susceptibility are also measured. These compounds show low melting points, good solubility in water and organic solvents, thermal stability, and paramagnetism. The products of molar susceptibility and temperature (χmol ⋅T) for the synthesized DcILs have been found between 4.05 to 4.79 emu mol-1  K Oe-1 and effective magnetic moment values have also been determined to be compared to that expected from the spin-only approximation.

Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria - A multi-facility study of 34 tertiary hospitals

Background

The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions.

Aims

We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments.

Materials and Methods

A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2).

Results

A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011].

Conclusions

The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

Highly efficient CRISPR-Cas9-mediated editing identifies novel mechanosensitive microRNA-140 targets in primary human articular chondrocytes

OBJECTIVE

MicroRNA 140 (miR-140) is a chondrocyte-specific endogenous gene regulator implicated in osteoarthritis (OA). As mechanical injury is a primary aetiological factor in OA, we investigated miR-140-dependent mechanosensitive gene regulation using a novel CRISPR-Cas9 methodology in primary human chondrocytes.

METHOD

Primary (passage 1/2) human OA chondrocytes were isolated from arthroplasty samples (six donors) and transfected with ribonuclear protein complexes or plasmids using single guide RNAs (sgRNAs) targeting miR-140, in combination with Cas9 endonuclease. Combinations of sgRNAs and single/double transfections were tested. Gene editing was measured by T7 endonuclease 1 (T7E1) assay. miRNA levels were confirmed by qPCR in chondrocytes and in wild type murine femoral head cartilage after acute injury. Predicted close match off-targets were examined. Mechanosensitive miR-140 target validation was assessed in 42 injury-associated genes using TaqMan Microfluidic cards in targeted and donor-matched control chondrocytes. Identified targets were examined in RNAseq data from costal chondrocytes from miR-140^-/- mice.

RESULTS

High efficiency gene editing of miR-140 (90-98%) was obtained when two sgRNAs were combined with double RNP-mediated CRISPR-Cas9 transfection. miR-140 levels fell rapidly after femoral cartilage injury. Of the top eight miR-140 gene targets identified (P < 0.01), we validated three previously identified ones (septin 2, bone morphogenetic protein 2 and fibroblast growth factor 2). Novel targets included Agrin, a newly recognised pro-regenerative cartilage agent, and proteins associated with retinoic acid signalling and the primary cilium.

CONCLUSION

We describe a highly efficient CRISPR-Cas9-mediated strategy for gene editing in primary human chondrocytes and identify several novel mechanosensitive miR-140 targets of disease relevance.

Highly Efficient Visible Light Active Doped ZnO Photocatalysts for the Treatment of Wastewater Contaminated with Dyes and Pathogens of Emerging Concern

Water is obligatory for sustaining life on Earth. About 71% of the Earth’s surface is covered in water. However, only one percent of the total water is drinkable. The presence of contaminants in wastewater, surface water, groundwater, and drinking water is a serious threat to human and environmental health. Their toxic effects and resistance towards conventional water treatment methods have compelled the scientific community to search for an environmentally friendly method that could efficiently degrade toxic contaminants. In this regard, visible light active photocatalysts have proved to be efficient in eliminating a wide variety of water toxins. A plethora of research activities have been carried out and significant amounts of funds are spent on the monitoring and removal of water contaminants, but relatively little attention has been paid to the degradation of persistent water pollutants. In this regard, nanoparticles of doped ZnO are preferred options owing to their low recombination rate and excellent photocatalytic and antimicrobial activity under irradiation of solar light. The current article presents the roles of these nanomaterials for wastewater treatment from pollutants of emerging concern.

Anti-Parkinson's evaluation of Brassica juncea leaf extract and underlying mechanism of its phytochemicals

