Three-Dimensional Printing of Hydrogels for Flexible Sensors: A Review.

The remarkable flexibility and heightened sensitivity of flexible sensors have drawn significant attention, setting them apart from traditional sensor technology. Within this domain, hydrogels-3D crosslinked networks of hydrophilic polymers-emerge as a leading material for the new generation of flexible sensors, thanks to their unique material properties. These include structural versatility, which imparts traits like adhesiveness and self-healing capabilities. Traditional templating-based methods fall short of tailor-made applications in crafting flexible sensors. In contrast, 3D printing technology stands out with its superior fabrication precision, cost-effectiveness, and satisfactory production efficiency, making it a more suitable approach than templating-based strategies. This review spotlights the latest hydrogel-based flexible sensors developed through 3D printing. It begins by categorizing hydrogels and outlining various 3D-printing techniques. It then focuses on a range of flexible sensors-including those for strain, pressure, pH, temperature, and biosensors-detailing their fabrication methods and applications. Furthermore, it explores the sensing mechanisms and concludes with an analysis of existing challenges and prospects for future research breakthroughs in this field.

Urinary Bladder Carcinoma in Females: A Clinico-Pathological Assessment.

BACKGROUND: Urinary bladder cancer is an uncommon cancer in females. Despite not being an infrequent encounter, female bladder cancer remains a poorly defined entity. There is a paucity of literature regarding bladder cancer in females, especially in North India. OBJECTIVE: This study aims to evaluate the clinico-pathological profile of bladder cancer in female patients managed at a single centre in north India. MATERIALS AND METHODS: This retrospective observational study was carried out in a tertiary care centre in North India. Medical records and a database of female patients with bladder cancer treated between January 2012 and January 2021 were retrieved. Data regarding age, duration of disease, associated comorbidity, histopathological variants, and outcomes were studied. RESULTS: Out of 56 female patients with bladder masses, 55 had transitional cell carcinoma (TCC), while one had pheochromocytoma. Painless hematuria (80.3%) was the commonest presentation. At the time of presentation, 5 patients (9.1%) had muscle-invasive bladder cancer (T2-T4), while 50 patients had non-muscle-invasive disease, out of which 31 (56.4%) patients had high-grade and 19 (34.5%) patients had low-grade papillary carcinoma. Twenty-three patients (41.8%) had a history of exposure to domestic chulha (open wood-burning cooking stove), and 11 patients (20%) were smokers; six patients (10.9%) were exposed to both risk factors. CONCLUSIONS: Female bladder cancer was most prevalent in the sixth decade of life, with the majority of patients having a high-grade but non-muscle-invasive disease. Of all the risk factors, chulha exposure was the main risk factor in the aetiology of female bladder cancer.

Feasibility of Performing Supine Percutaneous Nephrolithotomy for Solitary Renal Pelvic Stones (1.5-3 cm) Under Spinal Anaesthesia: A Single-Centre Study.

Introduction Percutaneous nephrolithotomy (PCNL) procedure has evolved over the years and one such evolution has been the introduction of supine PCNL by Valdivia in 1987. This approach offers the added advantage of safe access in patients with compromised cardiovascular and pulmonary function. General anesthesia is the preferred anesthetic technique for PCNL. However, in the last decade, there has been an increase in the usage of regional anesthesia for this procedure. We share our experience of supine PCNL for solitary renal pelvic stones under regional anesthesia. Aim and objective To assess the feasibility, safety, and efficacy of supine PCNL for solitary renal pelvic stones sized 1.5 to 3 cm under spinal anesthesia. Material and methods This was a retrospective record review of 35 patients (21 male) who underwent supine PCNL under regional anesthesia between January 2022 till December 2022 at our institute. All patients had a solitary renal pelvic calculus sized 1.5-3 cm. Intraoperative and postoperative data were analyzed. Results The mean age of patients was 38.5 ± 15 years. The postoperative pain visual analog scale (VAS) score was <5 in 31 (89%) and >5 in 4 (11%) patients. The mean hospital stay was 3.33 ± 0.88 days. Mean fall in hemoglobin level was 0.49 ± 0.43 mg/dL. Postoperatively, mild hematuria occurred in three patients (8.5%) and fever occurred in two (5.7%) patients. There was no injury to adjacent organs in this series. Blood transfusion was required only in one patient. Complete stone clearance was achieved in all patients. Conclusion In experienced hands, supine PCNL under regional anesthesia is a feasible, safe, and effective approach with minimal morbidity.

