Oxidised cellulose in musculoskeletal oncology procedure: Does it reduce postoperative blood loss?

BACKGROUND: Major musculoskeletal oncology procedures often result in perioperative bleeding. This exposes patients to allogeneic red blood cell transfusion and its potential complications, thus increasing the risk of surgical wound infection and prolonged hospital stay. This study aimed to investigate the efficacy of oxidised cellulose, a topical haemostatic agent, in reducing postoperative blood loss and its subsequent risks. METHODS: In this randomised controlled trial, 40 patients undergoing major musculoskeletal oncology procedures were assigned to control and intervention groups. Oxidised cellulose was inserted into the surgical wound after the resection's conclusion before the wound's closure to reduce postoperative bleeding for patients in the intervention group. Postoperative closed suction drain system (Redivac TM) volume, drop in haemoglobin level, allogeneic red blood cell transfusion rate, duration of surgery, and length of hospital stay were compared between the two groups. RESULTS: The postoperative Redivac volume (Control: 432 MLS vs. Intervention: 431.75 MLS), drop in haemoglobin level (Control: 3.12 g/dL vs. Intervention: 3.06 g/dL), duration of surgery (Control: 134 vs. Intervention: 156 min), and allogeneic red blood cell transfusion were lower in the intervention group (Control: 204 MLS vs. Intervention: 170 MLS), but they were not statistically significant (p > 0.05) (Control: 134 vs. Intervention: 156 min). Mean hospital stay was similar in both groups (Control: 5.45 days vs. Intervention: 5.85 days). CONCLUSION: Oxidised cellulose use does not significantly affect postoperative blood loss, the rate of allogeneic blood transfusion, and hospital stay. However, we believe its use contributes positively but not considerably towards lower postoperative blood loss in musculoskeletal oncology surgeries.

Interventions to Improve Adherence to Medication on Multidrug-Resistant Tuberculosis Patients: A Scoping Review.

INTRODUCTION: Inappropriate treatment and non-adherence use of anti-tuberculosis (TB) drugs trigger the spread of multidrug-resistant tuberculosis (MDR-TB) strains and causes an emerging public health threat worldwide. Therefore, non-adherence to MDR-TB treatment leading to prolonged medication period, increase incidence of adverse event and financial burden, thus it requires interventions to achieve a therapeutic outcome. OBJECTIVE: This scoping review aims to provide an overview of interventions to improve the adherence level to medication of MDR-TB patients. MATERIALS AND METHODS: A review of observational studies was conducted to discuss the accuracy, tolerability and ease of use of tonometers in measuring IOP in children with glaucoma. Three databases (PubMed, Web of Science, Scopus) were used in a scoping review. The data were synthesised using Rayyan AI. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to guide this review. RESULTS: A total of 11 articles were included in this review to describe the various interventions in MDR-TB treatment adherence. Psychological counselling or education intervention was the most popular intervention, and it significantly increased adherence levels among MDR-TB patients. Increased adherence level patients also reported by interventions with Medication Event Reminder Monitor (MERM), Video Directly Observed Therapy (VDOT), 30-day recall and Visual Analogue Scale (VAS), Financial Support, mHealth Application and directly observed therapy, short course (DOTS) and DOTS-Plus programs. However, we found that Electronic Dose Monitoring (EDM) device intervention has less effect on MDR-TB patients' adherence. CONCLUSION: The recovery of patients can be facilitated through MDR-TB treatment adherence interventions. It is acknowledged that the studies included in this review exhibit heterogeneity, with a majority showing significant improvement. Therefore, further study was required to investigate the specific on developing highly personalised interventions tailored to specific population or context, as well as to assess the cost-effectiveness of such interventions.

Practices of hygiene during complementary food feeding and associated factors among women with children aged 6-24 months in Dedo district, Southwest Ethiopia: A cross-sectional study.

