Causes of burnout in nursing seniors: A mixed methods study.

BACKGROUND: In recent years, the issue of burnout in newly graduated and student nurses has become an increasing interest of researchers. Burnout seriously affects the behavior, health, life and relationships of individuals. OBJECTIVES: This research was conducted to investigate the causes of burnout in nursing senior students in depth. DESIGN: This research, based on mixed method, was carried out with a sequential exploratory design. PARTICIPANTS: The study was conducted with 148 nursing students in their last year at a university in the Marmara Region of Türkiye. METHOD: Data were collected with Personal Information Form, The Burnout Measure Short Version (BMS) and Maslach Burnout Inventory-Student Form (MBI-SF) between March and April 2022. Qualitative interviews were conducted face-to-face with 16 students determined by criterion sampling method between May and June 2022. A semi-structured interview form was used to collect qualitative data. Descriptive statistics (number, percentage, mean, standard deviation) were used for the analysis of quantitative data. Thematic analysis was performed for qualitative data. RESULTS: The mean BMS total score for the sample group was 4.50. MBI-SF sub-dimension mean scores; It is in the form of exhaustion (16.52), depersonalization (12.66) and competence (12.41). According to the scores of nursing senior students from BMS, it was determined that 22.3 % (n = 33) had burnout, 23 % (n = 34) had a serious burnout problem, and 28.4 % (n = 42) needed professional help as soon as possible. In addition, three main themes emerged as a result of the thematic analysis: (i) Effects of Burnout, (ii) Factors Affecting Burnout, (iii) Ways to Cope with Burnout. CONCLUSION: It was determined that one of the five nursing students was in danger of burnout. The prevalence of burnout in nursing senior students was 73.7 %. Besides, it was determined that the problems experienced in the student's nursing education and professional practices, the pandemic process, financial concerns, family-related situations, not finding time for social activities, and future anxiety were the factors causing burnout.

PCR-based detection of the honeybee tracheal mite (Acarapis woodi) in Türkiye.

Acarapis woodi (Rennie 1921) (Acari: Tarsonemidae) is one of the mites that settles in the respiratory system of honeybees (Apis mellifera L. (Hymenoptera, Apidae)) and distributed throughout the world. It causes significant economic losses on honey production. In Türkiye, studies on the existence of A. woodi are very limited and so far, no studies on the molecular diagnosis and phylogenetic of it have been reported in Türkiye. This study was conducted to investigate the prevalence of A. woodi in Türkiye, especially in areas where beekeeping is intense. Diagnosis of A. woodi was performed using both microscopic and molecular methods using specific PCR primers. Adult honeybee samples were collected from 1.193 hives in 40 provinces of Türkiye between 2018 and 2019. Based on identification studies, the presence of A. woodi was detected in a total of 3 hives (0.5%) in 2018 and 4 hives (0.7%) in 2019. This is the first report for determination of A. woodi in Türkiye.

Incarcerated obturator hernia, an extremely rare cause of intestinal obstruction: case series.

Protrusion of abdominal contents through the obturator foramen is a rare type of abdominal wall hernia. It is usually seen unilaterally and right-sided. Predisposing factors are old age, high intra-abdominal pressure, pelvic floor dysfunction, and multiparity. Obturator hernia has one of the highest mortality rates of all abdominal wall hernias, with a difficult diagnostic process that can be misleading even for the most experienced surgeons. Therefore, to suspect and easily diagnose an obturator hernia, it is important to understand its characteristics. Computerized tomography scanning remains the best diagnostic tool with the highest sensitivity. Conservative ap-proach is not recommended in obturator hernia cases. Once diagnosed, urgent surgical repair is indicated to prevent further ischemia, necrosis, and risk of perforation that can lead to peritonitis, septic shock, and death. Although open repair is a widely used and effective method for reducing abdominal hernias, including obturator, laparoscopic repairs have been described and become preferred. In this study, we present female patients aged 86, 95, and 90 years who were operated with the diagnosis of obturator hernia on computed tomography. The diagnosis of obturatory hernia should always be kept in mind, especially in the presence of acute mechanical intestinal obstruction findings in an elderly woman.