Natural deep eutectic solvent (fructose-glycine) functionalized-celite/ polyethylene glycol hydrogel nanocomposite for phosphate adsorption: Statistical analysis.

The increasing usage of phosphate fertilizers for agricultural purposes has led to an augmented level of phosphorus in watercourses negatively impacting the ecosystems and water quality warranting its amputation from polluted water. This article describes the preparation of a novel natural deep eutectic solvent (NADES) functionalized-celite/polyethylene glycol hydrogel nanocomposite (NADES-Cel/PEG HNC) for adsorptive phosphate removal from water. The XRD, FTIR, SEM coupled with EDX spectroscopy, TEM, BET analysis, and pHpzc measurement were used to characterise the prepared material. Central composite design (CCD) in response surface methodology (RSM) was used for experimental design to analyse the individual and combined impact of five operational parameters on equilibrium adsorption capacity (Qe), and evaluate the optimal operating conditions by numerical optimization, which were obtained as: contact time (60 min), adsorbent dosage (1.0 g/L), initial [PO43-] (80 mg/L), initial solution pH (3.5), and temperature (304 K). The adsorption process was best explicated via Langmuir adsorption isotherm with a noteworthy saturation capacity, Qm of 111.80 mg PO43-/g at 298 K, and was favourable (S* = 0.99), feasible (ΔG° = -7.02 kJ/mol), exothermic (ΔH° = -8.39 kJ/mol) and physical in nature. The uptake mechanism largely involved H-bonding, electrostatic interaction, n-π interaction and pore-filling. Uptake kinetics of PO43- was best explicated by pseudo-second order model, and the rate-determining step involved both intraparticle and liquid film diffusion mechanisms. The admirable performance of NADES-Cel/PEG HNC was signified by its competent adsorption efficacy and effectual reusability. The pertinence of the hydrogel nanocomposite for treatment of real wastewater was tested. Hence, NADES-Cel/PEG HNC might prove to be a pragmatic adsorbent for decontamination of PO43- from an aqueous environment.

Monostotic Paget's Disease Involving the Scapula Encountered Incidentally on a Trans-arterial Aortic Valve Implantation Scan.

Paget's disease of the bone is a chronic bone disorder. However, to our knowledge, only a few cases of Paget's disease with isolated scapular involvement have been documented in the literature. In this case study, we describe an 81-year-old male patient who was incidentally diagnosed with monostotic Paget's disease of the left scapula during a computed tomography scan for the placement of a trans-arterial aortic valve. We discuss how crucial it is to recognise typical imaging appearances in order to prevent unnecessary investigations and interventions.

Efficient liquid phase confiscation of nile blue using a novel hybrid nanocomposite synthesized from guar gum-polyacrylamide and erbium oxide.

In recent times, biopolymer-metal oxide nanocomposites have gained prominent importance in the attenuation of environmental toxicants from aqueous phase. But lanthanide oxide-based biopolymer nanocomposites have scantly been evaluated for their adsorption potential. A novel guar gum-polyacrylamide/erbium oxide nanocomposite (GG-PAAm/Er2O3 NC) adsorbent was synthesized by copolymerization of guar gum (GG) and acrylamide (AAm) utilizing N-N'-methylenebisacrylamide as a crosslinker and Er2O3 as a reinforcing agent. The adsorptive efficacy of GG-PAAm/Er2O3 nanocomposite was evaluated using nile blue (NB) as a model pollutant dye from aquatic system. The prepared adsorbent was characterized by Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD) analysis, Brunauer-Emmett-Teller (BET) analysis, thermogravimetric analysis, scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDX), and high-resolution transmission electron microscopy (HRTEM). The optimal process parameters, which include dosage (0.8 g/L), agitation time (40 min), initial solution pH (6), and initial NB concentration (80 mg/L) were determined by batch methodology. The equilibrium data for NB confiscation was better expressed by Langmuir isotherm model, with maximal adsorption effectiveness (Qm) of 225.88 mg NB/g demonstrating the actively monolayer adsorption onto homogeneous surface of GG-PAAm/Er2O3 NC. The kinetics of NB sorption process onto GG-PAAm/Er2O3 NC was reliable with pseudo-second order model. Thermodynamic parameters such as ΔH° (15-17 kJ/mol) and ΔS° (0.079-0.087 kJ/mol/K), and - ΔG° (8.81-10.55 kJ/mol) for NB validated the endothermic, an increased randomness at the GG-PAAm/Er2O3-NB interface, and spontaneity and feasibility of the process, respectively. The spent nanocomposite was effectively regenerated with NaOH, and could be reused proficiently for five runs demonstrating the high reusability potential of the nanocomposite. The commendable removal efficiency and high reusability of GG-PAAm/Er2O3 NC recommended it to be a highly competent adsorbent for cationic dyes particularly NB diminution from aqueous waste.

