The effects of dietary Spirulina platensis or curcumin nanoparticles on performance, body chemical composition, blood biochemical, digestive enzyme, antioxidant and immune activities of Oreochromis niloticus fingerlings.

CONTEXT: Recently, prioritize has been given to using natural phytogenic or nano compounds as growth promoters and immunostimulants in fish diets as an alternative to antibiotics. AIMS: The main propose of this trial was to determine the impact of supplementing diets with spirulina or curcumin nanoparticles on the performance and health indicators of Nile tilapia fingerlings. METHODS: In a 56-day feeding trial, 180 tilapia fingerlings were assigned into three main groups, as follows: 1st, control group, 2nd, Spirulina platensis (SP; 5 g kg-1 diet) and 3rd, curcumin nanoparticles (CUR-NPs; 30 mg kg-1 diet). KEY RESULTS: Incorporating tilapia diets with SP or CUR-NPs significantly improved performance, body chemical analysis, blood biochemical and hematological indices, digestive enzyme activities, and antioxidant and immunostimulant features compared to the control. CONCLUSION: Fortified tilapia diets with CUR-NPs or SP efficiently boost the productivity and health of Nile tilapia fingerlings. IMPLICATIONS: The research introduces new practical solutions for applying safe feed additives as alternatives to antibiotics in tilapia farming.

Derivation and validation of a new score to predict long-term survival after sudden cardiac arrest.

BACKGROUND: There is insufficient information about the long-term prognosis of sudden cardiac arrest (SCA) survivors. We therefore derived a clinical score (Sudden Cardiac Arrest-mortality score, SCA-MS) that predicts long-term mortality in patients surviving to hospital discharge and validated it in an independent cohort of SCA survivors. METHODS: A total of 1433 SCA survivors data were collected, who were discharged from the hospitals of the University of Pittsburgh Medical Center between 2002 and 2012. The overall cohort was randomly divided into two near equal cohorts used for the derivation and validation of the SCA-MS, respectively. RESULTS: The derivation cohort included 768 patients and identified serum potassium level>4.2 mg/dL at admission, the presence of atrial fibrillation at any time during the index hospitalization, and the presence of asystole or pulseless electrical activity as the initial documented rhythm as independent predictors of long-term mortality. Based on the multivariable modeling result, one point was assigned to each one of these variables to create the SCA-MS that ranged from 0 to 3. In the validation cohort, the SCA-MS was predictive of long-term mortality (hazards ratio = 1.69, 95% confidence interval 1.50-1.91, P < 0.001) per 1-point increment in the SCA-MS. CONCLUSIONS: We describe a new clinical score that predicts long-term survival after SCA based on serum potassium levels at the admission, presence of atrial fibrillation, and documented rhythm of SCA.

Generalized sensitivity analysis of the minimal model of the intravenous glucose tolerance test.

Generalized sensitivity functions characterize the sensitivity of the parameter estimates with respect to the nominal parameters. We observe from the generalized sensitivity analysis of the minimal model of the intravenous glucose tolerance test that the measurements of insulin, 62 min after the administration of the glucose bolus into the experimental subject's body, possess no information about the parameter estimates. The glucose measurements possess the information about the parameter estimates up to three hours. These observations have been verified by the parameter estimation of the minimal model. The standard errors of the estimates and crude Monte Carlo process also confirm this observation.

Effect of dietary prebiotics and probiotics on snakehead (Channa striata) health: Haematology and disease resistance parameters against Aeromonas hydrophila.