Background and Aims: Poor food handling practices contribute to food contamination, leading to food-borne illnesses and childhood diarrhea in developing countries like Ethiopia. This study examines hygienic complementary food feeding practices and associated characteristics among women with children ages 6-24 months in the Dedo District. Method: A community-oriented cross-sectional study design was used in a multistage sampling strategy to gather information from 501 mothers of children between May 25 and July 10, 2022. There were absolute and relative frequencies assigned to each variable. Multiple logistic models have been used for factors that were 20% significant in univariate analysis. Odds ratios with corresponding 95% confidence intervals (CI) were produced to identify the important predictors. Results: This study showed that mothers with a diploma (adjusted odds ratio [AOR]: 11.2; CI: 5.51-22.8), urban residency (AOR = 6.35; CI: 3.57-11.3), a positive attitude toward hygienic complementary food feeding (AOR = 2.23; CI: 1.19-4.20), good knowledge of complementary food feeding practices (AOR = 3.95; CI: 2.39-6.55), access to a hand washing facility close to the latrine (AOR = 2.60; CI: 1.55-4.36), and access to water close to their home (AOR = 2.42; CI: 1.27-4.59) were highly associated with good hygiene practices of mothers. Conclusion: This study shows that mothers of children aged between 6 and 24 months have a very low overall prevalence of good hygienic complementary feeding practices. The concerned parties should therefore establish a healthcare educational program for mothers that emphasizes the importance of hand washing and informs them about the dangers of improper complementary feeding practices.

U.S. parents' intentions to use anti-bullying apps: Insights from a comprehensive model.

Cyberbullying has become a prominent risk for youth and an increasing concern for parents. To help parents reduce their child's cyberbullying risk, anti-bullying apps (ABAs)-mobile applications for identifying and preventing instances of cyberbullying-have been developed in recent years. Given that ABAs are an emerging technology, limited research has been conducted to understand the factors predicting parents' intentions to use them. Drawing on three interdisciplinary theoretical frameworks, a sample of parents in the U.S. recruited through Amazon Mechanical Turk completed an online survey to assess parents' knowledge of, attitudes about, and intentions to use ABAs. Participants also rated the importance of a range of ABA functions and provided information about their child's social media use and bullying history. A series of path analyses revealed that the importance parents placed on an app's ability to provide information about their child's cyberbullying risk predicted more positive attitudes toward ABAs and greater perceived usefulness of them. Stronger intentions to use ABAs were predicted by greater cyberbullying concern, greater importance of social recommendations, greater perceived usefulness, more positive attitudes toward the apps, and lower ratings of the importance of ease of use. These findings shed light on the factors predicting parents' intentions to use ABAs and the app features they view as most important. Crucial directions for future research and implications for anti-bullying efforts are discussed.

Magnitude and predictors of anemia among preschool children (36-59 months) in Atingo town, Jimma, Ethiopia.

Introduction: Anemia is a serious public health concern that affects more than 25% of the world's population. It is still widespread and at its most severe in Ethiopia. This study pointed to identify the magnitude and predictors of anemia in preschool children in Atinago. Method: A structured interview and anthropometric metrics had been used in a cross-sectional study to collect data from 309 preschool children using a systematic sampling strategy from May 10 to June 25, 2022. Frequencies, percentages, means, and a bar chart were created as descriptive statistics. Factors that were significant at the 25% level in univariate analysis were run through multiple logistic models. Odds ratios with respective 95% confidence intervals were developed to determine the relevant predictors. Result: The majority (51.7%) of preschool children in Atinago town had anemia. The finding reveals that poor dietary diversity (adjusted odds ratio [AOR] = 1.77, 95% confidence interval [CI] = 1.02-3.07), children from families with food insecurity (AOR = 2.28, 95% CI = 1.31-3.9), child-mothers used iron folate for less than 3 months during pregnancy (AOR = 1.93, 95% CI = 1.07-3.48), households with more than five children (AOR = 1.880, 95% CI = 1.12-3.18), and stunted children (AOR = 1.78, 95% CI = 1.05-3.01) were highly susceptible to anemia. Conclusion: The findings indicate that anemia was a serious issue among preschool children in Atinago. Therefore, stakeholders should provide community-based nutrition training on consuming diverse diets, dietary improvements in the home, consuming iron-rich meals, and the like; encourage mothers to participate in early ANC follow-up; and strengthen activities aimed at identifying households with food insecurity status.

Feasibility and Safety of a Combined Metabolic Strategy in Glioblastoma Multiforme: A Prospective Case Series.