Sustainable Mitigation of Paracetamol with a Novel Dual-Functionalized Pullulan/Kaolin Hydrogel Nanocomposite from Simulated Wastewater.

In the present investigation, a novel, green, and economical dual-functionalized pullulan/kaolin hydrogel nanocomposite (f-PKHN) was fabricated and subsequently applied for the liquid-phase decontamination of paracetamol (PCT), a pharmaceutical pollutant. Pullulan and kaolin were functionalized with l-asparagine and gallic acid, respectively. The physicochemical facets of the functionalized pullulan/kaolin hydrogel nanocomposite and its interactive behavior with PCT were elucidated by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDX), and elemental mapping. The process parameters along with the isotherm, kinetics, and thermodynamics were methodically appraised via a batch technique to unveil the adsorption performance of the as-fabricated hydrogel nanocomposite. The adsorption isotherm and kinetics of PCT uptake by f-PKHN conform well to Freundlich and pseudo-second-order models, respectively. Relying on hydrogen bonding, n-π, and van der Waals interactions, the maximum adsorption capacity was 332.54 mg g-1, higher than for most of the previous adsorbents reported in the literature for PCT removal. Thermodynamic calculations corroborated endothermic, spontaneous, and feasible adsorption phenomena. The maintenance of a high uptake percentage (69.11%) in the fifth consecutive adsorption-desorption cycle implied the significant reusable potential of f-PKHN. Swelling studies exhibited 90% swelling within 200 min, indicating the successful fabrication of a cross-linked hydrogel network. The real water (distilled water, tap water, and river water) samples spiked with PCT specified a significant uptake of PCT (>85%), and the minor influence of ionic strength on the adsorptive potential of f-PKHN validated its potentiality for the decontamination of real effluents. In conclusion, f-PKHN with substantial adsorption capacity, green characteristics, and excellent reusability can be reckoned with as a promising adsorbent for the de-escalation of PCT from aquatic sources as well as at the industrial level.

Statistical evaluation of liquid phase sequestration of acridine orange and Cr6+ by novel mesoporous glutamic acid-g-polyacrylamide/plaster of paris/riboflavin hydrogel nanocomposite.

The adsorption of acridine orange and Cr6+ ion onto plaster of paris reinforced glutamic acid-grafted-polyacrylamide hydrogel nanocomposite modified with riboflavin, Glu-g-PAM/POP/Rb HNC was studied. The Glu-g-PAM/POP/Rb HNC was physico-chemically characterized by Fourier transform infrared spectroscopy, X-ray diffraction analysis, scanning electron microscopy coupled with energy dispersive X-ray spectroscopy, transmission electron microscopy and Brunauer-Emmett-Teller analysis. The specific surface area, pore volume and pore diameter were 15.48 m2/g, 0.015 cm3/g and 4.23 nm, respectively. Adsorption process was strategized by response surface methodology (RSM) based on a 3-level 5-factor (initial solution pH, contact time, adsorbent dose, initial adsorbate concentration and temperature) central composite design (CCD), and validity of the estimated parameters was statistically evaluated using analysis of variance (ANOVA). The optimized operating variables were: pH (AO = 10; Cr6+ = 4.15), contact time (AO = 60 min; Cr6+ = 59 min), adsorbent dose (0.8 g/L), initial adsorbate concentration (60 mg/L) and temperature (298 K). Isotherm results were coincident with Langmuir isotherm model. The experimental kinetic adsorption data was congruous with pseudo-second order model, with the uptake rate controlled by both intraparticle and liquid film diffusions. The relatively high Langmuir saturation capacity of 202.63 mg AO/g and 143.68 mg Cr6+/g, supported by the decent recyclability up to four times affirmed the promising performance of the adsorbent. The efficacy of the adsorbent for simultaneous removal of AO and Cr6+ from bi-component system was assessed. The possible adsorption mechanism mainly involved hydrogen bonding, van der Waals forces, electrostatic and π-π interactions. Adsorption of AO and Cr6+ onto Glu-g-PAM/POP/Rb HNC was feasible and exothermic as revealed by the thermodynamic parameters. The findings demonstrated superior adsorbent efficacy for the seizure of pollutants, particularly AO and Cr6+ from aqueous solution.

