Exploring Ascorbic Acid's Role in Orthopedic Practices: Present Theories, Innovative Approaches, and Prospects.

In the human body, ascorbic acid (AA) is known for its potent antioxidant and reducing properties and also plays a vital role in supporting the growth of bones and cartilage. It has been used extensively in orthopedic surgery. Ongoing studies under the umbrella of ascorbic acid research investigate its impact on bone and tendon physiology, as well as its influence on joint replacement and postoperative pain. The majority of both laboratory and human studies link the usage of ascorbic acid to enhanced bone health and improved tendon healing. Recent literature suggest that ascorbic acid administration may have a positive impact on the outcome of orthopedic procedures. On the other hand, controversy exists regarding the efficacy of ascorbic acid in reducing the incidence of complex regional pain syndrome. In brief, the effectiveness of ascorbic acid in enhancing orthopedic procedure outcomes remains a subject of ongoing investigation. Although certain studies have hinted at the potential positive influence of ascorbic acid on these outcomes, further research is required to validate its effectiveness and ascertain the ideal dosage and method of administration for maximizing its anticipated advantages. To establish the efficacy of ascorbic acid in improving orthopedic procedure outcomes, rigorous human trials of high quality are imperative. The aim of this review was to provide an overview of ascorbic acid's utilization in orthopedic practices and to pinpoint prospective areas for future research.

Study of Antimicrobial Resistance (AMR) in Shigella spp. in India.

Antimicrobial agents are essential in reducing illness and mortality brought on by infectious diseases in both humans and animals. However, the therapeutic effect of antibiotics has diminished due to an increase in antimicrobial drug resistance (AMR). This article provides a retrospective analysis of AMR in Shigella infections in India, showing a rise in resistance that has contributed to a global burden. Shigella spp. are widespread and the second-leading cause of diarrheal death in people of all ages. The frequency and mortality rates of Shigella infections are decreased by antibiotic treatment. However, the growth of broad-spectrum antibiotic resistance is making it more difficult to treat many illnesses. Reduced cell permeability, efflux pumps, and the presence of enzymes that break down antibiotics are the causes of resistance. AMR is a multifaceted and cross-sectoral problem that affects humans, animals, food, and the environment. As a result, there is a growing need for new therapeutic approaches, and ongoing surveillance of Shigella spp. infections which should definitely be improved for disease prevention and management. This review emphasizes on the epidemiological data of India, and antimicrobial resistance in Shigella spp.

Layer-by-Layer Immobilization of DNA Aptamers on Ag-Incorporated Co-Succinate Metal-Organic Framework for Hg(II) Detection.

Layer-by-layer (LbL) immobilization of DNA aptamers in the realm of electrochemical detection of heavy metal ions (HMIs) offers an enhancement in specificity, sensitivity, and low detection limits by leveraging the cross-reactivity obtained from multiple interactions between immobilized aptamers and developed material surfaces. In this research, we present a LbL approach for the immobilization of thiol- and amino-modified DNA aptamers on a Ag-incorporated cobalt-succinate metal-organic framework (MOF) (Ag@Co-Succinate) to achieve a cross-reactive effect on the electrochemical behavior of the sensor. The solvothermal method was utilized to synthesize Ag@Co-Succinate, which was also characterized through various techniques to elucidate its structure, morphology, and presence of functional groups, confirming its suitability as a host matrix for immobilizing both aptamers. The Ag@Co-Succinate aptasensor exhibited extraordinary sensitivity and selectivity towards Hg(II) ions in electrochemical detection, attributed to the unique binding properties of the immobilized aptamers. The exceptional limit of detection of 0.3 nM ensures the sensor's suitability for trace-level Hg(II) detection in various environmental and analytical applications. Furthermore, the developed sensor demonstrated outstanding repeatability, highlighting its potential for long-term and reliable monitoring of Hg(II).

