Enhancing functional buffalo yogurt: Improving physicochemical properties, biological activities, and shelf life using Marjoram and Geranium essential oils.

The use of essential oils (EOs) has attracted interest in the food industry due to their wide range of beneficial properties. In this study, a new functional yogurt was developed using 2 essential oils [Marjoram (M) and Geranium (G)], at 3 different concentrations (0.2%, 0.4%, and 0.6% vol/vol). The physicochemical properties (syneresis, viscosity, pH, and chemical composition), bioactivities (antioxidant activity, anticancer and antibacterial effects, total phenolic content (TPC), and total flavonoid content (TFC)), and sensory characteristics of the developed yogurt were evaluated. The findings indicated that the yogurts fortified with 0.6% M or G exhibited higher viscosity and lower syneresis compared with other treatments. The yogurt supplemented with 0.6% M displayed significant antibacterial activity against Listeria monocytogenes, Staphylococcus aureus, Salmonella typhimurium, and Escherichia coli. In addition, the yogurt enriched with Geranium and Marjoram oils at a concentration of 0.6% had notably significant (P < 0.05) higher TFC levels compared with the control sample and other concentrations. In the same context, in terms of TPC, yogurt supplemented with 0.6% Marjoram oil displayed significantly (P < 0.05) elevated levels in comparison to the other samples tested. Yogurt enriched with Marjoram oil exhibited noteworthy antioxidant activity, followed by Geranium oil compared with the control samples. The yogurt supplemented with 0.6% M demonstrated strong radical scavenging activity, while the yogurt fortified with 0.6% G showed higher anticancer activity against HepG2 human liver carcinoma cells and oxidative stress enzyme activities. Among the various concentrations of EOs tested, the yogurts fortified with 0.6% M or G EOs exhibited the most favorable outcomes, followed by 0.4% M or G. To summarize, G and M EOs can be used as a potential nutritious ingredient and as a natural preservative for milk and related products.

Antibacterial Effects of Silver Diamine Fluoride with and without Potassium Iodide against Streptococcus mutans.

Introduction: Silver diamine fluoride (SDF) is a topical treatment for carious lesions and a primary preventative for newly exposed high-risk surfaces such as fissures and roots in the first molars. Using potassium iodide (KI) after applying SDF has been recommended as a way of reducing the severity of black staining, as well as preserving its antibacterial effect useful in deep caries. Objective: The objective of this research was to compare the antibacterial effect of SDF, with and without KI, on Streptococcus mutans (S. mutans) and dental biofilm. Methods: The antibacterial effects of SDF, KI, and the combination of both were measured using three different techniques (inhibition halo, minimum inhibitory effect [MIE], and colony-forming unit [CFU], testing). Results: The results were then subjected to statistical analysis. Analyzed by means of the Kruskal-Wallis statistical test, the inhibition halos yielded a value of P = 0.3309. Using the MIE test, only the SDF treatment produced an antibacterial effect, at 10%, compared to the KI group, with P = 0.001. Finally, the CFU test revealed a total absence of colonies for all three reagents. All three substances analyzed achieved total inhibition of S. mutans. SDF is effective even in its minimal commercial concentration. Its antibacterial capacity decreases with the addition of KI. Conclusions: The three substances analyzed at their maximum concentrations exhibited an antibacterial effect against S. mutans, resulting in total inhibition.

Assessment of the physicochemical and sensory characteristics of fermented camel milk fortified with Cordia myxa and its biological effects against oxidative stress and hyperlipidemia in rats.

