Hesperidin - loaded PVA/alginate hydrogel: targeting NFκB/iNOS/COX-2/TNF-α inflammatory signaling pathway.

Introduction: Skin injuries represent a prevalent form of physical trauma, necessitating effective therapeutic strategies to expedite the wound healing process. Hesperidin, a bioflavonoid naturally occurring in citrus fruits, exhibits a range of pharmacological attributes, including antimicrobial, antioxidant, anti-inflammatory, anticoagulant, and analgesic properties. The main objective of the study was to formulate a hydrogel with the intention of addressing skin conditions, particularly wound healing. Methods: This research introduces a methodology for the fabrication of a membrane composed of a Polyvinyl alcohol - Sodium Alginate (PVA/A) blend, along with the inclusion of an anti-inflammatory agent, Hesperidin (H), which exhibits promising wound healing capabilities. A uniform layer of a homogeneous solution comprising PVA/A was cast. The process of crosslinking and the enhancement of hydrogel characteristics were achieved through the application of gamma irradiation at a dosage of 30 kGy. The membrane was immersed in a Hesperidin (H) solution, facilitating the permeation and absorption of the drug. The resultant system is designed to deliver H in a controlled and sustained manner, which is crucial for promoting efficient wound healing. The obtained PVA/AH hydrogel was evaluated for cytotoxicity, antioxidant and free radical scavenging activities, anti-inflammatory and membrane stability effect. In addition, its action on oxidative stress, and inflammatory markers was evaluated on BJ-1 human normal skin cell line. Results and Discussion: We determined the effect of radical scavenging activity PVA/A (49 %) and PVA/AH (87%), the inhibition of Human red blood cell membrane hemolysis by PVA/AH (81.97 and 84.34 %), hypotonicity (83.68 and 76.48 %) and protein denaturation (83.17 and 85.8 %) as compared to 250 µg/ml diclofenac (Dic.) and aspirin (Asp.), respectively. Furthermore, gene expression analysis revealed an increased expression of genes associated with anti-oxidant and anti-inflammatory properties and downregulated TNFα, NFκB, iNOS, and COX2 by 67, 52, 58 and 60%, respectively, by PVA/AH hydrogel compared to LPS-stimulated BJ-1 cells. The advantages associated with Hesperidin can be ascribed to its antioxidant and anti-inflammatory attributes. The incorporation of Hesperidin into hydrogels offers promise for the development of a novel, secure, and efficient strategy for wound healing. This innovative approach holds potential as a solution for wound healing, capitalizing on the collaborative qualities of PVA/AH and gamma irradiation, which can be combined to establish a drug delivery platform for Hesperidin.

Varicella-Zoster Virus Myocarditis: Early Clinical Diagnosis and Outcome.

Varicella-zoster virus (VZV) is a viral infection that causes chickenpox and shingles. Although it is usually self-limiting, it can lead to severe complications, especially in pediatric and immunocompromised patients. VZV was first discovered as a cause of myocarditis in 1953. In this review article, we aim to investigate the early clinical diagnosis of myocarditis in VZV infections and the efficacy of the VZV vaccine in preventing myocarditis. The literature search was done using PubMed, Google Scholar, and Sci-Hub databases. A high VZV mortality rate was noted among adults, infants, and immunocompromised patients. The early diagnosis and treatment of VZV myocarditis can reduce mortality.

Acute Upper Airway Obstruction Due to Massive Cervical Subcutaneous Emphysema: A Case Report.

With upper airway obstruction being an emergency, a high index of suspicion and proper and timely treatment planning are crucial to the patient's life. Spontaneous esophageal perforation, also known as Boerhaave syndrome, has been observed to cause subcutaneous emphysema; however, airway compromise secondary to subcutaneous emphysema is extremely rare when there is no associated broncho-tracheal injury. Here, we present a case of esophageal perforation complicated with cervical emphysema that led to acute airway obstruction requiring invasive ventilation.

Optimizing Medium Composition and Environmental Culture Condition Enhances Antioxidant Enzymes, Recovers Gypsophila paniculata L. Hyperhydric Shoots and Improves Rooting In Vitro

Gypsophila paniculata L. is one of the most important commercial cut flowers worldwide. The plant is sterile and propagated mainly by in vitro culture techniques. However, hyperhydricity hinders its micropropagation and increases mortality during ex vitro acclimatization. Hyperhydric shoots of G. paniculata were proliferated from nodal explants on MS medium without growth regulators that contained 30 g L-1 sucrose, and gelled with 6.0 g L-1 agar. Medium components and environmental culture conditions were optimized to revert hyperhydricity in G. paniculata microshoots and develop an efficient micropropagation protocol for commercial production. Multiple shoots with high quality were successfully regenerated on MS medium fortified with potassium and ammonium nitrate at full concentration, 2.0 mg L-1 paclobutrazol, solidified with 9.0 g L-1agar in Magenta boxes of 62.87 gas exchange/day and incubated under light density of 60 µmol m-2s-1. We recorded 4.33 shoots, 40.00 leaves, 6.33 cm, 2.50 g and 95.00% for number of shoots/explant, number of leaves/shoot, shoot length, shoot fresh weight and normal shoots percentage, respectively. Well-rooted plantlets of G. paniculata were developed from the reverted microshoots, with the rooting percentage (95.00%) on MS medium augmented with 1.0 mg L-1 IBA in Magenta boxes of 62.87 gas exchange/day and 60 µmol m-2s-1 light density. In vitro-rooted plantlets exhibited reduced electrolyte leakage, and enhanced antioxidant enzymes activity of peroxidase, catalase, and polyphenol oxidase due to good ventilation at the highest gas exchange rate of the culture vessels.

Does Ultrasound Guidance Provide Pain Relief During Intrauterine Contraceptive Device Insertion? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: To evaluate ultrasound guidance effect in pain relief during intrauterine device (IUD) insertion. METHODS: Four different databases were searched from inception till June 2022. We selected randomized controlled trials (RCTs) that compared transabdominal ultrasound guidance versus traditional non-guided IUD insertion among women undergoing IUD placement for contraception. We used Revman software during performing our meta-analysis. Our primary outcome was the pain score during IUD insertion as evaluated by the Visual Analog Scale (VAS). Our secondary outcomes were the procedure insertion time, satisfaction, and incidences of complications and misplaced IUDs. RESULTS: Seven RCTs were retrieved with a total number of 1267 patients. There was a significant reduction in the VAS pain score during IUD insertion among the ultrasound-guided group (MD = -1.91, 95% CI [-3.08, -0.73], P = .001). The procedure insertion time was significantly shorter within the ultrasound guidance group compared with the control group (MD = -1.35, 95% CI [-1.81, -0.88], P < .001). Moreover, more women were significantly satisfied with the procedure among the ultrasound-guided group (P < .001). In addition, ultrasound-guided IUD insertion was linked to significant decline in incidences of complications and misplaced IUDs. CONCLUSION: Ultrasound guidance can be used as a modified technique during IUD insertion as it decreases pain, procedure time, and rates of complications and misplaced IUDs with better patient satisfaction.