This study examined the effect of dietary prebiotics and probiotics after 16 weeks, followed by 8 weeks of post feeding trial with the control unsupplemented diet on haematological and immune response against Aeromonas hydrophila infection in Channa striata fingerlings. Fish were raised on a 40% protein and 12% lipid feed containing three commercial prebiotics (ß-glucan, GOS or galacto-oligosaccharide, MOS or mannan-oligosaccharide); and two probiotics- (Saccharomyces cerevisiae, Lactobacillus acidophilus), respectively and a control. Throughout the study, supplementation with dietary prebiotics and probiotics led to significant (P < 0.05) improvement in the red blood cells, white blood cells, packed cell volume, haemoglobin concentration and serum protein level and lysozyme activities; and these improvements were effective significantly (P < 0.05) when the fish were challenged with Aeromonas hydrophila at the dose of 2 × 106. The disease resistance against A. hydrophila was higher significantly (P < 0.05) in fish fed with probiotic feed supplements (L.acidophilus was highest) compared to prebiotics and control. The study is the first to report the absence of differences in sustaining the efficacies attained after intake of ß-glucan, GOS and MOS upon post-feeding with an unsupplemented feed, over a prolonged period.

Screening of Baccaurea ramiflora (Lour.) extracts for cytotoxic, analgesic, anti-inflammatory, neuropharmacological and antidiarrheal activities.

BACKGROUND: It has been observed that the various part of Baccaurea ramiflora plant is used in rheumatoid arthritis, cellulitis, abscesses, constipation and injuries. This plant also has anticholinergic, hypolipidemic, hypoglycemic, antiviral, antioxidant, diuretic and cytotoxic activities. The present studyaimed to assess the cytotoxic, analgesic, anti-inflammatory, CNS depressant and antidiarrheal activities of methanol extract of Baccaurea ramiflora pulp and seeds in mice model. METHODS: The cytotoxic activity was determined by brine shrimp lethality bioassay; anti-nociceptive activity was determined by acetic acid-induced writhing, formalin- induced licking and biting, and tail immersion methods. The anti-inflammatory, CNS depressant and anti-diarrheal activities were assessed by carrageenan-induced hind paw edema, the open field and hole cross tests, and castor oil-induced diarrheal methods, respectively. The data were analyzed by one way ANOVA (analysis of variance) followed by Dunnett's test. RESULTS: In brine shrimp lethality bioassay, the LC50 values of the methanol extracts of Baccaurea ramiflora pulp and seed were 40 µg/mL and 10 µg/mL, respectively. Our investigation showed that Baccaurea ramiflora pulp and seed extracts (200 mg/kg) inhibited acetic acid induced pain 67.51 and 66.08%, respectively (p < 0.05) that was strongly comparable with that of Ibuprofen (72%) (p < 0.05). The Baccaurea ramiflora pulp and seed extracts (200 mg/kg) significantly (p < 0.05) reduced 58.5 and 53.4 in early and 80.8%, 76.61% in late phase of formalin-induced licking and biting. At 60 and 90 min pulp and seed extracts (200 mg/kg) inhibited nociception of thermal stimulus 50.16 and 62.4%, respectively (p < 0.05) which was comparable with the standard (morphine, 75.9% inhibition). The pulp and seed extracts (200 mg/kg) significantly (p < 0.05) reduced inflammation (42.00 and 55.22%, respectively) in carrageenan-induced hind paw edema and defecations (59.7 and 63.03%, respectively) in castor oil induced diarrhea. Both the extracts showed high sedative activity at 30, 60, 90, and 120 min. CONCLUSION: Our investigation demonstrated significant cytotoxic, analgesic, anti-inflammatory, CNS depressant and antidiarrheal activities of methanol extract of Baccaurea ramiflora pulp and seeds (200 mg/kg).

Gender Differences in Cardiac Resynchronization Therapy Device Choice and Outcome in Patients ≥75 Years of Age with Heart Failure.

