Functional Outcome of Bilateral Total Knee Replacement in Advanced Osteoarthritis in Simultaneous Versus Staged Procedure

Osteoarthritis (OA) is a chronic, progressive disease involving the degeneration of cartilage and joint tissue, resulting in pain and disability. Bilateral total knee arthroplasty (TKA) is is an effective intervention that improves quality of life, reduces pain and increases functional capability. This study was performed to compare the functional outcomes between staged and simultaneous total knee arthroplasty. This prospective interventional study was carried out in Arthroscopic and Arthroplasty unit of BSMMU, Dhaka from January 2017 to December 2018. A total of 60 OA patients underwent TKA were included in this study. Thirty patients underwent simultaneous TKA procedure and 30 patients underwent staged TKA procedures performed with 1-6 months between stages were included. Pre-operative and post operative data were collected. Data were analyzed using SPSS 12.0. Numerical data were analyzed using unpaired t test and categorical data were analyzed using Chi-Square test. A value of p<0.05 was considered statistically significant. Mean age of the study subjects was 60.47±10.13 years in staged group and 59.30±9.90 years in simultaneous group. Male to female ratio was 1:1.5 in staged group and 1:2 in simultaneous group. Mean BMI of the study subjects was 30.70±4.91kg/m² in staged group and 30.06±4.79kg/m² in simultaneous group (p>0.05). In both groups, maximum study subjects were housewife (33.3% vs. 33.3%). In staged group 13.3% and 16.7% in simultaneous group were heavy worker; 20.0% in staged group and 16.7% in simultaneous group were medium worker (p>0.05). Pain, motion, stability and function were significantly changed after surgery comparing before surgery.Infection was observed in 10.0% cases in both groups. Stiffness was observed in 10.0% cases in staged group but in 6.7% cases in simultaneous group. Even final outcome showed better in simultaneous procedure, there was no significant difference between two procedures. The outcome of both simultaneous andstaged procedure of bilateral total knee replacement in Advanced Osteoarthritis is similar.

Case-Control Study to Evaluate Zinc Deficiency as a Risk Factor for Oxygen Requirement in Patients with COVID-19

Zinc is one of the important trace elements of blood. It helps in maturation of immune system in our body. In the past studies originate the relationship between viral disease and serum zinc deficiency. This was a multicenter case-control study to measure the serum zinc level of COVID-19 patients with different respiratory supports and to evaluate the Odds Ratio (OR) and Relative risk (RR) of zinc deficiency for oxygen requirement for COVID-19 patients. Study places were COVID-19 unit of three tertiary hospitals of Sylhet, a Northern district of Bangladesh. There were 30 controls and 90 cases in this study. The mean zinc level of cases (53-38mcg/dl) was significantly (p=0.000072) lower than the level of controls (73-23mcg/dl). The mean zinc level of the COVID-19 patients required oxygen (49-33mcg/dl) was significantly (p=0.0054) lower than the patients were not treated by oxygen therapy (64-51mcg/dl). The RR of getting affected by COVID-19 was 1-91 for the low zinc level people. Among the COVID-19 affected participants the lower zinc level people had a RR of 1-93 to receive oxygen supplementation. Lower zinc level people are more likely to be affected by COVID-19 in comparison to the normal zinc level people. Among the COVID-19 patients the lower zinc level people had nearly double (RR 1-93) risk of becoming hypoxic and eventually prone for oxygen support.