Natural feed additives and their potential benefits in production of safe and highly nutritious food have gained the attention of many researchers the last decades. Cordia myxa is a nutrient-dense food with various health benefits. Despite this fact, very limited studied investigated the physicochemical and sensory impacts of incorporation of fermented camel milk with Cordia myxa and its biological effects. The current study aimed to assess the physical, chemical, and sensory characteristics of fermented camel milk (FCM) fortified with 5, 10, and 15% Cordia myxa pulp. The study demonstrated that fortification of camel milk efficiently enhanced protein, total solids, ash, fiber, phenolic substance, and antioxidant activity. When compared to other treatments, FCM supplemented with 10% Cordia myxa pulp had the best sensory features. In addition, FCM fortified with 10% Cordia myxa pulp was investigated as a potential inhibitor of hypercholesterolemia agents in obese rats. Thirty-two male Wistar rats were split into two main groups including normal pellet group (n = 8) served as negative control group (G1) and a group of hyperlipidemic animals (n = 24) were feed on a high-fat diet (HFD). Hyperlipidemic rats group (n = 24) were then divided into three subgroups (8 per each); second group or positive control (G2) which include hyperlipidemic rats received distilled water (1 mL/day), the third group (G3) involved hyperlipidemic rats feed on FCM (10 g/day) and the fourth group (G4) included hyperlipidemic animals feed on 10 g/day FCM fortified with 10% of Cordia myxa pulp by oral treatment via an intestinal tube for another 4 weeks. In contrast to the positive control group, G4 treated with Cordia myxa showed a substantial decrease in malondialdehyde, LDL, cholesterol, triglycerides, AST, ALT, creatinine, and urea levels, while a significant increase in HDL, albumin, and total protein concentrations. The number of large adipocytes decreased while the number of small adipocytes increased after consumption of fortified FCM. The results indicated that fermented milk fortified with Cordia myxa pulp improved the functions of the liver and kidney in hyperlipidemic rats. These results demonstrated the protective effects of camel milk and Cordia myxa pulp against hyperlipidemia in rats.

The effects of packaging type and storage temperature on some of UHT milk quality indexes.

The objective of the present study was to illustrate the changes in physicochemical properties in ultra-high temperature (UHT) milk packed into a pouch and Tetra Brik during storage. UHT milk samples were kept at 5 and 25 °C for 3 months and regularly analyzed monthly. During storage, significant increases (p < 0.05) in titratable acidity (TA), water-soluble nitrogen (WSN), and non-protein nitrogen (NPN) when UHT milk was packed into pouch versus Tetra Brik and stored at 25 versus 5 °C. Neither type of packaging nor storage temperature affect pH values during storage. Spore-forming bacterial (SFB) count was always higher in UHT milk packed into pouch versus Tetra Brik. Refrigerated storage kept UHT milk without detectable SFB compared to UHT milk held at 25 °C. Pouch packages were responsible for the migration of phthalate derivatives [dimethyl phthalate "DMP", diethyl phthalate "DEP", dibutyl phthalate "DBP", and di-(2-Ethylhexyl) phthalate "DEHP"] into milk with significantly greater levels than milk filled into Tetra Brik. The total sensory scores were decreased significantly during storage, which was more pronounced in UHT milk filled into pouch versus Tetra Brik or stored at 25 °C versus 5 °C. It is concluded that UHT milk filled into Tetra Brik stored at 5 and 25 °C is better in terms of quality and safety indexes than such filled into a pouch.