Association Between Sarcopenia and Chronic Renal Failure (Overt and Concealed) in Chronic Obstructive Pulmonary Disease (COPD) Patients: A Cross-Sectional Study.

Background Sarcopenia, a syndrome characterized by a progressive decline in skeletal muscle mass, strength, and function, is frequently associated with chronic diseases such as chronic obstructive pulmonary disease (COPD). Chronic kidney disease (CKD) is a prevalent condition among patients with sarcopenia. Reports suggest that between 15% and 55% of stable COPD patients have sarcopenia. Therefore, the present study aims to determine the association between sarcopenia and chronic renal failure (overt and concealed) in COPD patients. Methodology This institutional-based cross-sectional study was conducted on patients diagnosed with COPD. Hospitalized adult COPD patients who gave consent were included. Sociodemographic information such as age, gender, residence, and prolonged length of stay in the hospital (categorized by a median of 10 days, considering its data distribution in our sample) was obtained using electronic medical records. Skeletal muscle %, visceral fat %, and body fat % were calculated using a bio-electrical impedance analysis device (Omron Body Composition Monitor, Model HBF-702T). Additionally, the strength of the hand grip was measured using a hand dynamometer. Sarcopenia was assessed following the criteria set by the Asian Working Group on Sarcopenia (AWGS). Chronic renal failure (CRF) was assessed by calculating the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) Study Group equation. Quantitative data were compared using an independent sample t-test. The association was determined using chi-square and multivariate logistic regression analyses. A p-value of <0.05 was considered significant. Results The study found that the proportion of sarcopenia in COPD patients was 52%, with overt and concealed CRF prevalence rates of 31.5% and 27%, respectively. Sarcopenic individuals had significantly lower FEV1 and FEV1/FVC compared to non-sarcopenic patients. The incidence of sarcopenia significantly increased with rising BODE index (body mass index (BMI, B), airflow obstruction (O) as measured by the post-bronchodilator FEV1 (percentage of predicted value), dyspnea (D) assessed by the modified Medical Research Council (MMRC) score, and exercise tolerance (E) measured by 6-minute walking distance) and mMRC (modified Medical Research Council dyspnea scale) dyspnea scale scores. Both concealed CRF and overt CRF patients had four times higher odds of having sarcopenia (AOR=4). Conclusion The study reveals a high prevalence of sarcopenia and provides evidence for the association between sarcopenia and chronic renal failure in COPD patients. These findings underscore the importance of early detection and management of sarcopenia and CRF in COPD patients to optimize their clinical outcomes.

Unusually Giant Solitary Osteochondroma of the Ilium: A Case Report with Review of Literature.

Introduction: Osteochondroma is the most common benign bone tumor where a chondrogenic lesion is derived from aberrant cartilage from the perichondral ring. Although it commonly arises from the growing ends of long bones, less commonly, it may arise from the scapula, pelvis, or vertebra. Case Report: We encountered a 16-year-old male patient with a painless left pelvic solid mass for 3 years, which was suggestive of osteochondroma on X-ray and magnetic resonance imaging findings. Besides cosmetic issues, the main indication for surgery was the constant discomfort in wearing pants/shorts/belts. He underwent en bloc excision followed by a biopsy of the surgical specimen by two independent histopathologists confirming the tumor to be osteochondroma. He was followed up for 2 years with no signs of post-operative complications or recurrence. This case represents one of the very few reported so affecting the iliac wing, where the excision was performed before skeletal maturation. We also performed a review of the current literature on iliac wing osteochondroma to understand the tumor better, identify gaps in current knowledge, and suggest areas for future research. Conclusion: Since one of the differential diagnoses includes secondary chondrosarcoma, which could be a rare progression of osteochondroma, early recognition and comprehensive evaluation of such unusual cases needs to be dealt with a high index of suspicion to avoid misdiagnosis and to provide effective treatment.

Antimicrobial activity of synthesized graphene oxide-selenium nanocomposites: A mechanistic insight.