Background: Parkinson's disease (PD) is associated with progressive neuronal damage and dysfunction. Oxidative stress helps to regulate neurodegenerative and neuronal dysfunction. Natural compounds could attenuate oxidative stress in a variety of neurological disorders. B. juncea is a rich source of antioxidants. The present study aimed to evaluate the therapeutic potential of B. juncea leaves for the treatment of PD by applying behavioral, in vivo and in silico studies. For in vivo studies rats were divided into six groups (n = 6). Group-I served as normal control (vehicle control). Group-II was disease control (haloperidol 1 mg/kg). Group-III was kept as a standard group (L-Dopa 100 mg/kg + carbidopa 25 mg/kg). Groups (IV-VI) were the treatment groups, receiving extract at 200-, 400- and 600 mg/kg doses respectively, for 21 days orally. Results: In vivo study results showed that the extract was found to improve muscles strength, motor coordination, and balance in PD. These behavioral outcomes were consistent with the recovery of endogenous antioxidant defence in biochemical analysis which was further corroborated with histopathological ameliorations. Dopamine levels increased and monoamine oxidase B (MAO-B) levels decreased dose-dependently in the brain during the study. Herein, we performed molecular docking analysis of the proposed extracted phytochemicals has explained that four putative phytochemicals (sinapic acid, rutin, ferulic acid, and caffeic acid) have presented very good results in terms of protein-ligand binding interactions as well as absorption, distribution, metabolism, excretion & toxicity (ADMET) profile estimations. Conclusion: The undertaken study concluded the anti-Parkinson activity of B. juncea and further suggests developments on its isolated compounds in PD therapeutics.

Preconcentration of rifampicin prior to its efficient spectroscopic determination in the wastewater samples based on a nonionic surfactant

Every year, tuberculosis affects the lungs of millions of people and rifampicin is the commonly used medicine for its treatment due to its antibiotic nature. The frequent use of rifampicin may lead to its increased concentration in the water resources. This research work is focused on the cloud point extraction (CPE) procedure for the preconcentration of rifampicin prior to its determination in water. The UV/vis spectrophotometric method was adapted for the measurement of rifampicin content after the phase separation. Triton-X 100 was used as the nonionic surfactant which contains hydrophilic polyethylene chain feasible for the extraction of analyte. Various analytical parameters that can affect the extraction efficacy were optimized to achieve linearity of the proposed method in the concentration range of 3.54–81.41 mgL^–1. The Limit of detection and quantification were 1.261 and 4.212 mgL^–1, respectively. The Preconcentration factor was 40 with relative standard deviation (%RSD) of 2.504%. The standard addition methodology was adopted for the validation of this procedure and effectively applied for the determination of rifampicin in real wastewater samples.

Radioprotective Potential of Nutraceuticals and their Underlying Mechanism of Action

Radiations are an efficient treatment modality in cancer therapy. Besides the treatment effects of radiations, the ionizing radiations interact with biological systems and generate reactive oxygen species that interfere with the normal cellular process. Previous investigations of synthetic radioprotectors have shown less effectiveness, mainly owing to some limiting effects. The nutraceuticals act as efficient radioprotectors to protect the tissues from the deleterious effects of radiation. The main radioprotection mechanism of nutraceuticals is the scavenging of free radicals while other strategies are involved modulation of signaling transduction of pathways like MAPK (JNK, ERK1/2, ERK5, and P38), NF-kB, cytokines, and their protein regulatory genes expression. The current review is focused on the radioprotective effects of nutraceuticals including vitamin E, -C, organosulphur compounds, phenylpropanoids, and polysaccharides. These natural entities protect against radiation-induced DNA damage. The review mainly entails the antioxidant perspective and mechanism of action of their radioprotective activities on a molecular level, DNA repair pathway, anti-inflammation, immunomodulatory effects, the effect on cellular signaling pathways, and regeneration of hematopoietic cells.

Variation of uncoupling protein 2 (–866G/A), dietary fat intake and blood pressure: an Indonesian Nutrigenetic Cohort

Background/Introduction

The uncoupling protein 2 (UCP2) is recently being recognized as an important molecule involved in the development of cardiovascular diseases such as vascular dysfunction, atherosclerosis, and hypertension. It was previously reported that the UPC2 –866 G/A gene variation was associated with obesity and hypertension.

Purpose

The objective of this study was to investigate the association between UCP2 –866 G/A gene variation on changes in blood pressure after 2 years of follow up. Additionally, we investigate the interaction between UCP2 –866G/A and dietary fat on changes in blood pressure.

Methods

This was a cohort study conducted in 503 men and women without chronic diseases in the city of Yogyakarta, Indonesia. Bodyweight, systolic (SBP) and diastolic blood pressure (DBP) were measured at baseline and after 2 years while the dietary intake was recorded once within 2 years period using a semi-quantitative food frequency questionnaire. Subjects were divided based on UCP2 gene variations: GG genotype and GA+AA genotypes.