Cardiac resynchronization therapy (CRT) is an established therapy for heart failure and can be delivered through a CRT pacemaker (CRT-P) or a CRT defibrillator (CRT-D). CRT-P devices are smaller and less expensive, have better battery longevity, and have been subject to fewer recalls and advisories but cannot deliver high-energy shocks to terminate potentially lethal ventricular arrhythmias. As published guidelines do not distinguish between CRT-P and CRT-D indications, we examined the practice of prescribing these devices in older women and men with heart failure. A total of 512 CRT recipients (age ≥75 years, 26% women, 21% CRT-P) were included in this analysis. Baseline characteristics were collected on all patients, and overall survival was compared by gender and type of CRT device implanted. Women were more likely to receive CRT-Ps than men (26% vs 19%). Men with CRT-Ps were significantly older than women with CRT-Ps and both men and women with CRT-Ds (p = 0.04). In addition, women had lower all-cause mortality compared with men (hazard ratio [HR] 0.75, confidence interval [CI] 0.58 to 0.99, p = 0.04), mainly among CRT-P recipients (HR 0.48, CI 0.26 to 0.8, p = 0.02), but this association was attenuated after adjusting for differences in patient characteristics (HR 0.56, CI 0.26 to 1.18, p = 0.13). In conclusion, women are more likely to receive CRT-Ps than men. Whether this difference is driven by patient preference or physician biases remains unclear. Women with CRT, particularly CRT-Ps, have a better overall survival than men. These differences, which may be driven by unbalanced baseline characteristics of patients or by differences in gender response to CRT, deserve further investigation.

Dietary Prebiotics and Probiotics Influence the Growth Performance, Feed Utilisation, and Body Indices of Snakehead (Channa striata) Fingerlings.

This study used a two-phase feeding trial to determine the influence of selected dietary prebiotics and probiotics on growth performance, feed utilisation, and morphological changes in snakehead (Channa striata) fingerlings as well as the duration of these effects over a post-experimental period without supplementation. Triplicate groups of fish (22.46 ±0.17 g) were raised on six different treatment diets: three prebiotics (0.2% ß-glucan, 1% galacto-oligosaccharides [GOS], 0.5% mannan-oligosaccharides [MOS]), two probiotics (1% live yeast [Saccharomyces cerevisiae] and 0.01% Lactobacillus acidophilus [LBA] powder) and a control (unsupplemented) diet; there were three replicates for each treatment. All diets contained 40% crude protein and 12% crude lipid. Fish were fed to satiation three times daily. No mortalities were recorded during Phase 1; however, 14% mortality was documented in the control and prebiotic-amended fish during Phase 2. At the end of Phase 1, growth performance and feed utilisation were significantly higher (p<0.05) in the LBA-treated fish, followed by live yeast treatment, compared with all other diets tested. The performance of fish on the three prebiotic diets were not significantly different from one another but was significantly higher than the control diet. During Phase 2 (the post-feeding phase), fish growth continued until the 6th week for the probiotic-based diets but levelled off after four weeks for the fish fed the prebiotic diets. The feed conversion ratio (FCR) was higher in all treatments during the post-feeding period. The hepatosomatic index (HSI) did not differ significantly among the tested diets. The visceral somatic index (VSI) and intraperitoneal fat (IPF) were highest in the LBA-based diet and the control diet, respectively. The body indices were significantly different (p<0.05) between Phases 1 and 2. This study demonstrates that probiotic-based diets have a more positive influence on the growth, feed utilisation, and survival of C. striata fingerlings compared with supplementation with prebiotics.

Does cryomaze injure the circumflex artery?: a preliminary search for occult postprocedure stenoses.