Nanoparticles have recently gained interest as an anti-bacterial agent due to their large surface area/volume ratio and potential to compromise the integrity of bacterial cell membranes. Due to its versatility and anti-bacterial activity, graphene-based materials have drawn significant interest in biomedical applications. One of the greatest threats to life in the modern technological era is the pervasiveness of infectious diseases since bacteria cells are constantly updating themselves to resist antibiotics. In this presented study, GO-Se nanocomposite has been synthesized using polymer solution via a simple dispersion method. The structural and physicochemical properties of nanocomposite were investigated in detail. Staphylococcus aureus, Proteus vulgaris, and Bacillus subtilis bacterial strains were employed to study the anti-bacterial activity of GO-Se nanocomposite. The results show that the synthesized nanocomposites have good efficacy as an anti-bacterial agent. UV-vis spectroscopy, FTIR spectroscopy, HRTEM, XPS, and Raman spectroscopy were used to analyze the as-prepared GO and GO-Se nanocomposite.

Exploring bioactive peptides as potential therapeutic and biotechnology treasures: A contemporary perspective.

In preceding years, bioactive peptides (BAPs) have piqued escalating attention owing to their multitudinous biological features. To date, many potential BAPs exhibiting anti-cancer activities have been documented; yet, obstacles such as their safety profiles and consumer acceptance continue to exist. Moreover, BAPs have been discovered to facilitate the suppression of Coronavirus Disease 2019 (CoVID-19) and maybe ideal for treating the CoVID-19 infection, as stated by published experimental findings, but their widespread knowledge is scarce. Likewise, there is a cornucopia of BAPs possessing neuroprotective effects that mend neurodegenerative diseases (NDs) by regulating gut microbiota, but they remain a subject of research interest. Additionally, a plethora of researchers have attempted next-generation approaches based on BAPs, but they need scientific attention. The text format of this critical review is organized around an overview of BAPs' versatility and diverse bio functionalities with emphasis on recent developments and novelties. The review is alienated into independent sections, which are related to either BAPs based disease management strategies or next-generation BAPs based approaches. BAPs based anti-cancer, anti-CoVID-19, and neuroprotective strategies have been explored, which may offer insights that could help the researchers and industries to find an alternate regimen against the three aforementioned fatal diseases. To the best of our knowledge, this is the first review that has systematically discussed the next-generation approaches in BAP research. Furthermore, it can be concluded that the BAPs may be optimal for the management of cancer, CoVID-19, and NDs; nevertheless, experimental and preclinical studies are crucial to validate their therapeutic benefits.

Nitrogen concentration and physical properties are key drivers of woody tissue respiration.

BACKGROUND AND AIMS: Despite the critical role of woody tissues in determining net carbon exchange of terrestrial ecosystems, relatively little is known regarding the drivers of sapwood and bark respiration. METHODS: Using one of the most comprehensive wood respiration datasets to date (82 species from Australian rainforest, savanna and temperate forest), we quantified relationships between tissue respiration rates (Rd) measured in vitro (i.e. 'respiration potential') and physical properties of bark and sapwood, and nitrogen concentration (Nmass) of leaves, sapwood and bark. KEY RESULTS: Across all sites, tissue density and thickness explained similar, and in some cases more, variation in bark and sapwood Rd than did Nmass. Higher density bark and sapwood tissues had lower Rd for a given Nmass than lower density tissues. Rd-Nmass slopes were less steep in thicker compared with thinner-barked species and less steep in sapwood than in bark. Including the interactive effects of Nmass, density and thickness significantly increased the explanatory power for bark and sapwood respiration in branches. Among these models, Nmass contributed more to explanatory power in trunks than in branches, and in sapwood than in bark. Our findings were largely consistent across sites, which varied in their climate, soils and dominant vegetation type, suggesting generality in the observed trait relationships. Compared with a global compilation of leaf, stem and root data, Australian species showed generally lower Rd and Nmass, and less steep Rd-Nmass relationships. CONCLUSIONS: To the best of our knowledge, this is the first study to report control of respiration-nitrogen relationships by physical properties of tissues, and one of few to report respiration-nitrogen relationships in bark and sapwood. Together, our findings indicate a potential path towards improving current estimates of autotrophic respiration by integrating variation across distinct plant tissues.