Results

There was no difference in blood pressure at baseline between UCP2 genotypes (SBP AA+GA vs. GG: 130.5±26.3 vs. 127.2±24.9 mmHg, p=0.178; DBP AA+GA vs. GG: 80.9±16.1 vs. 78.9±13.8 mmHg, p=0.171). After 2 years, a total of 310 individuals were followed and measured (AA+GA n=197; GG n=113). In all subjects, there was a significant reduction in SBP (from 130.6±26.3 to 126.4±22.8 mmHg, p&lt;0.001) and increment in DBP (from 80.9±15.5 to 82.2±13.7 mmHg, p=0.013). Subjects in GA + AA genotype group had a greater reduction in SBP (−5.3±15.4 vs. −1.5±18.0 mmHg, p=0.018) and lesser increment in DBP (0.7±10.6 vs. 2.7±12.2 mmHg, p=0.045). In this study, we showed that sex and age were not associated with changes in blood pressure (all p&gt;0.05) but changes in body weight were positively correlated with SBP (r=0.219, p&lt;0.001) and DBP (r=0.227, p&lt;0.001). In all subjects, energy, protein, and carbohydrate intake were not correlated with changes in SBP and DBP (all p&gt;0.05). By contrast, total fat intake (B=0.137, p=0.017), saturated fat (B=0.123, p=0.032) and MUFA (B=0.142, p=0.014) were positively correlated with increased SBP while PUFA, trans fat, and cholesterol were not correlated with SBP. There was no correlation between dietary intake and changes in DBP. Among subjects with GA+AA genotype, total fat, saturated fat and MUFA were positively correlated with changes in SBP (all p&lt;0.05) but these correlations were not seen among subjects with GG genotype (all p&gt;0.05).

Conclusion

We concluded that UCP2 –866G/A gene variation was associated with changes in blood pressure and those who have an A allele were more protected towards increased blood pressure. Total fat, saturated fat, and MUFA were positively correlated with blood pressure and those with A allele were more responsive to the hypertensive effect of dietary fat.

Funding Acknowledgement

Type of funding source: Public Institution(s). Main funding source(s): Universitas Gadjah Mada

A Wide Bandgap Ag/MgO@Fe3O4 Nanocomposite as Magnetic Sorbent for Cd(II) in Water Samples

Background:

The magnetic nanocomposites are very important as a reusable sorbents for the extraction of Cd(II) and other toxic metals from water samples.

Methods:

The Ag/MgO@Fe3O4 nanocomposite was synthesized by the coprecipitation method and characterized by the XRD, EDX, SEM, UV-vis spectroscopy and FTIR. This nanocomposite was used to extract Cd(II) from water samples prior to its quantitative analysis with FAAS. Different variables, i.e. pH, temperature, amount of nanosorbent, adsorption/desorption and dilution were optimized.

Results:

The method was successfully applied to determine Cd(II) in real water samples with excellent recoveries (98%). The present method has lower detection (0.29) and quantification limit (0.97 ng mL-1).

Conclusions:

The Ag/MgO@Fe3O4 nanocomposite based magnetic extraction is a simple, fast, reproducible, less expansive and efficient technique for the Cd(II) extraction in water samples. The developed sorbent can be recycled and reused (20 times).

Superoxide Scavenging and Antiglycation Activity of Rhinacanthins-rich Extract Obtained from the Leaves of Rhinacanthus nasutus

Background:

Oxidative stress and nonenzymatic protein glycation lead to serious diabetic complications that increase the risk of mortality. Rhinacanthus nasutus leaf crude extracts are previously reported for their antidiabetic, antiglycation, and antioxidant potential.

Objective:

The present study was performed to prepare a standardized rhinacanthins-rich extract (RRE) and evaluate its superoxide scavenging and antiglycation effects as compared to its marker compounds, namely, rhinacanthin-C (RC), rhinacanthin-D (RD), and rhinacanthin-N (RN).

Materials and Methods:

RRE was obtained by microwave-assisted green extraction along with a simple step of fractionation using Amberlite^® column. RC, RD, and RN were isolated from the RRE using silica gel column chromatography. Superoxide scavenging activity was performed by cyclic voltammetry, and fructose-mediated human serum albumin glycation model was used for antiglycation activity. In silico studies were conducted to identify the structure-activity relationships of rhinacanthins.