OBJECTIVE: Ensuring the transmurality of the mitral isthmus lesion, a critical component of the cryomaze, entails mirror-image application of the cryoprobe both on endocardial and epicardial surfaces when carrying out ablation. Concerns of circumflex artery injury have been expressed during the epicardial application of the cryoprobe over the coronary sinus as the artery courses on the posterior surface of the sinus in the atrioventricular (AV) groove. The objective of this study was to analyze the incidence of significant injury to the circumflex artery and its impact on outcomes, if any, in those patients who have undergone cryomaze. METHODS: Between August 2004 and December 2009, a total of 223 patients underwent argon-based cryoablation (120-second application at -140°C). After Western Institutional Review Board approval, 20 consecutive patients with normal results of preoperative coronary angiograms (right dominance, 75%; left dominance, 15%; codominant circulation, 10%) and who were at least 6 months postablation were enrolled in this study. The mean ± SD age was 60.74 ± 14.99 years, 35% were men, and 50% belonged to New York Heart Association class III/IV. The mean ± SD atrial fibrillation duration was 23.83 ± 36.28 months (65% were paroxysmal). Ten percent (n = 2) underwent primary cryomaze, 40% (n = 8) underwent cryomaze plus mitral valve repair, and 50% (n = 10) underwent two or more concomitant valvular procedures. Twelve patients underwent biatrial cryomaze, and eight underwent only left-sided cryomaze. All patients underwent a 24-hour Holter monitoring, electrocardiogram stress test, and a coronary computed tomographic angiogram, as per the protocol of this study. RESULTS: At discharge, 85% had normal sinus rhythm, whereas 15% of the patients were paced. On a mean ± SD follow-up at 32.57 ± 19.51 months, the Holter and/or pacemaker interrogation revealed AV synchrony in all patients-16 in sinus rhythm and 4 with heart block who converted to AV synchrony after subsequent pacemaker implantation. The stress test was available for 18 patients, and its results were negative in all of them. On the computed tomographic angiogram, 95% of the patients had a completely patent circumflex artery. Stenosis was noticed in only one patient (right dominant circulation), with a 30% to 40% tubular stenosis of the circumflex artery. However, this lesion corresponded to the P1 area of the mitral annulus and was significantly proximal on the circumflex to the P3 area, where the cryoprobe was applied during the cryomaze procedure. CONCLUSIONS: Barring one case of partial circumflex stenosis, likely due to the ongoing normal progression of coronary artery disease, these data derived from a limited prospective trial suggest that epicardial application during the cryomaze procedure does not cause anatomic or physiological compromise of the circumflex artery. Nevertheless, laboratory and anecdotal evidence exist that conflict with this conclusion, and caution should be exercised when applying cryothermy in the vicinity of coronary arteries.

An updated audit of fine needle aspiration cytology procedure of solitary thyroid nodule.

This study was conducted to see the sensitivity, specificity, and accuracy of fine needle aspiration cytology (FNAC) for solitary thyroid nodules and to compare our experience with that of other regions of the world. It was a prospective cross sectional study conducted on 76 thyroid samples submitted and reported at the Department of Pathology, King Edward Medical University, Lahore. There were 65 (85.5%) females and 11 (14.5%) males. Male to female ratio was 1:5.9. Ages of the patients ranged from 10 to 60 year with mean age 35.37 +/- 12.17. Thirty-three (43.42%) samples were indeterminate. There were 30 cases (39.47%) of benign lesions, comprising of colloid goiter, follicular adenoma, and diffuse hyperplasia. The final reports of these cases were almost the same. On FNAC, 13 cases were declared as malignant (6 cases) or suggestive of malignancy (3 cases) or suspicious for malignancy [4 cases (5.26%)]. Only 9 cases (11.84%) were clearly committed as malignant lesions, comprising of papillary carcinoma, anaplastic carcinoma and suggestive of follicular carcinoma. Comparison of malignant cases on histopathology (14 cases) was close to that of FNAC (13 cases). After comparison of FNAC results with histopathology, overall sensitivity of FNAC was found to be 90%, specificity 87.5%, and accuracy 87%, while positive predictive value (PPV) was 93% and negative predictive value (NPV) was 79.5%. In conclusion, we recommend this procedure in the light of views of other experts as a primary investigation of thyroid lesions. We strongly recommend the suggestion that in a patient with one or more thyroid nodule, FNAC should be advised for every patient for exclusion of cancer. We will also encourage the clinicians to embrace this procedure in the initial management of patients. As FNAC is inexpensive, sensitive, specific, and an accurate procedure it should be adapted as an initial investigation of thyroid diseases in all tertiary hospitals in developing countries like Pakistan.