Primary ovarian malignant mixed Müllerian tumor: a rare case report.

Primary malignant mixed Müllerian tumor (MMMT) of the ovary is an extremely uncommon neoplasm. These tumors show very aggressive clinical course and high mortality as compared to epithelial ovarian neoplasms. The objective of present study is to present a rare case of primary MMMT homologous type of ovary for its aggressive clinical course and immunohistochemistry findings. A 48-year-old woman presented with complaints of lower abdominal pain, dullness of 3 months duration. USG abdomen pelvis revealed bilateral ovarian solid and cystic mass lesion suggestive of malignant potential. Peritoneal fluid cytology reported as positive for malignant cells. Patient underwent exploratory laparotomy which showed large bilateral ovarian masses with extensive nodular deposits all over pelvic-abdominal organs. Optimal debulking surgery was performed and specimen examined for histopathology. On histopathology, it was reported as bilateral ovarian MMMT homologous type. Immunohistochemistry was done which showed the tumor cell expression positive for CK, EMA, CK7, CA-125, and WT1. Also a distinct population tumor cells express Cyclin D1 and focal and patchy expression of CD-10. Tumor was negative for Desmin, PLAP, Calretin, and inhibin. The patient received operative, chemotherapy and adjuvant therapy along with extensive electrolyte, nutritive, and supplementary support. The patient, however, rapidly deteriorated and died within 9 months of postoperative day. Primary ovarian MMMT is an extremely uncommon neoplasm, and it showed extensive aggressive clinical course and even with operative, chemotherapy, and adjuvant therapy, the patient yields poor prognosis.

Primary ovarian malignant mixed Müllerian tumor: a rare case report Ovarian carcinomas: These are the most common type of ovarian cancer. About two-thirds of these cancers are of epithelial origin. Obesity, hormone replacement therapy, not having children, and family history of ovarian cancer are risk factors for ovarian cancer. A neoplasm is a type of abnormal and excessive growth of tissue. Neoplasms arising from more than one cell type or germ layer are called 'mixed tumors'. Ovarian carcinosarcoma, also known as a malignant mixed Müllerian tumor (MMMT) of the ovary, is a rare, aggressive cancer of the ovary with characteristics of two types of cancer: carcinoma and sarcoma. In this case, we reported a very uncommon and rapidly progressive tumor with a high chance of death even with an advance treatment protocol. Because women with this cancer often have no symptoms, more than half of women are diagnosed at an advanced stage. These cancer cells spread first from surface of the ovary to the lining and organs of the pelvis and abdomen and then to other parts of the body. Diagnosis of ovarian cancer starts with a physical examination, a blood test (for CA-125 and sometimes other markers), transvaginal ultrasound, CT scanning, and so on. The diagnosis must be confirmed with surgery to inspect the abdominal cavity and take biopsies for microscopic analysis. Required advanced ovarian cancer treatment depend on various factors, such as surgery, chemotherapy, radiation, hormonal therapy, and palliative care as per required. Message: Primary ovarian MMMT is an extremely uncommon neoplasm, and in this case we showed a patient with an extensive aggressive clinical course, and even with surgery, chemotherapy, and adjuvant therapy, it showed poor prognosis.

Hydraulic failure and tree size linked with canopy die-back in eucalypt forest during extreme drought.