The Relationship Between Depression, Anxiety, and Stress Levels and Eating Behavior in Emergency Service Workers.

Introduction It is seen that shift work causes various biological, psychological, and behavioral problems in individuals. This study aimed to determine the eating attitudes and behaviors of health workers working in shifts in a stressful environment such as the emergency service and to examine the relationship between depression, anxiety, and stress levels and eating behaviors (emotional eating, restrictive eating, and external eating) in terms of sociodemographic and clinical characteristics. Material and Methods Sociodemographic data form; Depression, Anxiety, and Stress Scale (DASS); and Dutch Eating Behavior Questionnaire (DEBQ) were used. The study sample consisted of 92 employees (doctor, nurse, emergency medical technician (EMT), medical secretary, and security, staff) who were actively on duty in the emergency department of Alanya Alaaddin Keykubat University Medical Faculty Training and Research Hospital. Results In our study, when the eating behavior of emergency service workers was evaluated in terms of "emotional, external, and restricted eating" sub-dimensions, depression (p=0.043), anxiety (p=0.017), increased stress levels (p=0.002), being female (p=0.022), nurse-emergency medical technician profession (p=0.001), working in 24-hour shifts (p=0.001), and diet history (p=0.013) were associated with "emotional eating." In addition, an increase in depression levels (p=0.048), being single (p=0.015), working in 24-hour shifts (p=0.005), a decrease in age (p<0.001) with "extrinsic eating," an increase in body mass index (BMI) (p=0.020) and waist circumference (p=0.049), and diet history (p<0.001) were associated with "restricted eating." Conclusions In our study, among the sociodemographic factors, being female, being single, working in 24-hour shifts, diet history, nurse-EMT profession, and undergraduate education level were found to increase the tendency to develop eating behavior problems. An increase in depression levels, being single, working in 24-hour shifts, and a decrease in age were associated with "extrinsic eating." There is a correlation between depression, anxiety, and stress scores and emotional eating scores. Additionally, we found significant correlations between body mass index, waist circumference, diet history, and restricted eating scores. In the approach to eating behavior problems, it is important to determine the individual eating behavior disorder. Due to the increased risk of eating behavior disorder in those who work in long shifts such as 24 hours, it will be possible to organize work programs and increase the quality of service.

The effect of a new topographic classification on determining the prognosis of nasal fracture and treatment modality.

BACKGROUND: Classifications of nasal fracture are based on clinical findings or radiological findings. The classification systems of nasal fracture usually determine the type of nasal fracture. It is important that a classification gives information about treatment modality and prognosis rather than determining the type of fracture. The objective of this study was to show the effect of the new topographic classification on determining the parameters of prognosis and deciding on treatment modality of the nasal fracture. METHODS: We reviewed patients with nasal fracture that was referred from emergency department between December 2018 and September 2020. The views of lateral nasal radiography, the facial view of computed tomography (CT), and/or the views of three-dimensional CT were examined to analyze 120 patients with nasal bone fractures. The length of the nasal bone from the top to the base was divided into equal three levels by two lines perpendicular to the length of the nose. The location of fracture was determined as level I, II, and III, respectively, from caudal part to cranial part of the nasal bone. The demographic features of patients, the side of the fracture, the pattern of fracture, accompanying fractures, and the treatment modality were noted. RESULTS: The frequencies of location of nasal fractures were 44%, 28%, and 27% at level I, level II, and level III, respectively, in 120 cases. It was an expected result that the frequency of fractures was low in parts with the thick bone. Considering the rates of being bilateral or unilateral, it was found that the frequency of unilateral was higher in group of level I, where the thickness of nasal bone was thin, but it was less in group of level III (p<0.05). Non-depressed/minimal-depressed pattern of fracture in group of level I accounted for 92.6% which was the highest frequency (p<0.05). Depressed/elevated fracture patterns were more common in group of level II (p<0.05). Comminuted pattern was mostly observed in group of level III. The rate of accompanying fractures and the applied treatment modality was consistent with anatomic feature of fracture's level. CONCLUSION: We believe that the new topographic classification evaluates the parameters of clinical prognosis such as accompanying fracture, site of fracture and pattern of fracture, and also requirement of closed or open reduction better than other classifications.