Background: Glioblastoma multiforme (GBM) may be susceptible to metabolic strategies such as fasting and ketogenic diets, which lower blood glucose and elevate ketones. Combining these two strategies may be an ideal approach for sustaining a potentially therapeutic glucose ketone index (GKI). In this prospective case series, we observed whether a combined metabolic strategy was feasible, safe, and capable of sustaining a GKI <6 in patients with GBM. Methods: We provided recommendations and guidelines to 10 GBM patients at various stages of tumour progression and treatment that enabled them to complete a 5-7-day fast every 1-2 months combined with a modified ketogenic diet during the intervening weeks. Patients monitored their blood glucose and ketone levels and body weight. Adverse effects were assessed. Results: Patients completed a mean of 161 ± 74 days of the combined metabolic strategy, with 34 ± 18 (21%) days of prolonged fasting (mean fast duration: 6.0 ± 1.4 days) and 127 ± 59 (79%) days on the ketogenic diet. The mean GKI for all 10 patients was 3.22 (1.28 during the fasts, 5.10 during the ketogenic diet). Body weight decreased by 8.4 ± 6.9 kg (11.2% decrease in baseline weight). The most common adverse effects attributed to the fasts and ketogenic diet were fatigue, irritability, and feeling lightheaded. The metabolic strategy did not interfere with standard oncological treatments. Conclusion: This is the first study to observe the feasibility and safety of repeated, prolonged fasting combined with a modified ketogenic diet in patients with GBM. Using minimal support, patients maintained the combined metabolic strategy for 5-6 months while sustaining a potentially therapeutic mean GKI of 3.22. Weight loss was considerable. Adverse effects attributed to the metabolic strategy were mild, and it did not interfere with standard oncological treatments. Study Registration: This study is registered on the Australia New Zealand Clinical Trials Registry, number ACTRN12620001310954. The study was registered on 4 December 2020.

An insight of -50 (G>A) mutation in the direct repeat element of the ß-globin gene: From Malaysian perspective.

No abstract available.

Hydrogen sulphide alleviates cadmium stress in Trigonella foenum-graecum by modulating antioxidant enzymes and polyamine content.

Cadmium (Cd) toxicity reduces growth and yield of crops grown in metal-polluted sites. Research was conducted to estimate the potential of hydrogen sulphide (H2 S) to mitigate toxicity caused by Cd in fenugreek seedlings (Trigonella foenum-graecum L.). Different concentrations of CdCl2 (Cd1-1 mM, Cd2-1.5 mM, Cd3-2mM) and H2 S (HS1-100 µM, HS2-150 µM, HS3-200 µM) were assessed. Seeds of fenugreek were primed with sodium hydrosulphide (NaHS), as H2 S donor. Seedlings growing in Cd-spiked media treated with H2 S were harvested after 2 weeks. Cd stress affected growth of fenugreek seedlings. Cd toxicity decreased leaf relative water content (LRWC), intercellular CO2 concentration, net photosynthesis, stomatal conductance and transpiration. However, application of H2 S significantly improved seedling morphological attributes by increasing the activity of antioxidant enzymes, i.e. APX, CAT and SOD, in Cd-contaminated soil. H2 S treatment also regulated phenolic and flavonoid content. H2 S-induced biosynthesis of spermidine (Spd) and putrescine (Put) could account for the enhancement of growth and physiological performance of fenugreek seedlings under Cd stress. H2 S treatment also reduced H2 O2 production (38%) and electrolyte leakage (EL, 51%) in seedlings grown in different concentrations of Cd. It is recommended to evaluate the efficacy of H2 S in alleviating Cd toxicity in other crop plants.

Cyberbullying and Mental Health in Adults: The Moderating Role of Social Media Use and Gender.

Previous research has identified a link between mental health and cyberbullying, primarily in studies of youth. Fewer studies have examined cyberbullying in adults or how the relation between mental health and cyberbullying might vary based on an individual's social media use. The present research examined how three indicators of mental health-depression, anxiety, and substance use-interact with social media use and gender to predict cyberbullying in adults. In Study 1, U.S. adults recruited through Amazon Mechanical Turk (N = 525) completed an online survey that included measures of mental health and cyberbullying. Multiple regression analyses revealed significant three-way interactions between mental health, degree of social media use, and gender in models predicting cyberbullying victimization and perpetration. Specifically, for men, depression and anxiety predicted greater cyberbullying victimization and perpetration, particularly among men with relatively higher levels of social media use. In contrast, depression and anxiety were uncorrelated with cyberbullying for women, regardless of level of social media use. Study 2 largely replicated these findings using well-validated measures of mental health (e.g., Center for Epidemiological Studies-Depression scale, Beck Anxiety Inventory, Global Appraisal of Individual Needs Substance Use scale) in U.S. adults recruited through Prolific.co (N = 482). Together, these results underscore the importance of examining mental health correlates of cyberbullying within the context of social media use and gender and shed light on conditions in which indicators of mental health may be especially beneficial for predicting cyberbullying in adults.