Eastern Australia was subject to its hottest and driest year on record in 2019. This extreme drought resulted in massive canopy die-back in eucalypt forests. The role of hydraulic failure and tree size on canopy die-back in three eucalypt tree species during this drought was examined. We measured pre-dawn and midday leaf water potential (Ψleaf ), per cent loss of stem hydraulic conductivity and quantified hydraulic vulnerability to drought-induced xylem embolism. Tree size and tree health was also surveyed. Trees with most, or all, of their foliage dead exhibited high rates of native embolism (78-100%). This is in contrast to trees with partial canopy die-back (30-70% canopy die-back: 72-78% native embolism), or relatively healthy trees (little evidence of canopy die-back: 25-31% native embolism). Midday Ψleaf was significantly more negative in trees exhibiting partial canopy die-back (-2.7 to -6.3 MPa), compared with relatively healthy trees (-2.1 to -4.5 MPa). In two of the species the majority of individuals showing complete canopy die-back were in the small size classes. Our results indicate that hydraulic failure is strongly associated with canopy die-back during drought in eucalypt forests. Our study provides valuable field data to help constrain models predicting mortality risk.

Leptomeningeal Carcinomatosis Secondary to Esophageal Cancer Diagnosed on Cytology.

Esophageal carcinoma is considered a common malignancy across the globe. These patients usually present with an advanced stage of the disease at the time of diagnosis. Herein, we report a 55-year male patient who presented with leptomeningeal carcinomatosis, detected on cerebrospinal fluid (CSF) cytology in a case of adenocarcinoma lower third esophagus. On radiological imaging, he also had extensive metastatic deposits in the liver, pleura, and regional and paravertebral lymph nodes.

Minimally Invasive Esophagectomy in Semi-Prone Position (Pawar Technique): Technical Aspects and Outcome in 224 Patients.

Background and Objectives There are two patient positions described for minimally invasive esophagectomy (MIE) for esophageal cancer, viz., left lateral and prone positions. To retain the benefits and overcome the disadvantages of these positions, a semi-prone position was developed by us. Our objective was to analyze the feasibility of performing MIE in this position. Materials and Methods A retrospective review of patients who underwent MIE at our center from January 2007 to December 2017 was done. A semi-prone position is a left lateral position with an anterior inclination of 45 degrees. Intraoperative parameters including conversion rate, immediate postoperative outcomes, and long-term oncological outcomes were analyzed. Statistical Analysis Statistical Package for the Social Sciences version 19 (IBM SPSS, IBM Corp., Armonk, New York, United States) was utilized for analysis. Survival analysis was done using Kaplan-Meier graph. Quantitative data were described as mean or median with standard deviation, and qualitative data were described as frequency distribution tables. Results Consecutive 224 patients with good performance status were included. After excluding those who required conversion (14 [6.6%]), 210 patients were further analyzed. Median age was 60 years (range: 27-80 years). Neoadjuvant treatment recipients were 160 (76%) patients. Most common presentation was squamous cell carcinoma (146 [70%]) of lower third esophagus (140 [67%]) of stage III (126 [60%]). Median blood loss for thoracoscopic dissection and for total operation was 101.5 mL (range: 30-180 mL) and 286 mL (range: 93-480 mL), respectively. Median operative time for thoracoscopic dissection alone was 67 minutes (range: 34-98 minutes) and for entire procedure was 215 minutes (range: 162-268 minutes). There was no intraoperative mortality. Median 16 lymph nodes were dissected (range: 5-32). Postoperative complication rate and mortality was 50% and 3.3%, respectively. Disease-free interval was 18 months (range: 3-108 months) and overall survival was 22 months (range: 6-108 months). Conclusion MIE with mediastinal lymphadenectomy in a semi-prone position is feasible, convenient, oncologically safe, which can combine the benefits of the two conventional approaches. Further prospective and comparative studies are required to support our findings.

Aerobic granular sludge and naphthenic acids treatment by varying initial concentrations and supplemental carbon concentrations.