Remedial role of exercise training to deep-fried oil-induced metabolic and histological changes in Wistar rats

Exercise training is a well-known lifestyle to maintain good health. The present study was conducted to explore the effect of regular exercise training (for 15 min) on biochemical, physiological, and histological changes in fried oil intake (5 g/kg body weight, for 5 weeks) with or without raw oil supplementation. Liver disease and heart muscle injury were accounted for by significant (p < .05) increase in liver and heart biomarker enzymes in serum. Creatinine and urea level were also significantly increased in the fried oil-fed group as a sign of kidney injury. But all the biological markers including triglycerides, low-density lipoprotein cholesterol (LDL-C) was decreased significantly (p < .05) in the exercise-trained rat group. These metabolic changes were substantiated by the histological study of respective organs. Therefore, people should avoid repeatedly deep-fried oil consumption rather than fresh ones though regular exercise training has been found to resolve these metabolic abnormalities. PRACTICAL APPLICATIONS: Exercise training is a common practice to reduce the onset of some metabolic abnormalities for example cardiovascular disease, non-alcoholic fatty liver disease, chronic kidney disease, and also prevents various cell and tissue damages. Repeated frying of vegetable oil not only reduces its nutritional value but also produce free fatty acids and other toxic compounds. The present study revealed that repeatedly heated vegetable oil consumption causes injuries in the heart, liver, kidney, and small intestine by the oxidative products. As a result, the level of biomarkers of these responsive organs was found to be elevated. But regular exercise training ameliorated these detrimental effects. So, in terms of public health concern, regular exercise is one of the best ways to keep the body fit especially those who are consuming deep-fried oil.

Effect of raw and repeatedly fried mustard oil intake on metabolic and organ histological changes in Wistar rat

Fried dietary oils often cause adverse health effects due to altered chemical and nutritional properties. In the present study with mustard oil, the effect of repeated frying (180°C for 10 min, three times) on chemical characteristics and oral intake of raw and fried mustard oil (5 g/kg for 5 weeks) in Wistar rats were investigated. Repeated frying caused oxidation reactions and free fatty acid content in mustard oil. This fried oil feeding to rats increased serum LDL cholesterol and triglycerides and decreased HDL leading to nonalcoholic fatty liver disease accounted by significant increment of liver enzymes (ALT, AST, ALP) compared with raw oil-fed group. Higher level of serum CK-MB and creatinine in fried oil-fed rats indicate disrupted kidney function. Histological findings of the respective organs ascertained metabolic abnormalities due to fried oil intake. Thus, the study suggests avoidance of using repeatedly fried oils in food products for better consumer health. PRACTICAL APPLICATIONS: Vegetable oil is a common ingredient of food products. Mustard oil is used in many countries both as raw and fried forms for various food preparations. When it is being fried at elevated temperatures in the presence of air, both thermal and oxidative decomposition take place which alter the nutritional and functional bioactive properties of the oil. The findings of the current study revealed the repeatedly fried mustard oil-induced detrimental effects on various organs of Wistar rats. Human beings consuming repeatedly fried mustard oil regularly might also face these acute problems. Thus in context to the public health issue, it is a message to avoid in taking repeated fried oils at household cooking or food industry to maintain better health.

Genomics dataset on unclassified published organism (patent US 7547531)

Nucleotide (DNA) sequence analysis provides important clues regarding the characteristics and taxonomic position of an organism. With the intention that, DNA sequence analysis is very crucial to learn about hierarchical classification of that particular organism. This dataset (patent US 7547531) is chosen to simplify all the complex raw data buried in undisclosed DNA sequences which help to open doors for new collaborations. In this data, a total of 48 unidentified DNA sequences from patent US 7547531 were selected and their complete sequences were retrieved from NCBI BioSample database. Quick response (QR) code of those DNA sequences was constructed by DNA BarID tool. QR code is useful for the identification and comparison of isolates with other organisms. AT/GC content of the DNA sequences was determined using ENDMEMO GC Content Calculator, which indicates their stability at different temperature. The highest GC content was observed in GP445188 (62.5%) which was followed by GP445198 (61.8%) and GP445189 (59.44%), while lowest was in GP445178 (24.39%). In addition, New England BioLabs (NEB) database was used to identify cleavage code indicating the 5, 3 and blunt end and enzyme code indicating the methylation site of the DNA sequences was also shown. These data will be helpful for the construction of the organisms’ hierarchical classification, determination of their phylogenetic and taxonomic position and revelation of their molecular characteristics.