Predictive Utility of Near-Infrared Spectroscopy for the Outcomes of Hypoxic-Ischemic Encephalopathy: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to assess the utility of near-infrared spectroscopy (NIRS) in predicting the perinatal outcomes of neonates with hypoxic-ischemic encephalopathy (HIE). We conducted a literature search on Medline via PubMed, Web of Science, Scopus, and CENTRAL Library. We included studies that utilized early NIRS monitoring to study the accuracy of NIRS in predicting the perinatal outcomes of neonates with hypoxic-ischemic encephalopathy. Nine studies that met our eligibility criteria were included. These studies were published between 2012 and 2023. In this meta-analysis, no significant differences in regional cerebral oxygen saturation (cSpO2) were found between normal and abnormal groups at 12 hours (MD = 0.21, 95% CI: -6.39 to 6.82, P = 0.95) and 24 hours (MD = -1.96, 95% CI: -6.95 to 3.03, P = 0.44). However, at 48 hours, cSpO2 was significantly lower in the normal group (MD = -4.9, 95% CI: -5.91 to -3.89, P < 0.00001). At 72 hours, our analysis revealed a significant difference with lower cSpO2 in the normal group (MD = -3.0, 95% CI: -5.5 to -0.5, P = 0.02). Regarding cerebral fractional tissue oxygen extraction (FTOE), no significant differences were observed at 12 hours (MD = 0.03, 95% CI: -0.02 to 0.09, P = 0.24). After 24 hours, the normal group exhibited lower FTOE (MD = -0.03, 95% CI: -0.04 to -0.01, P < 0.001), while after 48 hours, the normal group had higher FTOE (MD = 0.07, 95% CI: 0.04 to 0.10, P < 0.0001). Early cerebral NIRS monitoring is beneficial in predicting the outcomes of HIE in term neonates. Our analysis showed that several NIRS parameters, such as regional cSpO2 and cerebral FTOE, are significantly associated with adverse outcomes in the first 72 hours of birth.

Prevalence of anti-SARS-CoV-2 antibody in hemodialysis facilities: a cross-sectional multicenter study from Madinah.

BACKGROUND: Since the occurrence of coronavirus disease in 2019 (COVID-19), the global community has witnessed its exponential spread with devastating outcomes within the general population and specifically within hemodialysis patients. OBJECTIVES: Compare the state of immunity to SARS-CoV-2 among hemodialysis patients and staff. DESIGN: Cross-sectional study with a prospective follow-up period. SETTING: Hemodialysis centers in Madinah region. PATIENTS AND METHODS: We prospectively tested for SARS-CoV-2 antibodies in dialysis patients using dialysis centers staff as controls. The participants were tested on four occasions when feasible for the presence of anti-SARS-CoV-2 antibodies. We also analyzed factors that might be associated with seropositivity. MAIN OUTCOME MEASURES: SARS-CoV-2 positivity using immunoglobulin G (IgG) levels SAMPLE SIZE: 830 participants, 677 patients and 153 dialysis centers staff as controls. RESULTS: Of the total participants, 325 (257 patients and 68 staff) were positive for SARS-CoV-2 IgG antibodies, for a prevalence of 38.0% and 44.4% among patients and staff, respectively (P=.1379). Participants with a history of COVID-19 or related symptoms were more likely to have positive IgG (P<.0001). Surprisingly, positivity was also center-dependent. In a multivariable logistic regression, a history of infection and related symptoms contributed significantly to developing immunity. CONCLUSION: The high prevalence of SARS-CoV-2 antibody among hemodialysis patients and previously asymptomatic staff suggested past asymptomatic infection. Some centers showed more immunity effects than others. LIMITATIONS: Unable to collect four samples for each participant; limited to one urban center. CONFLICT OF INTEREST: None.

The worst-case scenario: Bridging repair with a biologic mesh in high-risk patients with very large abdominal wall hernias-a prospective multicenter study.