Aerobic granular sludge (AGS) has previously been utilized in the treatment of toxic compounds due to its diverse and dense microbial structure. The present study subjected mature AGS to model naphthenic acids (NAs) representative of the Canadian oil sands. To this effect, three NA concentrations (10, 50 and 100 mg/L) and three supplemental carbon source concentrations (600, 1200 and 2500 mg/L) were studied in batch reactors for 5 days. The responding variables were chemical oxygen demand (COD), NA concentrations and nutrients. Cyclohexane carboxylic acid (CHCA), cyclohexane acetic acid (CHAA) and 1-adamantane carboxylic acid (ACA) were chosen to study structure-based degradation kinetics. The optimal COD according to the runs was 1200 mg/L. CHCA was removed completely with biodegradation rate constants increasing with lower NA concentrations and lower COD concentrations. CHAA was also removed completely, however, an optimal rate constant of 1.9 d-1 was achieved at NA and COD concentrations of 50 mg/L and 1200 mg/L, respectively. ACA removal trends did not follow statistically significant regressions; however, degradation and sorption helped remove ACA up to 19.9%. Pseudomonas, Acinetobacter, Hyphomonas and Brevundimonas spp. increased over time, indicating increased AGS adaptability to NAs.

Ultrasound assisted synthesis of biodiesel from karanja oil by interesterification: Intensification studies and optimization using RSM.

The present work deals with the optimization of interesterification of karanja oil using response surface methodology (RSM) analysis with intensification studies based on the use of ultrasound. Esterification of karanja oil was performed as a pretreatment under fixed optimum conditions of molar ratio of 1:10, catalyst loading of 3.5% and temperature of 60 °C to reduce the acid value from initial of 10.5 mg of KOH/g to 1.8 mg of KOH/g. The pretreated oil was used for interesterification where the process parameters considered for optimization were time (X1), catalyst loading (X2), reactant ratio (X3) and duty cycle (X4), each varied at three levels. The maximum yield of FAME achieved using optimum parameters as time of 35 min, catalyst loading of 1 wt%, reactant ratio of 1:9 (mol:mol) and duty cycle of 60% was 91.56% (on the basis of theoretical ester formation). The effect of reaction temperature was also studied keeping other parameters constant at optimum conditions and it was observed that yield increases continuously with an increase in the temperature over the entire range of temperature. It was also demonstrated that ultrasound assisted interesterification approach gives less requirement of methyl acetate and catalyst as compared to the conventional approach. It was also observed that higher yield was obtained in the presence of ultrasound (91%) as compared to the conventional approach (60%). Kinetic studies established that second order rate equation fits the obtained data well. A mathematical model in RSM was also successfully developed which can be used to make predictions about the expected conversion. Overall the work demonstrated the intensification benefits of using ultrasound and established the optimum conditions for maximum benefits using RSM analysis.

Survival and prognostic factors for glioblastoma multiforme: Retrospective single-institutional study.

INTRODUCTION: Glioblastoma multiforme (GBM) is the most common and aggressive primary brain tumor in adults. The standard management has been maximum surgical resection followed by adjuvant radiotherapy with concurrent chemotherapy followed by adjuvant chemotherapy. Although the survival rate of patients with GBM has improved with recent advancements in treatment, the prognosis remains generally poor. The median survival rates are in the range of 9-12 months and 2-year survival rates are in the range of 8%-12%. MATERIALS AND METHODS: A single-institution retrospective review of 61 patients of GBM from 2012 to 2014. Data regarding patient factors, disease factors, and treatment factors were collected and survival has been calculated. RESULTS: A total of 61 patients with GBM were analyzed. GBM is commonly seen in sixth decade of life. Male to female ratio is 2.6:1. The right side of the brain is commonly involved with right frontal lobe being the most common site. The median follow-up was 4.6 months. The median survival of our patients was 8 months. The 1-year and 2-year survival rates were 20% and 3.27%, respectively. CONCLUSIONS: The overall survival and prognosis in patients with GBM remains poor despite of constant research and studies. Concurrent chemoradiotherapy followed by adjuvant chemotherapy with temozolomide should be used after maximal resection to improve the survival.