Efficiency of iron modified Pyrus pyrifolia peels biochar as a novel adsorbent for methylene blue dye abatement from aqueous phase: equilibrium and kinetic studies.

Herein, a magnetic biochar adsorbent based on Pyrus pyrifolia discarded peels impregnated with precursor FeCl3·6H2O was fabricated and probed as a low-cost adsorbent for toxic cationic dye methylene blue (MB). The textural characterization of Pyrus pyrifolia magnetic biochar (PMBC) obtained from BET analysis exhibited its mesoporous nature with SBET of 133.960 m2/g. The physicochemical characteristics of PMBC were elucidated using XRD, FTIR, SEM-EDX and TEM techniques. The impregnation of FeCl3 has a significant impact on the microstructure of Pyrus pyrifolia based biochar which resulted in enhancement in adsorption efficiency of PMBC. The sorption parameters adsorbent dosage, time, initial MB concentration, and pH were thoroughly elucidated using a batch methodology which were found to be 0.8 g/L, 40 min, 90 mg/L and 6, respectively. Temkin and pseudo-second-order rate equation respectively appropriated the equilibrium data than the rest of the models. The maximum adsorption capacity determined by the Langmuir model was found to be 967.80 mg/g. The adsorbent exhibited better regeneration up to 3 cycles validating its practical usage. The facile synthesis, economic, and environmentally benign characteristic of Pyrus pyrifolia magnetic biochar corroborated it as a highly efficient adsorbent to sequester MB from an aqueous phase.

Pyrus pyrifolia discarded peels impregnated with FeCl₃·6H₂O were exploited as a novel magnetic biosorbent for the abatement of cationic dye from wastewater. The impact of operative variables was analyzed using batch methodology. Isotherm and kinetic modeling on equilibrium data was executed via non-linear approach which is very reliable in comparison to linear way.

Deciphering the adsorption potential of a functionalized green hydrogel nanocomposite for aspartame from aqueous phase.

Herein, a functionalized green hydrogel nanocomposite based on carboxymethylated gum tragacanth and nanobentonite (GTBCH) was designed via free-radical polymerization approach for the elimination of Aspartame (AS) from wastewater. The GTBCH fabrication was validated by Fourier Transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), Transmission electron microscopy (TEM), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDX) techniques. Central composite design (CCD) was efficaciously applied to determine the quadratic polynomial approach for predicting the adsorption capacity (qe) of AS. The optimum sequestration conditions were dosage (0.8 g L‒1), agitation time (35 min) initial AS concentration (60 mg L-1), pH (6) and temperature (308 K). The CCD results revealed that dosage of GTBCH and initial concentration have greater impact on qe followed by pH, time, and temperature. The significant adsorption capacity (392.04 mg g-1), calculated from Langmuir model, could be attributed to the stronger interactions prevalent between AS and GTBCH. Diffusion investigations depicted the uptake of AS via surface adsorption, liquid film and intraparticle diffusion, respectively. Ionic strength and real water have minor effect on the adsorption capacity demonstrating electrostatic interaction has least impact in adsorption process. The pHzpc, FTIR and XPS investigations revealed hydrogen bonding, n-π and van der Waals interactions as the principal removal mechanisms. Robust design, high adsorption capacity, eco-friendly facets along with excellent reusability indicated the GTBCH as a competent adsorbent for AS decontamination from wastewater.

Mechanistic evaluation of metformin drug confiscation from liquid phase on itaconic acid/kaolin hydrogel nanocomposite.

