The Effect of Tranexamic Acid Local Injection on Bleeding during and after Tonsillectomy: A Double-Blind Randomized Placebo-Controlled Trial.

Background: Tonsillectomy-related bleeding is one of the most prevalent and potentially fatal complications of this common surgical procedure. We aimed to assess the effect of tranexamic acid (TXA) local injection on bleeding during and after tonsillectomy. Methods: This double-blind, randomized placebo-controlled trial included 20 candidates for tonsillectomy referred to Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran, in 2022. The subjects were randomized into two groups. Ten patients received TXA on their left side and the other ten on their right side 10 min before surgery. Placebo was administered to the contralateral side. The primary outcome was the volume of blood loss during tonsillectomy and up to 24 hours post-tonsillectomy. The secondary outcomes were surgeon satisfaction (rated 0-10), hemodynamic complications (patients' heart rate (HR) and mean arterial pressure (MAP) were recorded every 10 min), and rebleeding. The duration of surgery was also noted. Results: The mean age of the patients was 21.35 ± 3.16 years, of whom 8 (30%) were male and 12 (60%) were female. there was no significant difference between groups in terms of HR and MAP at any time point. The median of surgery duration did not differ significantly between the two groups; however, the surgeon satisfaction with the procedure was significantly higher with TXA compared to placebo. None of the patients developed hemodynamic complications, and rebleeding did not occur in any of the subjects. Conclusions: TXA local injection was not superior to placebo in terms of bleeding control during and after tonsillectomy, hemodynamic complications, rebleeding, and surgery duration.

Biomimetic Rose Petal Structures Obtained Using UV-Nanoimprint Lithography.

This study aims to produce a hydrophobic polymer film by mimicking the hierarchical micro/nanostructures found on the surface of rose petals. A simple and two-step UV-based nanoimprint lithography was used to copy rose petal structures on the surface of a polyurethane acrylate (PUA) film. In the first step, the rose petal was used as a template, and its negative replica was fabricated on a commercial UV-curable polymer film. Following this, the negative replica was used as a stamp to produce rose petal mimetic structures on UV curable PUA film. The presence of these structures on PUA influenced the wettability behavior of PUA. Introducing the rose petal mimetic structures led the inherently hydrophilic material to display highly hydrophobic behavior. The neat PUA film showed a contact angle of 65°, while the PUA film with rose petal mimetic structures showed a contact angle of 138°. Similar to natural materials, PUA with rose petal mimetic structures also displayed the water pinning effect. The water droplet was shown to have adhered to the surface of PUA even when the surface was turned upside down.

Bio-inspired electrospun micro/nanofibers with special wettability.

Inspired by the extreme wetting states displayed by the natural materials, various techniques have been widely investigated to fabricate superhydrophobic and superhydrophilic surfaces. Electrospinning has gained huge amount of interest as fibers with suitable combination of surface chemistry and surface roughness can be easily obtained. This study provides a comprehensive overview of the progress that has been made on electrospun fibers that display superhydrophobicity, superhydrophilicity or a combination of both. The article discusses various modification techniques that can be implemented to obtain fibers with surface heterogeneity for improving its hydrophobicity or hydrophilicity. Both nanometer size of the fibers and secondary nanoscale structures ensure that the fibers have suitable surface topography to exhibit extreme wetting states. Additionally, for the first time, we critically review and identify the role of intrinsic structures such as crystallinity and chain orientation on the wettability of the fibers. We highlight some new emerging application areas that are being explored using superhydrophobic and superhydrophilic fibers. Further, methods for fabricating smart materials with special wettability are also discussed. Such fibers with special wettability show tremendous promise for water harvesting, unidirectional water collection and oil-water filtration applications.

Effect of nasal beclomethasone spray in the treatment of otitis media with effusion.

BACKGROUND: Antimicrobials treatment of Otitis media (OM) reduces some complications, but some of chronic complications, and specially otitis media with effusion (OME), seem to increase. Theoretically the usage of nasal corticosteroid sprays may prevent this problem by reducing the local inflammation around the eustachian tube. So, this study aimed to evaluate the role of nasal corticosteroid spray as an adjuvant for the treatment of OME. METHODS: In a randomized, prospective clinical trial, 2 groups of 46 subjects who had OME were recruited. A questionnaire containing patients' characters, history, complaints, otologic examinations, and the report of tympanometries was filled for all before and after treatment. We administered a period of amoxicillin and a decongestant for both group and nasal beclomethasone spray only for case group. RESULTS: Thirty five of cases (76.1%) and 22 (47.8%) of controls had an improvement in their symptoms or the quality of hearing (p = 0.005). Partial remission was the most common finding in 52.2% of the patients in the case group but for control group there was no change (p = 0.024). The higher improvement in the tympanic retraction in the case group was significant (p < 0.05). A significant better tympanometric result has showed in the treatment of left ear in the patients of the case group (p = 0.038) but not for right ear (p = 0.136). CONCLUSIONS: We concluded that the administration of nasal beclomethasone spray as an adjuvant for the treatment of OME not only improved the results treatment but also increased the resolution of symptoms and the patients' quality of hearing.