Results:

On the basis of kinetic measurements, RRE exhibited the most potent antioxidant activity via E_rC_i mechanism, with a 50% inhibitory concentration (IC₅₀) value of 8.0 μg/mL, antioxidant capacity of 39439 M⁻¹, and binding constant of 45709 M⁻¹. Antiglycation assay showed that RRE exhibited almost equivalent glycation inhibitory effect to that of RC, with IC₅₀ values of 39.7 and 37.3 μg/mL, respectively, but higher than that of RD (IC₅₀ of 50.4 μg/mL), RN (IC₅₀ of 89.5 μg/mL), as well as the positive control, rutin (IC₅₀ of 41.5 μg/mL).

Conclusions:

The potent superoxide scavenging and albumin glycation inhibitory effect of RRE rationalized its therapeutic application in various chronic diseases, especially in the complications of diabetes.

SUMMARY

Rhinacanthins-rich extract (RRE) exhibited potent superoxide scavenging activity

RRE and rhinacanthin-C showed remarkable and comparable antiglycation effect

Rhinacanthins exhibited antiglycation activity by masking specific residues of albumin.

Abbreviations used: RRE: Rhinacanthins-rich extract; RC: Rhinacanthin-C; RD: Rhinacanthin-D; RN: Rhinacanthin-N; IC₅₀: 50% inhibitory concentration; Kao: Antioxidant activity coefficient; Kb: Binding constant; E_rC_i: Reversible electron transfer followed by an irreversible chemical reaction; DM: Diabetes mellitus; AGEPs: Advanced glycation end products; NMR: Nuclear magnetic resonance; HPLC: High-performance liquid chromatography; CV: Cyclic voltammetry; DMSO: Dimethyl sulfoxide; Ipa: Anodic peak current; Ipc: Cathodic peak current; HSA: Human serum albumin; MOE: Molecular operating environment; PASSonline: Online prediction of activity spectra for substances.

Genotoxicity following Organophosphate Pesticides Exposure among Orang Asli Children Living in an Agricultural Island in Kuala Langat, Selangor, Malaysia

Background:

Agriculture is an important sector for the Malaysian economy. The use of pesticides in agriculture is crucial due to its function in keeping the crops from harmful insects. Children living near agricultural fields are at risk of pesticide poisoning.

Objective:

To evaluate the genotoxic risk among children who exposed to pesticides and measure DNA damage due to pesticides exposure.

Methods:

In a cross-sectional study 180 Orang Asli Mah Meri children aged between 7 and 12 years were studied. They were all living in an agricultural island in Kuala Langat, Selangor, Malaysia. The data for this study were collected via modified validated questionnaire and food frequency questionnaire, which consisted of 131 food items. 6 urinary organophosphate metabolites were used as biomarkers for pesticides exposure. For genotoxic risk or genetic damage assessment, the level of DNA damage from exfoliated buccal mucosa cells was measured using the comet assay electrophoresis method.

Results:

Out of 180 respondents, 84 (46.7%) showed positive traces of organophosphate metabolites in their urine. Children with detectable urinary pesticide had a longer tail length (median 43.5; IQR 30.9 to 68.1 µm) than those with undetectable urinary pesticides (median 24.7; IQR 9.5 to 48.1 µm). There was a significant association between the extent of DNA damage and the children's age, length of residence in the area, pesticides detection, and frequency of apple consumption.

Conclusion:

The organophosphate genotoxicity among children is associated with the amount of exposure (detectability of urinary pesticide) and length of residence in (exposure) the study area.

PREVALENCE OF METABOLIC SYNDROME AMONG APPARENTLY HEALTHY ADULTS IN A RURAL COMMUNITY, IN NORTH-WESTERN NIGERIA

BACKGROUND

Metabolic syndrome (MetS) is a cluster of multiple metabolic abnormalities that increases the risk of cardiovascular morbidity and mortality, and a resultant severe economic implication. This study assessed the burden of MetS in a Nigerian rural community setting.

METHOD

This was a cross-sectional, community based study on apparently healthy subjects. A multi stage cluster sampling technique was employed to recruit the study subjects. A standardized pre-tested questionnaire was used to obtain data, and blood samples from subjects were analysed using standard laboratory techniques. MetS was defined using the NCEP-ATP3 criteria. Data were analysed using STATA version II, and a p value of < 0.05 was considered statistically significant.

RESULTS

A total of 450 subjects completed the study, with 38% being males, and a mean age of 40.27 ± 16.41 years. MetS was found in 116 (25.78%) of the subjects. Of these, systemic hypertension was found in 91(78.45%), while all (116) had elevated cholesterol and triglycerides. Abdominal adiposity was found in 45 (38.79%) subjects and 44 (37.93%) had Type 2 diabetes mellitus.