Herein, kaolin (K) was amended by a novel gemini surfactant to attain nano-kaolin (nK), which was subsequently employed as a cross-linker in the preparation of itaconic acid/kaolin hydrogel nanocomposite (IA/nK) via free radical polymerization route employing the sonochemical technique, which has been used for the first time to extract metformin (MF) from water solution. The aspects which affect sorption behavior of IA/nK on metformin (MF) were systematically investigated via batch experiments, in harmony with effect of sorbent dosage, contact time, pH, MF concentration, equilibrium curves, kinetic behavior, and thermodynamic parameters. BET studies of IA/nK exhibited SBET of 106.42 m2g-1, pore volume 0.281 cm3 g-1, and a pore radius of 16.627 Å. Kinetic and isotherm modelling portrayed that pseudo-second order and Freundlich model appropriated adsorption data with maximum sorption capacity of 278.35 mg g-1. Thermodynamic parameters ΔHO (13.67 kJmol-1) and ΔGO (-7.648 kJmol-1) revealed that sequestration of MF on IA/nK was endothermic, spontaneous, and dominated by physisorption. Molecular docking study along with X-ray photoelectron spectroscopy inferred electrostatic interaction and hydrogen bonding as main mechanism of MF removal. IA/nK demonstrated dose-reliant inhibition of both gram-positive and gram-negative bacterial strains. IA/nK demonstrated good regeneration properties, up to four cycles without considerable decrease in its efficacy. The admirable sorption capacity coupled with good reusability, and low toxicity substantiates IA/nK as promising adsorbent for MF confiscation.

Casein (CSN) gene variants and parity affect the milk protein traits in crossbred (Bos taurus x Bos indicus) cows in sub-tropical climate.

Genotypes at four casein (CSN) loci-A26181G of CSN1S1, C6227T of CSN1S2, A8101C of CSN2, and A13104C of CSN3-along with non-genetic factors were studied for their effects on various milk protein traits in 100 crossbred cows with major inheritance of Holstein Frisian (Bos taurus) and Tharparkar (Bos indicus). Results demonstrated the presence of all CSN genotypes with a predominance of heterozygotes. At CSN2 (A8101C; His67Pro) locus, the A2 allele, desirable for human health, was present in 62% as heterozygous and 29% in homozygous condition. Among non-genetic factors, parity of the cows had a significant influence on the milk protein traits in these crossbreds. The genotypes at CSN1S1, CSN2, and CSN3 loci were found to influence (p<0.05 to 0.01) the casein and whey protein yields and composition traits. The casein index and total milk yield were most influenced by the CSN1S2 locus. The AA (A1 milk) genotype of CSN2 had significantly higher yields and percentages of casein and whey proteins. Positive influence of CC genotype of CSNS3 on milk proteins of was observed similar to Bos taurus cows; however, such influence of AA genotype of CSN2 locus may be distinctive to the crossbred cows maintained in subtropical condition. Overall, the results revealed the diverse effects of CSN genotypes on milk proteins in crossbred cattle.

Synthesis of Poly(methacrylic acid)/Montmorillonite Hydrogel Nanocomposite for Efficient Adsorption of Amoxicillin and Diclofenac from Aqueous Environment: Kinetic, Isotherm, Reusability, and Thermodynamic Investigations.

Herein, a simplistic redox polymerization strategy was utilized for the fabrication of a poly(methacrylic acid)/montmorillonite hydrogel nanocomposite (PMA/nMMT) and probed as a sorbent for sequestration of two pharmaceutical contaminants, viz., amoxicillin (AMX) and diclofenac (DF), from wastewater. The synthesized hydrogel nanocomposite was characterized by the Fourier transform infrared, X-ray diffraction, X-ray photoelectron spectroscopy, scanning electron microscopy-energy dispersive X-ray spectroscopy, and transmission electron microscopy techniques to analyze structural characteristics and sorption interactions. The efficacy of PMA/nMMT was thoroughly investigated for the sequestration of AMX and DF from the aquatic phase with a variation in operative variables like agitation time, sorbent dosage, pH, and initial sorbate concentration. The reaction kinetics was essentially consistent with the pseudo-second-order model with rate dominated by the intraparticle diffusion model as well as the film diffusion mechanism. The Freundlich isotherm appropriated the equilibrium data over the entire range of concentration. Thermodynamic investigation explored the spontaneous and endothermic nature of the process. The most possible mechanism has been explained, which includes electrostatic interaction, hydrogen bonding, cationic exchange, and partition mechanism. Economic feasibility, better sorption capacity (152.65 for AMX and 152.86 mg/g for DF), and efficient regeneration and reusability even after four consecutive sorption-desorption cycles ascertained PMA/nMMT as a potential sorbent for AMX and DF uptake from the aqueous phase.