Bromelain protects against cisplatin-induced ocular toxicity through mitigating oxidative stress and inflammation.

The aim of this study was to investigate the molecular, biochemical, and histopathological effects of bromelain, which has antioxidant and anti-inflammatory properties, against cisplatin-induced ocular toxicity. The groups were designed as (1) Control, (2) Cisplatin (7 mg/kg, intraperitoneally), (3) Cisplatin + Bromelain (50 mg/kg, orally for 14 consecutive days), (4) Cisplatin + Bromelain (100 mg/kg, orally for 14 consecutive days). The activity of total antioxidant capacity (TAC) and total oxidant status (TOS) and levels of reactive oxygen species (ROS), superoxide dismutase (SOD), malondialdehyde (MDA), interleukin-1ß (IL-1ß), IL-10, nuclear factor kappa B (NF-κB), tumor necrosis factor-alpha (TNF-α) and 8-OHdG were measured in ocular tissue. The mRNA expression of NF-κB and Caspase-3 was also evaluated. Also, ocular sections were evaluated histopathologically. Bromelain demonstrated a dose-dependent protective effect in cisplatin-induced toxicity by regulating oxidative stress, inflammation, and tissue damage. Our results suggested that bromelain may be a potential adjuvant that can protect the eye from cisplatin-induced toxicity.

Revisiting surgical management of breast cancer in a geriatric population.

OBJECTIVE: Breast cancer is a leading cause of death not only in the young population but also in the elderly. There are no consensus treatment guidelines for elderly breast cancer patients. We purposed to discuss surgical treatment options for breast cancer cases over 80 years concerning morbidity and mortality. METHODS: This retrospective study includes 58 patients over 80 years of age at the time of surgery for breast cancer between 2006 and 2017. A sum of 58 cases (54 females and 4 males), over 80 years of age, with an average age of 84.5±4.07 (80-94) years were included in the study. The modified radical mastectomy was the most common surgical modality in 30 (51.7%) cases, and the axillary intervention was performed on 41 (70.7%). Axillary dissection and sentinel lymph node biopsy were performed for 30 (51.7%) and 11 (18.9%) cases, respectively. RESULTS: Minor and major complications were observed in 8 (13.8%) cases. The average follow-up period of the patients was 37.5 (1-120) months. During the follow-up period, breast cancer-related mortality was observed in 9 (15.52%) cases. No statistical differences were detected in mortality with/without axillary intervention and chosen surgical modality. CONCLUSIONS: Comorbidity, the American Society of Anesthesiologists score, and life expectancy should be considered in the management and surgical planning of patients over 80 years of age with breast cancer. Minimally invasive approaches should be preferred for the elderly whenever feasible and applicable in the light of oncologic surgery principles in order to reduce complications and mortality rates.

Ambulatory Laparoscopic Appendectomy: Does the Conventional Approach Need a Reappraisal?

A Deucalione, acute abdomen remains significant in abdominal pain. The entity of acute abdomen accounts for up to 10% of all emergency admissions. The differences between countries' income and level of prosperity are pertinent, particularly in terms of severity, radiological modalities, and surgical management of the condition. Of note, surgical modalities have been the most widely used treatment modality, and current evidence indicates that the laparoscopic approach, per se, is the most effective surgical therapy with a lower incidence of wound infection, post-intervention morbidity, shorter hospital stay, and better quality of life scores compared to the conventional method. In light of this, the present study aimed to evaluate ambulatory appendectomy in a series of sequential laparoscopic appendectomies (LApp), which included both complicated and uncomplicated cases.

Management of appendicitis in coronavirus disease 2019, severe acute respiratory syndrome coronavirus 2, pandemic era: decreasing incidence with increasing complicated cases?