BACKGROUND: While modern techniques allow midline fascial closure for most abdominal hernias, a bridge repair with mesh may be the only alternative in very large defects. When the risk of infection is high, the use of prosthetic mesh is controversial. We aim to examine outcomes after bridge repair of very large abdominal hernias at high risk for postoperative infection with a second-generation biologic mesh. METHODS: Prospective, multicenter, single-arm study of patients with very large abdominal hernias who received bridge repair with a neonatal bovine dermis mesh. Primary outcome was hernia recurrence, as identified on computed tomography 1 year after the operation. Secondary outcomes included mesh laxity, surgical site occurrences, and any other mesh-related complications. Independent risk factors of the outcomes were determined by univariate and multivariable analyses. RESULTS: A total of 117 bridge repair patients were enrolled with a mean defect size of 442.5 ± 254.2 cm2. The patients were predominantly obese (mean body mass index 36.5 ± 10.5) and with multiple comorbidities (Charlson comorbidity index 3 ± 2.5). Hernia recurrence was identified in 24 (20.5%) patients. An infected mesh at the index operation was an independent predictor of hernia recurrence, whereas obesity was an independent predictor of the pooled endpoint of recurrence and mesh laxity. Surgical site occurrences were recorded in 36.8% of the patients, and no independent risk factors were identified. CONCLUSION: In patients with very large abdominal hernias and at high risk for postoperative infection, who cannot undergo midline fascial closure, a bridge repair with neonatal bovine dermis mesh offers an acceptable profile in terms of hernia recurrence and wound occurrences.

Aquatic beetles Cercyon unipunctatus as bioindicators of pollution in Lake Edku and Mariut, Egypt.

The lakes of the North Delta give a rich and imperative territory for marine fish and its regeneration, and have dependably been major areas of fish creation in Egypt, 75% of the production was collected from them. As of late, many difficulties are confronting these lakes and prompt the exhaustion of fish production from them. The aim of the present study is to evaluate different inorganic pollutants in Coleopterons aquatic insect (Cercyon unipunctatus) taken from both Lake Edku and Mariut and also, to estimate their effect on oxidative stress markers and chromosomal aberrations. The average concentrations of heavy metals differ in the two locations. The concentration of (Pb, Cd, Fe, Co, Cu, Zn, and Mn) was significantly higher in water samples of Lake Mariut than those of Lake Edku. Also, the present work, showed the physical and chemical characters of the two lakes water. In the current study, the obtained results showed that there was a significant increase in (Pb, Cd, Fe, Co, Cu, Zn, and Mn) concentrations in C. unipunctatus tissues which were collected from Lake Mariut. The biochemical parameters of oxidative stress have been affected by the pollution in Lake Mariut water. Significant increases in the activity level of aspartate aminotransferase, alanine aminotransferase, and malondialdehyde concentration were recorded, while there were significant decreases in (total protein content, GSH content, and GPx activity). The result of chromosomal aberration test showed that there were different types of aberrations as binucleate cell, lagging chromosome, and abnormal distribution of chromosomes. The obtained data showed that C. unipunctatus highly affected by environmental stressors in water. So we suggest that these beetles could be a suitable monitor for ecotoxicological studies.

Effects of astaxanthin in mice acutely infected with Trypanosoma cruzi.

During Trypanosoma cruzi infection, oxidative stress is considered a contributing factor for dilated cardiomyopathy development. In this study, the effects of astaxanthin (ASTX) were evaluated as an alternative drug treatment for Chagas disease in a mouse model during the acute infection phase, given its anti-inflammatory, immunomodulating, and anti-oxidative properties. ASTX was tested in vitro in parasites grown axenically and in co-culture with Vero cells. In vivo tests were performed in BALB/c mice (4-6 weeks old) infected with Trypanosoma cruzi and supplemented with ASTX (10 mg/kg/day) and/or nifurtimox (NFMX; 100 mg/kg/day). Results show that ASTX has some detrimental effects on axenically cultured parasites, but not when cultured with mammalian cell monolayers. In vivo, ASTX did not have any therapeutic value against acute Trypanosoma cruzi infection, used either alone or in combination with NFMX. Infected animals treated with NFMX or ASTX/NFMX survived the experimental period (60 days), while infected animals treated only with ASTX died before day 30 post-infection. ASTX did not show any effect on the control of parasitemia; however, it was associated with an increment in focal heart lymphoplasmacytic infiltration, a reduced number of amastigote nests in cardiac tissue, and less hyperplasic spleen follicles when compared to control groups. Unexpectedly, ASTX showed a negative effect in infected animals co-treated with NFMX. An increment in parasitemia duration was observed, possibly due to ASTX blocking of free radicals, an anti-parasitic mechanism of NFMX. In conclusion, astaxanthin is not recommended during the acute phase of Chagas disease, either alone or in combination with nifurtimox.