Over-admission and over-treatment of patients with cellulitis: a 5-year audit against international guidelines.

BACKGROUND/AIMS: Application of evidence-based guidelines in the management of cellulitis is poorly studied in Ireland and it is observed that current admission and prescription practices in this country vary widely from internationally accepted standards of care. We aimed to examine the management of cellulitis with regard to hospital admission and initial antibiotic therapy. METHODS: A retrospective audit of patients admitted with cellulitis from 2013 to 2017 in an Irish district general hospital. Exclusion criteria included specialist regions of the body and surgical site infections. Appropriateness of admission and management was compared against international guidelines (Clinical Research Efficiency Support Team (CREST) and Infectious Disease Society of America (IDSA)). RESULTS: Five hundred twenty emergency admissions with cellulitis were analysed. Thirty-five percent (n = 182) were deemed inappropriate admissions compared with CREST and IDSA guidelines, with an estimated cost of €152,203 per annum. Ninety-six percent (n = 501) of patients with cellulitis were treated with a combination of flucloxacillin and benzylpenicillin, despite level 1 evidence showing combination therapy to provide no benefit over appropriate monotherapy. CONCLUSIONS: There is a significant discrepancy between current clinical practice and international guidelines for the management of cellulitis in Ireland; local guidelines are not in keeping with newer evidence and there is a lack of national guidelines for this common condition. Closer adherence to international guidelines would significantly reduce costs by reducing unnecessary admissions and initial monotherapy would improve antibiotic stewardship. This study shows a clear need for local institutions to re-examine antibiotic guidelines to ensure the HSE provides effective evidence-based treatment in the correct setting.

Ultrasonic-assisted synthesis of polyacrylamide/bentonite hydrogel nanocomposite for the sequestration of lead and cadmium from aqueous phase: Equilibrium, kinetics and thermodynamic studies.

Clay-hydrogel nanocomposites are suitable material for mitigating the pollution/environmental impact because of their high adsorption capacity. In this study, the synthesis of polyacrylamide/bentonite hydrogel nanocomposite was assisted by ultrasound through successful incorporation of nanobentonite as filler and cross-linker into polyacrylamide framework. The adsorbent was characterized by FTIR, XRD, BET, SEM-EDX, and TEM in order to observe structural changes and sorption interactions. The effect of adsorbent dose, contact time, initial metal ion concentration and pH on the sequestration of Pb2+ and Cd2+ was analyzed. The adsorbent removed more than 95% Pb2+ and Cd2+ within first 20 min, which corresponds to relatively high pseudo-first order rate constant, k1 (0.240 for Pb2+ and 0.253 1/min for Cd2+) and pseudo-second order rate constant, k2 (0.031 for Pb2+ and 0.033 g/mg/min for Cd2+). The isotherm and kinetics modeling data were best described by Freundlich isotherm over the entire concentration range and pseudo-second order rate equation, respectively. The thermodynamic studies implied spontaneous and endothermic nature of adsorption process. The maximum adsorption capacity (138.33 for Pb2+ and 200.41 mg/g for Cd2+) determined using Langmuir model along with a good regeneration potential depicts that polyacrylamide/bentonite hydrogel nanocomposite could be used effectively for Pb2+ and Cd2+ uptake from aqueous solution.

Consumption of Probiotic Lactobacillus fermentum MTCC: 5898-Fermented Milk Attenuates Dyslipidemia, Oxidative Stress, and Inflammation in Male Rats Fed on Cholesterol-Enriched Diet.