Concomitant back pain as a predictor of outcome after single level lumbar micro-decompressive surgery - A study of 995 patients.

OBJECTIVE: To determine if preoperative leg pain and low back pain severity affected postoperative outcome. METHOD: Prospectively collected Spine-Tango data was analysed for 995 consecutive patients who underwent a primary, single level, lumbar micro-decompression/microdiscectomy at a single tertiary spinal centre. RESULT: At 3 months, 72% of patients were satisfied with the outcome of surgery. Pre-operative low back pain was a significant predictor of poor outcome (P < 0.01). CONCLUSION: Our study has shown that patients with a low back pain VAS of 6 or more have a significantly greater chance of a poor outcome following primary lumbar microdecompressive/microdiscectomy surgery.

Fatty acid profile from immobilised Chlorella vulgaris cells in different matrices.

The immobilisation of Chlorella vulgaris 211/11B entrapped in combinations of natural matrices to simplify the harvesting process was demonstrated in this study. Three combinations of matrices composed of calcium alginate (CA) and sodium alginate (SA), sodium carboxymethyl cellulose (CMC) and SA, and mixed matrices (SA, CA, and CMC) were investigated. The number of cells grown for each immobilised matrix to microalgae volume ratios (0.2:1-1:1) were explored and compared with using SA solely as a control. The optimum volume ratios obtained were 1:1 for SA, 0.3:1 for CA and SA, 1:1 for CMC and SA, and 0.3:1 for mixed matrices. The immobilised microalgae of mixed matrices exhibited the highest number of cells with 1.72 × 109 cells/mL at day 10 and 30.43% of oil extraction yield followed by CA and SA (24.29%), CMC and SA (13.00%), and SA (6.71%). Combining SA, CA, and CMC had formed a suitable structure which improved the growth of C. vulgaris and increased the lipid production compared to the immobilisation using single matrix. Besides, the fatty acids profile of the oil extracted indicates a high potential for biodiesel production.

Comparison of harvesting methods for microalgae Chlorella sp. and its potential use as a biodiesel feedstock.

Three methods for harvesting Chlorella sp. biomass were analysed in this paper--centrifugation, membrane microfiltration and coagulation: there was no significant difference between the total amount of biomass obtained by centrifugation and membrane microfiltration, i.e., 0.1174 +/- 0.0308 and 0.1145 +/- 0.0268 g, respectively. Almost the same total lipid content was obtained using both methods, i.e., 27.96 +/- 0.77 and 26.43 +/- 0.67% for centrifugation and microfiltration, respectively. However, harvesting by coagulation resulted in the lowest biomass and lipid content. Similar fatty acid profiles were obtained for all of the harvesting methods, indicating that the main components were palmitic acid (C16:0), oleic acid (C18:1) and linoleic acid (C18:2). However, the amounts of the individual fatty acids were higher for microfiltration than for centrifugation and coagulation; coagulation performed the most poorly in this regard by producing the smallest amount of fatty acids (41.61 +/- 6.49 mg/g dw). The harvesting method should also be selected based on the cost benefit and energy requirements. The membrane filtration method offers the advantages of currently decreasing capital costs, a high efficiency and low maintenance and energy requirements and is thus the most efficient method for microalgae harvesting.

Kinetic studies and thermodynamics of oil extraction and transesterification of Chlorella sp. for biodiesel production.