OBJECTIVE: This study aimed to examine the impact of the coronavirus disease 2019 (COVID-19) pandemic on appendicitis and the relevant outcomes in a tertiary hospital, designated as a "pandemic institution" by the Ministry of Health, between pre-COVID-19 and post-COVID-19, i.e., between 2019 and 2020, of the identical period in terms of the annual schedule. METHODS: The data of cases with acute appendicitis, who were followed up at the Department of General Surgery, a 400-bed, tertiary care, a university-affiliated education and research hospital, providing health care to a population of approximately 450,000 people, during the novel coronavirus SARS-CoV-2, during the identical time intervals of pre-COVID-19 (March 12, 2020 to November 12, 2020) and post-COVID-19 (March 12, 2019 to November 12, 2019), were retrospectively analyzed in a detail. RESULTS: Of the 212 appendectomy operations in total, 99 (46.7%) were performed in the pre-COVID-19 and 113 (53.3%) were performed in post-COVID-19. Compared to the pre-pandemic period, patients who had undergone appendectomies in post-COVID-19 revealed significantly lower neutrophil counts and significantly greater appendix diameters (p<0.001 for both). A significantly lower (p=0.041) acute appendicitis with abundant gangrenous appendicitis and phlegmonous appendicitis (p=0.043 and p=0.032, respectively) was recognized in post-COVID-19 compared with pre-COVID-19 interval. CONCLUSION: The number of appendectomy operations decreased in the COVID-19 pandemic. Patients operated during the pandemic period had wider appendix diameter and lower neutrophil levels. The pathological diagnosis was less frequent acute appendicitis, more frequent gangrenous appendicitis, and phlegmonous appendicitis in the pandemic period.

Case series: isolated small bowel perforations, secondary to blunt abdominal traumas.

Isolated small bowel trauma after blunt abdominal trauma is rare and diagnosis may be difficult. The method used in the diagnostic is computed tomography so there is no consensus on this issue. Difficulty in diagnosis and delay in treatment can cause increased morbidity and mortality. We present the diagnosis and treatment modalities of interesting three cases, admitted to the Emergency Service with the complaint of blunt abdominal trauma and were found to have isolated small bowel perforations. Isolated small bowel perforation is secondly seen in cases with blunt abdominal trauma. To this end, a careful examination and the way of the trauma that occurs are crucial for diagnosis. Of note, we postulate that a physician should remain vigilant whether taking the decision of immediate operation to be able to attenuate the morbidity and mortality for a blunt trauma phenomenon. KEY WORDS: Trauma, Blunt trauma; Small bowel perforation; Emergency.

Analysis of patients with emergency surgery in a pandemic hospital.

AIM: This study aimed at comparing the patients that received emergency management surgery (surgery and medical treatment) in our hospital, which is a pandemic hospital and provides emergency surgery, with the pre-pandemic period. MATERIAL AND METHODS: Data of the patients who received treatment at the emergency surgery clinic of our hospital between March 12 and May 12, 2020, were compared with those of the patients treated between March 12 and May 12, 2019. RESULTS: A 55% decrease was observed in the number of patients hospitalized in the emergency surgery clinic. There was a 37% decrease in the number of patients with medical treatment, a 63% decrease in the number of the operated patients, and a 60% decrease in the number of patients hospitalized due to trauma. CONCLUSION: Patients requiring urgent surgical treatment hesitate to apply to the pandemic hospital. Histopathologically, delayed surgery might be concerned with significantly more-inflammatory alterations which may lead to irreversible histopathologic and cytostructural changes in the era of emergency surgery. Therefore, we assume that it would be more useful to follow up and treat COVID-19 suspected and positive patients in the pandemic hospitals and to provide the emergency branch service in other hospitals in case of a possible second wave. KEY WORDS: COVID-19, SARS-CoV-2, Pandemic, Trauma, Emergency surgery, Emergency.

Transport dynamics of SARS-CoV-2 under outdoor conditions.