Novel simulation for training trauma surgeons.

BACKGROUND: Clinical training in operative technique is important to boost self-confidence in residents in all surgical fields but particularly in trauma surgery. The fully trained trauma surgeon must be able to provide operative intervention for any injury encountered in practice. In this report, we describe a novel training model using a human cadaver in which circulation in the major vessels can be simulated to mimic traumatic injuries seen in clinical practice. METHODS: Fourteen human cadavers were used for simulating various life-threatening traumatic injuries. The carotid and femoral arteries and the jugular and femoral vein were cannulated and connected to perfusate reservoirs. The arterial reservoir was connected to an intra-aortic balloon pump, which adds pulsatile flow through the heart and major arteries. Fully trained trauma surgeons evaluated the utility of this model for repairing various injuries in the thoracic and abdominal cavity involving the heart, lungs, liver, and major vessels while maintaining emergent airway control. RESULTS: Surgeons reported that this perfused cadaver model allowed simulation of the critical challenges faced during operative trauma while familiarizing the student with the operative techniques and skills necessary to gain access and control of hemorrhage associated with major vascular injuries. CONCLUSION: In this report, we describe a novel training model that simulates the life-threatening injuries that confront trauma surgeons. An alternative to living laboratory animals, this inexpensive and readily available model offers good educational value for the acquisition and refinement of surgical skills that are specific to trauma surgery.

Common bile duct adenoma: case report and brief review of literature.

Papillary adenomas of the common bile duct are a rare entity with few published case reports and limited knowledge on its natural progression. We report here a case of common bile duct papillary adenoma in a 69-year-old female who presented with symptoms of common bile duct obstruction. She was treated with local endoscopic excision of the mass that has benign features. A brief review of literature is discussed with a proposed treatment plan for follow-up with surveillance endoscopy and ultrasonography as opposed to the radical resection for benign findings on pathology.

An evaluation of multidetector computed tomography in detecting pancreatic injury: results of a multicenter AAST study.

BACKGROUND: Efforts to determine the suitability of low-grade pancreatic injuries for nonoperative management have been hindered by the inaccuracy of older computed tomography (CT) technology for detecting pancreatic injury (PI). This retrospective, multicenter American Association for the Surgery of Trauma-sponsored trial examined the sensitivity of newer 16- and 64-multidetector CT (MDCT) for detecting PI, and sensitivity/specificity for the identification of pancreatic ductal injury (PDI). METHODS: Patients who received a preoperative 16- or 64-MDCT followed by laparotomy with a documented PI were enrolled. Preoperative MDCT scans were classified as indicating the presence (+) or absence (-) of PI and PDI. Operative notes were reviewed and all patients were confirmed as PI (+), and then classified as PDI (+) or (-). As all patients had PI, an analysis of PI specificity was not possible. PI patients formed the pool for further PDI analysis. As sensitivity and specificity data were available for PDI, multivariate logistic regression was performed for PDI patients using the presence or absence of agreement between CT and operative note findings as an independent variable. Covariates were age, gender, Injury Severity Score, mechanism of injury, presence of oral contrast, presence of other abdominal injuries, performance of the scan as part of a dedicated pancreas protocol, and image thickness < or =3 mm or > or =5 mm. RESULTS: Twenty centers enrolled 206 PI patients, including 71 PDI (+) patients. Intravenous contrast was used in 203 studies; 69 studies used presence of oral contrast. Eight-nine percent were blunt mechanisms, and 96% were able to have their duct status operatively classified as PDI (+) or (-). The sensitivity of 16-MDCT for all PI was 60.1%, whereas 64-MDCT was 47.2%. For PDI, the sensitivities of 16- and 64-MDCT were 54.0% and 52.4%, respectively, with specificities of 94.8% for 16-MDCT scanners and 90.3% for 64-MDCT scanners. Logistic regression showed that no covariates were associated with an increased likelihood of detecting PDI for either 16- or 64-MDCT scanners. The area under the curve was 0.66 for the 16-MDCT PDI analysis and 0.77 for the 64-MDCT PDI analysis. CONCLUSION: Sixteen and 64-MDCT have low sensitivity for detecting PI and PDI, while exhibiting a high specificity for PDI. Their use as decision-making tools for the nonoperative management of PI are, therefore, limited.