High-resolution crystal structure of apolipoprotein(a) kringle IV type 7: insights into ligand binding

Apolipoprotein(a) [apo(a)] consists of a series of tandemly repeated modules known as kringles that are commonly found in many proteins involved in the fibrinolytic and coagulation cascades, such as plasminogen and thrombin, respectively. Specifically, apo(a) contains multiple tandem repeats of domains similar to plasminogen kringle IV (designated as KIV(1) to KIV(10)) followed by sequences similar to the kringle V and protease domains of plasminogen. The KIV domains of apo(a) differ with respect to their ability to bind lysine or lysine analogs. KIV(10) represents the high-affinity lysine-binding site (LBS) of apo(a); a weak LBS is predicted in each of KIV(5)-KIV(8) and has been directly demonstrated in KIV(7). The present study describes the first crystal structure of apo(a) KIV(7), refined to a resolution of 1.45 A, representing the highest resolution for a kringle structure determined to date. A critical substitution of Tyr-62 in KIV(7) for the corresponding Phe-62 residue in KIV(10), in conjunction with the presence of Arg-35 in KIV(7), results in the formation of a unique network of hydrogen bonds and electrostatic interactions between key LBS residues (Arg-35, Tyr-62, Asp-54) and a peripheral tyrosine residue (Tyr-40). These interactions restrain the flexibility of key LBS residues (Arg-35, Asp-54) and, in turn, reduce their adaptability in accommodating lysine and its analogs. Steric hindrance involving Tyr-62, as well as the elimination of critical ligand-stabilizing interactions within the LBS are also consequences of this interaction network. Thus, these subtle yet critical structural features are responsible for the weak lysine-binding affinity exhibited by KIV(7) relative to that of KIV(10).

Antifibrinolytic effect of single apo(a) kringle domains: relationship to fibrinogen binding

Elevated plasma concentrations of lipoprotein(a) [Lp(a)] are associated with an increased risk for the development of atherosclerotic disease which may be attributable to the ability of Lp(a) to attenuate fibrinolysis. A generally accepted mechanism for this effect involves direct competition of Lp(a) with plasminogen for fibrin(ogen) binding sites thus reducing the efficiency of plasminogen activation. Efforts to determine the domains of apolipoprotein(a) [apo(a)] which mediate fibrin(ogen) interactions have yielded conflicting results. Thus, the purpose of the present study was to determine the ability of single KIV domains of apo(a) to bind plasmin-treated fibrinogen surfaces as well to determine their effect on fibrinolysis using an in vitro clot lysis assay. A bacterial expression system was utilized to express and purify apo(a) KIV (2), KIV (7), KIV (9) DeltaCys (which lacks the seventh unpaired cysteine) and KIV (10) which contains a strong lysine binding site. We also expressed and examined three mutant derivatives of KIV (10) to determine the effect of changing critical residues in the lysine binding site of this kringle on both fibrin(ogen) binding and fibrin clot lysis. Our results demonstrate that the strong lysine binding site in apo(a) KIV (10) is capable of mediating interactions with plasmin-modified fibrinogen in a lysine-dependent manner, and that this kringle can increase in vitro fibrin clot lysis time by approximately 43% at a concentration of 10 microM KIV (10). The ability of the KIV (10) mutant derivatives to bind plasmin-modified fibrinogen correlated with their lysine binding capacity. Mutation of Trp (70) to Arg abolished binding to both lysine-Sepharose and plasmin-modified fibrinogen, while the Trp (70) -->Phe and Arg (35) -->Lys substitutions each resulted in decreased binding to these substrates. None of the KIV (10) mutant derivatives appeared to affect fibrinolysis. Apo(a) KIV (7) contains a lysine- and proline-sensitive site capable of mediating binding to plasmin-modified fibrinogen, albeit with a lower apparent affinity than apo(a) KIV (10). However, apo(a) KIV (7) had no effect on fibrinolysis in vitro. Apo(a) KIV (2) and KIV (9) DeltaCys did not bind measurably to plasmin-modified fibrinogen surfaces and did not affect fibrinolysis in vitro.