This study aimed at estimating the transport dynamics of a single severe acute respiratory syndrome corona-virus 2 (SARS-CoV-2)-laden droplet of 1 to 500 µm in diameter at a wind speed from 1 to 4 m/s. Motion dynamics of SARS-CoV-2-laden respiratory droplets under calm or turbulent air conditions were quantified using a combined model. Dalton's law was implemented to estimate their evaporation. One-factor-at-a-time procedure was applied for the sensitivity analysis of model of deposition velocity. The transport distance of the single virus ranged from 167 to 1120 m as a function of the droplet size, wind speed, and falling time. The evaporation times of the droplets ≤ 3 and ≤ 14 µm in diameter were shorter than their settling times from 1.7 m in height at midnight and midday, respectively. Such droplets remained in the air for about 5 min as the droplet nuclei with SARS-CoV-2. The minimum transport distance of the respiratory droplets of 1-15 µm varied between 8.99 and 142 m at a wind speed range of 1-4 m/s, based on their deposition velocity. With their short transport distance, the larger droplet (30 to 500 µm) was not suspended in the air even under the windy conditions. The deposition velocity was found most sensitive to the droplet diameter. The droplets < 15 µm in diameter completely evaporated at midday and the droplet nuclei with the single virus can travel a minimum distance of 500 m under a horizontal wind speed of 3 m/s.

Phytobezoar: An Unusual Condition Leading to Small Bowel Obstruction.

Bezoar is described as a swallowed, extraneous, and indigestible mass located in the gastrointestinal system; it accounts for 0.4-4.0% of all cases of mechanical intestinal obstruction. Intestinal obstruction is the most frequent complication of bezoar formation. Apart from intestinal obstructions, bezoars may also exhibit clinical symptoms such as abdominal pain, nausea, vomiting, weight loss, upper gastrointestinal bleeding, and gastric perforation. However, a considerable number of cases tend to be asymptomatic. Of note, its clinical symptoms cannot be differentiated easily from intestinal obstructions caused by other factors. As such, preoperative CT examination can provide invaluable information about the level of obstruction, etiology, and the existence of additional pathology and thereby help plan the type of surgical procedure required. If prompt diagnosis and timely treatment are not carried out, the condition may lead to significant morbidity and mortality.

Association of Serum C-Reactive Protein Level and Treatment Duration in Acute Cholecystitis Patients Treated Conservatively.

BACKGROUND: Acute cholecystitis (AC) is one of the most common gastrointestinal diseases that require hospitalization and surgical treatment. The treatment of the disease depends upon the severity of the disease and the patients' medical status. OBJECTIVE: In this study, we aimed to investigate if there is an association between the serum C-reactive protein (CRP) value and treatment response and the duration and length of hospital stay in AC patients who are treated conservatively. METHODOLOGY: The medical records of all patients with the diagnosis of AC who were treated with conservative management were included in the study. The demographic and laboratory data including CRP level at first admission to hospital, length of hospital stay, and complications during the conservative treatment were obtained from the patients' records. Patients were divided into two groups according to the treatment response and length of hospital stay. Group 1 patients were defined as patients who responded to the medical treatment in less than three days, and Group 2 patients were defined as patients who did not respond to the medical treatment in three days and stayed at the hospital for more than three days. RESULTS: We identified 101 patients with AC treated medically. Mean age (51.3 ± 16.3, 59.5 ± 15.7; p = 0.013), total leukocyte count (11.8 ± 4.4, 8.2 ± 2.8; p = 0.0005), and CRP value (19.3 ± 13.9, 9.6 ± 5.2; p = 0.0003) were higher in Group 2 compared to Group 1. Correlation analyses demonstrated a significant positive association between the length of hospital stay, total leukocyte count (r = 0.35; p = 0.0002), and CRP value (r = 0.59; p = 0.0004). CONCLUSION: We found that CRP level is associated with treatment duration and hospital stay in AC patients. However, large-scale, prospective further studies are needed to confirm our results and to determine whether CRP levels can be used to discriminate which patient would benefit from medical treatment.

Congenital Nasolacrimal Duct Obstruction and Refractive Amblyopia Risk Factors: Effect of Age at the Time of Probing.