There is a growing and alarming prevalence that increased serum cholesterol is closely related to increased cardiovascular disease risk. Probiotic consumption could be a safe and natural strategy to combat. Therefore, we sought to examine the cholesterol-lowering potential of co-supplementation of probiotic bacteria Lactobacillus fermentum MTCC: 5898-fermented buffalo milk (2.5% fat) in rats fed cholesterol-enriched diet. Male Wistar rats were divided into three groups on the basis of feed, viz. group 1, fed standard diet (SD); group 2, fed cholesterol-enriched diet (CED); and group 3, fed cholesterol-enriched diet along with L. fermentum MTCC: 5898-fermented milk (CED+LF) for 90 days. At the endpoint, significantly higher levels of serum total cholesterol, low-density lipoprotein cholesterol, triacylglycerols, very low density lipoprotein cholesterol, atherogenic index, coronary artery risk index, hepatic lipids, lipid peroxidation, and mRNA expression of inflammatory cytokines (TNF-α and IL-6) in the liver while significantly lower levels of serum high-density lipoprotein cholesterol and anti-oxidative enzyme activities, catalase, superoxide dismutase, and glutathione peroxidase in the liver and kidney were observed in the CED group compared to the SD group. Compared to the CED group, these adverse physiological alterations were found significantly improved in the CED+LF group. Hence, this study proposes that L. fermentum MTCC: 5898 is a potential probiotic bacteria that can be consumed to tackle hypercholesterolemia. Graphical Abstract ᅟ.

Meconium pseudocyst presenting as massive ascites in a new-born.

Meconium pseudocyst (MPC) is a rare but well-known surgical condition due to prenatal bowel perforation. A case of MPC secondary to prenatal bowel perforation is presented. Massive ascites requiring peritoneal drainage and disappearance of prenatal intraperitoneal calcifications have not been previously reported in MPC. MPC may present at birth with large ascites requiring peritoneal drainage to establish breathing and ventilation. Absence of prenatal intra-abdominal calcifications does not rule out MPC.

Use of second-generation antipsychotics in the acute inpatient management of schizophrenia in the Middle East.

BACKGROUND: Management of acute psychotic episodes in schizophrenic patients remains a significant challenge for clinicians. Despite treatment guidelines recommending that second-generation antipsychotics (SGAs) should be used as monotherapy, first-generation antipsychotics, polypharmacy, and lower than recommended doses are frequently administered in clinical practice. Minimal data exist regarding the use of SGAs in the Middle East. The objective of this study was to examine the discrepancies between current clinical practice and guideline recommendations in the region. METHODS: RECONNECT-S Beta was a multicenter, noninterventional study conducted in Egypt, Kuwait, Saudi Arabia, and the United Arab Emirates to observe the management of schizophrenic patients who were hospitalized due to an acute psychotic episode. Patients underwent one visit on the day of discharge. Demographic and medical history, together with data on antipsychotic treatment and concomitant medication during the hospitalization period and medication recommendations at discharge were recorded. RESULTS: Of the 1,057 patients, 180 (17.0%) and 692 (65.5%) received SGAs as monotherapy and in combination therapy, respectively. Overall, the most frequently administered medications were given orally, and included risperidone (40.3%), olanzapine (32.5%), and quetiapine (24.6%); the doses administered varied between countries and deviated from the recommended guidelines. Upon discharge, 93.9% of patients were prescribed SGAs as maintenance therapy, and 84.8% were prescribed the same medication(s) as during hospitalization. CONCLUSION: Current clinical practice in the Middle East differs from guideline recommendations. Patients frequently received antipsychotics in combination therapy, by various methods of administration, and at doses above and below the recommended guidelines for the management of their acute psychotic episodes.

A comparison of intra-operative margin management techniques in breast-conserving surgery: a standardised approach reduces the likelihood of residual disease without increasing operative time.

INTRODUCTION: Breast-conserving surgery (BCS) is established as a standard treatment option for women with early-stage invasive breast cancers. Margin status predicts local disease recurrence. Up to 59 % of patients may undergo re-excision of their tumour cavity to establish clear margins. Intra-operative margin assessment may decrease re-excision rates. It is unclear if this procedure increases operative time. We compared intra-operative macroscopic assessment of margins, routine cavity shave margins and no formal intra-operative margin assessment to assess their impact on re-excision rates, residual disease burden and operative time. METHODS: Over a 42 month period, 188 patients from our retrospective breast cancer database were reviewed in our study. Of these, 68 had macroscopic margin assessment, 70 had cavity shave margins and 50 had no formal intra-operative assessment. Statistical analysis was performed as appropriate. RESULTS: Formal intra-operative margin assessment had a re-excision rate of 25 %, compared with 34 % for those without formal assessment. Formal assessment had a significantly reduced likelihood of having residual disease following the primary procedure (p = 0.02). Close margins (<2 mm) also predicted the presence of residual disease (p = 0.01). There was no difference in operative duration between the groups. CONCLUSION: Directed intra-operative margin assessment reduces residual disease burden in BCS without increasing operative duration.