CONCLUSION

The prevalence of MetS and its components in our studied population was high; hence the need for further large population based studies to determine its predictors in our environment.

Evaluation of the genotoxicity of Orthosiphon stamineus aqueous extract

AIM OF THE STUDY

Orthosiphon stamineus, Benth, also known as Misai Kucing in Malaysia and Java tea in Indonesia, is traditionally used in Southeastern Asia to treat kidney dysfunctions, diabetes, gout and several other illnesses. Recent studies of Orthosiphon stamineus pharmacological profile have revealed antioxidant properties and other potentially useful biological activities thereby lending some scientific support to its use in folk medicine. So far the genotoxicity of Orthosiphon stamineus extracts has not been evaluated. In this study the genotoxic potential of Orthosiphon stamineus aqueous extract was investigated by the Salmonella/microsome mutation assay and the mouse bone marrow micronucleus test.

MATERIALS AND METHODS

Chemical composition of Orthosiphon stamineus aqueous extract was analyzed by High Performance Liquid Chromatography-Diode Array Detector (HPLC-DAD). The Salmonella/microsome assay (TA97a, TA98, TA100 and TA1535; plate incorporation method) was performed in the presence or in the absence of extrinsic metabolic activation (S9 mixture). In the mouse micronucleus assay, Orthosiphon stamineus extract was administered by gavage (0, 500, 2000 and 4000 mg/kg body weight/day for 3 days) to male and female Swiss Webster mice (N=6 per dose per sex) and bone marrow cells were harvested 24 h after the last dose. Ethoxy-resorufin-O-dealkylase (EROD) and benzyloxy-resorufin-O-dealkylase (BROD) activities were determined in mouse liver microsomes.

RESULTS

The chemical analysis revealed that the Orthosiphon stamineus extract contained flavonoids (sinensetin, eupatorin), caffeic acid, and rosmarinic acid (44.00±1.879 μg/mg), the latter seemed to be one of its major constituent. Tested at doses up to 5000 μg/plate, the Orthosiphon stamineus extract was not toxic to Salmonella tester strains and did not increase the number of revertant colonies over the background incidence. In the mouse bone marrow assay, the extract did not alter the polychromatic:normochromatic erythrocytes (PCE:NCE) ratio, nor did it increase the incidence of micronucleated polychromatic erythrocytes (MNPEs). No overt toxicity and no change of CYP1A (EROD) and 2B9/10 (BROD) activities were noted.

CONCLUSIONS

Based on the aforementioned findings, it is concluded that the use of Orthosiphon stamineus in the traditional medicine poses no genotoxic risk.

The problem of illegally induced abortion: results from a hospital-based study conducted at district level in Dar es Salaam

Illegal abortion is known to be a major contributor to maternal mortality. The objective of the study was firstly to identify women with illegally induced abortion, (IA) and to compare them with women admitted with a spontaneous abortion (SA) or receiving antenatal care (AC), and secondly to describe the circumstances which characterized the abortion. The population of this cross-sectional questionnaire study comprised patients from Temeke District Hospital, Dar es Salaam, Tanzania. After an in-depth confidential interview, 603 women with incomplete abortion were divided into two groups: 362 women with IA and 241 with SA. They were compared with 307 AC women. IA women were significantly younger, more often better educated, unmarried, nulliparous and students than AC women. Regarding civil-status, educational level, proportion of nullipara and proportion of students, SA patients were similar to AC women. These results lend support to the assumption that the in-depth confidential interview made it possible to distinguish IA women from SA women.

Self-reports of induced abortion: an empathetic setting can improve the quality of data

OBJECTIVES

This study estimated the proportion of incomplete abortions that are induced in hospital-based settings in Tanzania.

METHODS

A cross-sectional questionnaire study was conducted in 2 phases at 3 hospitals in Tanzania. Phase 1 included 302 patients with a diagnosis of incomplete abortion, and phase 2 included 823 such patients.

RESULTS

In phase 1, in which cases were classified by clinical criteria and information from the patient, 3.9% to 16.1% of the cases were classified as induced abortion. In phase 2, in which the structured interview was changed to an empathetic dialogue and previously used clinical criteria were omitted, 30.9% to 60.0% of the cases were classified as induced abortion.

CONCLUSIONS

An empathetic dialogue improves the quality of data collected among women with induced abortion.