Objectives: To determine whether treatment time of congenital nasolacrimal duct obstruction (CNLDO) has any effect on refractive amblyopia risk factors (ARFs). Methods: This is a cross-sectional study and it was conducted in the Pediatric Ophthalmology Department at Kayseri City Training and Research Hospital. The ages of 174 patients who underwent probing were obtained from electronic medical charts and used to divide the patients into two groups: an early-probing group (<24 months old) and a late-probing group (≥24 months old). After inclusion criteria were applied, a pediatric ophthalmologist examined 189 eyes of the 174 patients. The groups were evaluated and compared for cycloplegic refractive errors. Results: The median age of patients who underwent probing was 30 months (ranging from 11-44 months). A total of 40 of 189 eyes (21.2%) examined had refractive ARFs, which were significantly more prevalent in the late-probing group (p=0.044). The ARFs associated with astigmatism were greater in the late- versus the early-probing group (p=0.037), whereas no other refractive ARFs or anisometropia differed between the groups (p=0.887 for myopia, p=0.364 for hyperopia, and p=0.672 for anisometropia). Astigmatic ARFs were significantly higher in the late-treatment group. Conclusion: Astigmatic ARFs were significantly higher in the late-treatment group. Therefore, ophthalmologists should regularly monitor the refractive status of children with CNLDO, especially those treated after 24 months old.

Hepatoprotective and neuroprotective effect of taxifolin on hepatic encephalopathy in rats.

This study was planned to assess the potential protective effects of taxifolin against thioacetamide-induced hepatic encephalopathy and subsequently to portray its behavioural results. The experimental model was induced with three doses of (200 mg/kg i.p.) thioacetamide and taxifolin (50 and 100 mg/kg, p.o.) was administered for fourteen days. Taxifolin effectively attenuated hepatic encephalopathy through decrease in AST, ALT, ALP and LDH concentrations and improvement of hyperammonemia, and increase in antioxidant capacity by decreasing MDA, ROS, and increasing CAT and GSH. In addition, the expressions of NF-κB, TNF-α, IL-1ß, caspase-3 and Bax was down-regulated while IL-10 and Bcl-2 expressions were up-regulated with taxifolin treatment. The recovery was confirmed by downregulation of iNOS and 8-OHdG expressions in our immunohistochemical analysis. Taxifolin treatment reduced the disrupting role of thioacetamide as seen by corrected hyperammonemia as well as preservation of astrocyte and hepatocyte structure. Elevated plus maze and locomotor activity tests also proved that taxifolin might repeal the neurobehavioral disabilities. In conclusion, taxifolin has shown hepatoprotective and neuroprotective roles with antioxidant and anti-inflammatory effects, as well as suppressing the excessive release of ammonia, and it eventually reversed neurobehavioral impairments.

Analysis of mitochondrial DNA cytochrome-b (CYB) and ATPase-6 gene mutations in COVID-19 patients.

Coronavirus disease of 2019 (COVID-19) is a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Mutations of mitochondrial DNA (mtDNA) are becoming increasingly common in various diseases. This study aims to investigate mutations in the cytochrome-b (CYB) and adenosine triphosphatase-6 (ATPase-6) genes of mtDNA in COVID-19 patients. The association between mtDNA mutations and clinical outcomes is investigated here. In the present study, mutations of the mtDNA genes CYB and ATPase-6 were investigated in COVID-19 (+) (n = 65) and COVID-19 (-) patients (n = 65). First, we isolated DNA from the blood samples. After the PCR analyses, the mutations were defined using Sanger DNA sequencing. The age, creatinine, ferritin, and CRP levels of the COVID 19 (+) patients were higher than those of the COVID-19 (-) patients (p = 0.0036, p = 0.0383, p = 0.0305, p < 0.0001, respectively). We also found 16 different mutations in the CYB gene and 14 different mutations in the ATPase-6 gene. The incidences of CYB gene mutations A15326G, T15454C, and C15452A were higher in COVID-19 (+) patients than COVID-19 (-) patients; p < 0.0001: OR (95% CI): 4.966 (2.215-10.89), p = 0.0226, and p = 0.0226, respectively. In contrast, the incidences of A8860G and G9055A ATPase-6 gene mutations were higher in COVID-19 (+) patients than COVID-19 (-) patients; p < 0.0001: OR (95%CI): 5.333 (2.359-12.16) and p = 0.0121 respectively. Yet, no significant relationship was found between mtDNA mutations and patients' age and biochemical parameters (p > 0.05). The results showed that the frequency of mtDNA mutations in COVID-19 patients is quite high and it is important to investigate the association of these mutations with other genetic mechanisms in larger patient populations.