Ultrasound-guided transvaginal ovarian needle drilling (UTND) for treatment of polycystic ovary syndrome: a randomized controlled trial.

OBJECTIVE: To evaluate the outcome of ovarian needle drilling using transvaginal ultrasound guidance as an alternative to the traditional laparoscopic electrosurgical drilling for patients with polycystic ovary syndrome (PCOS). DESIGN: A randomized controlled study. SETTING: University teaching hospital and private practice setting. PATIENT(S): The study comprised 163 patients with clomiphene-resistant PCOS. INTERVENTION(S): Patients were randomly allocated to either treatment with ultrasound-guided transvaginal needle ovarian drilling (UTND; n = 82) or laparoscopic electrosurgery ovarian drilling (n = 81). MAIN OUTCOME MEASURE(S): Hormonal changes (FSH, LH, T), ovulation and pregnancy. RESULT(S): There were no significant differences between the two groups with regard to body mass index, hormonal profiles, clinical manifestations, and ultrasound findings of PCOS. The duration of UTND was 15.3 +/- 5.61 minutes (10.5-22.3 minutes), while it was 25.6 +/- 8.2 minutes (20.3-38.1 minutes) in laparoscopic drilling, with a statistically significant difference between the two groups. There were no significant differences between the two groups with regard to resumption of normal menstruation, hirsutism, acne, ovulation, and pregnancy. UTND resulted in significant improvement in the ovulation, pregnancy, hirsutism, and acne. There were significant decreases in the serum LH and T levels but not in the FSH or LH/FSH levels after UTND as well. CONCLUSION(S): UTND can be adopted as an outpatient office procedure. The ease of scheduling, reduced costs, and rapid recovery suggest it as a first-line treatment for PCOS cases resistant to clomiphene citrate.

Unexpected intraoperative patient death: the imperatives of family- and surgeon-centered care.

Conveying to family members that their loved one has unexpectedly died during an operation is perhaps the most stressful task a surgeon must perform. The loss of a patient's life precipitates enormous personal and professional anxiety and stress on a surgeon: profound grief, damage to self-esteem, loss of self-confidence and reputation, and the specter of litigation. Most surgeons feel unskilled in such a setting, yet how they communicate-what they say and how they say it-is extremely important for everyone involved. Two distinct, but interactive, phases of response are relevant when communicating with a family before and after an unexpected death of their loved one: a proactive phase ("CARE") intended to establish a positive therapeutic relationship, and a reactive phase ("SHARE") intended to respond to the crisis in a compassionate and respectful manner and to ensure self-care for the physician.

Middle colic artery thrombosis as a result of retained intraperitoneal gallstone after laparoscopic cholecystectomy.

Spilled gallstones during laparoscopic cholecystectomy are associated with a number of complications such as infection, abscess, inflammation, adhesions, cutaneous sinuses, small bowel obstruction, incarcerated hernia, and generalized septicemia. We report a case of a patient with middle colic vessel erosion and thrombosis secondary to a retained gallstone following laparoscopic cholecystectomy 11 years ago. At operation, the patient was found to have a necrotic transverse colon with a large 2 cm gallstone compressing her middle colic vessels. An extended right hemicolectomy was performed with a primary anastomosis. The importance of stone retrieval during laparoscopic cholecystectomy is emphasized.