Centella asiatica extract protects against cisplatin-induced hepatotoxicity via targeting oxidative stress, inflammation, and apoptosis.

This study was designed to investigate the protective effects of Centella asiatica (CA) on cisplatin-induced hepatotoxicity and to clarify the underlying mechanism by biochemical, molecular, immunohistochemical, and histopathological analyses. Rats were pre-treated with two doses of CA (100 and 200 mg/kg, p.o.) for 14 consecutive days. Then, on the 15th day, hepatotoxicity was induced by a single cisplatin injection (10 mg/kg i.p.). On the 18th day, the rats were euthanized. CA effectively alleviated cisplatin-induced hepatic injury via reduction in AST, ALT, and ALP enzymes and a decrease in oxidative stress (decreased MDA and ROS, and increased SOD, CAT, and GSH). CA also mitigated the inflammatory damage by the inhibition of TNF-α, IL-1ß, and NF-κB. The liver expression of caspase-3 and Bax was downregulated, while Bcl-2 was upregulated. Moreover, immunohistochemical results confirmed the recovery with CA by downregulation of iNOS and 8-OHdG expression. These results showed that with its antioxidant, anti-inflammatory, and anti-apoptotic activities, CA could help alleviate the hepatotoxic effects of cisplatin chemotherapy.

Orally disintegrating tablet containing carbamazepine and levetiracetam: formulation and in vitro and in vivo characterization.

This study aimed to prepare and characterize the orally disintegrating tablet (ODT) formulations containing the combination of levetiracetam (LEV) and carbamazepine (CBZ) (CBZ + LEV combination) for the treatment of epilepsy. The ODT formulations were prepared using the lyophilization (L) and direct compression (DC) methods. The flowability of the mixed powders used for DC formulation was evaluated. The quality control tests for the ODTs were performed. Also, the antiepileptic effects of pure drugs, their combination, and the suspension of CBZ + LEV-DC-ODT formulation were evaluated in the rats with pentylenetetrazole (PTZ)-induced epilepsy model. The obtained results for the mixed powders of the DC formulation (angle of repose: 26.18 ± 0.794°; compressibility index: 15.24 ± 0.764%) suggest that the flow properties of the powder blend were suitable for the preparation of CBZ + LEV-ODT using DC method. The mean values of diameter and hardness of L-ODTs and DC-ODTs were found to be 16.87 mm and 16.18 mm and 11.96 N and 30.11 N, respectively. The friability of both formulations was <1%. Both formulations were disintegrated in seconds. Drugs in L-ODT had faster dissolution than those in DC-ODT. Compared to the seizure scores obtained for the groups treated with LEV or CBZ, generally, there was a higher decrease in seizure scores in the groups treated with CBZ + LEV combination or the suspension of CBZ + LEV-DC-ODTs. Consequently, the ODT formulations containing the CBZ + LEV combination might be beneficial in the treatment of epilepsy.

A model for indoor motion dynamics of SARS-CoV-2 as a function of respiratory droplet size and evaporation.

A simplified model has been devised to estimate the falling dynamics of severe acute respiratory syndrome corona-virus 2 (SARS-CoV-2)-laden droplets in an indoor environment. Our estimations were compared to existing literature data. The spread of SARS-CoV-2 is closely coupled to its falling dynamics as a function of respiratory droplet diameter (1 to 2000 µm) of an infected person and droplet evaporation. The falling time of SARS-CoV-2 with a respiratory droplet diameter of about 300 µm from a height of 1.7 m remained almost the same among the Newtonian lift equation, Stokes's law, and our simplified model derived from them so as to account for its evaporation. The evaporative demand peaked at midday which was ten times that at midnight. The evaporating droplets [Formula: see text] 6 µm lost their water content rapidly, making their lifetimes in the air shorter than their falling times. The droplets [Formula: see text] 6 µm were able to evaporate completely and remained in the air for about 5 min as droplet nuclei with SARS-CoV-2.