In this work, a mixture of chloroform and methanol (1:1, v/v) was applied to oil extraction from Chlorella sp. at 30, 40, 50 and 60 degrees C for 150 min extraction times. Kinetic studies revealed that the values of n and the rate constants were found to depend strongly on temperature. The activation energy was Ea = 38.893 kJ/mol, and the activation thermodynamic parameters at 60 degrees C were ΔS≠ = -180.190 J/mol , ΔH≠ = 36.124k J/mol and ΔG≠ = 96.128k J/mol. Both ΔH and ΔS yielded positive values, whereas ΔG was negative at 60 degrees C, indicating that this process is endothermic, irreversible and spontaneous. The acidic transesterification process was also investigated by gas chromatographic analysis of the microalgae fatty acid methyl esters (biodiesel) at different temperatures and reaction times. The fatty acid profile indicated that the main components were palmitic, linoleic and linolenic acids. The concentration of linolenic acid increased and oleic acid decreased as the temperature increased. Two-hour transesterification is the best reaction time for biodiesel production because it produces the highest percentage of unsaturated fatty acids (74%). These results indicate the potential of Chlorella sp. to produce biodiesel of good quality.

A child with rotor syndrome and Capillaria philippinensis: case report and review of literature.

This paper reported Capillaria philippinensis in an Egyptian child based on clinical and laboratory diagnosis. The patient was successfullly treated with albendazole.

Effects of electrode positioning on perception threshold and paresthesia coverage in spinal cord stimulation.

Objectives. This pilot study aims to validate the hypothesis that a smaller distance between spinal cord stimulation (SCS) lead and spinal cord results in more extensive paresthesia and less energy consumption. Materials and Methods. After insertion of a percutaneous SCS lead in patients with chronic pain (condition A), a first catheter was temporarily placed alongside the lead (condition B), and a second catheter was placed on the other side of the lead (condition C). In all three conditions paresthesia coverage, perception threshold (PT) of paresthesia, and maximum comfortable (MC) stimulus amplitude were determined and the catheters were subsequently removed. Results. Paresthesia coverage in all six patients was increased markedly in condition C when compared to condition A, whereas the mean values of PT, MC, and therapeutic range (MC/PT) dropped by 22%, 14%, and 13%, respectively. Conclusions. The results suggest that paresthesia coverage is increased when the space between the SCS lead and spinal cord gets smaller, whereas PT and energy consumption are reduced.

Application of spinal cord stimulation for the treatment of abdominal visceral pain syndromes: case reports.

Spinal cord stimulation (SCS) has traditionally been applied to the treatment of neuropathic pain with good to excellent outcomes. Visceral pain syndromes can be just as debilitating and disabling as somatic and neuropathic pain, however, there seems to be a general lack of consensus on appropriate treatment strategies for these disorders. We present here several case studies to demonstrate the viscerotomal distribution of abdominal visceral pain pathways and the application of traditional SCS techniques for its management. Nine patients, experiencing abdominal visceral pain due to various conditions including chronic nonalcoholic pancreatitis, post-traumatic splenectomy, and generalized abdominal pain secondary to laparotomies, were treated with SCS. Efficacy of treatment was evaluated using the Visual Analog Scale (VAS) for pain intensity and a reduction, if any, in opioid intake. There was an overall mean reduction of 4.9 points in the VAS score for pain intensity and a substantial (> 50%) decrease in narcotic use. All patients were followed for more than one year with excellent outcomes and minimal complications. We conclude, based on these case reports, that SCS might be an effective, nondestructive, and reversible treatment modality for abdominal visceral pain disorders.

Side effects of antiepileptics--a review.

Older generation antiepileptic drugs like Phenobarbital (Luminal), carbamazepine (Tegretol), phenytoin (Dilantin), and valproic acid (Depakote) have several shortcomings such as suboptimal response rates, significant adverse effects, several drug interactions, and a narrow therapeutic index. New antiepileptic drugs have been developed in the last decade to overcome some of these problems. These newer generation antiepileptics like felbamate (Felbatol), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), tiagabine (Gabitril), topiramate (Topamax), and zonisamide (Zonegran) have better tolerability profiles, low interaction potential, and significantly less enzyme inducing or inhibiting properties. As the use of antiepileptic drugs has expanded to include treatment of neuropathic pain, newer side effects have been reported. In addition to the common side effects of antiepileptic drugs, like dizziness, drowsiness, and mental slowing; other side effects like weight gain, metabolic acidosis, nephrolithiasis, angle closure glaucoma, skin rash, hepatotoxicity, colitis, and movement and behavioral disorders, to name a few, have been brought to our attention. This review is an attempt to highlight the features and incidences of some of these side effects.

A management of early CRPS I caused by ankle sprain: a case report.

We present a case of a 13-year-old boy who developed signs and symptoms of neuropathic pain/early Complex Regional Pain Syndrome (CRPS) Type I, formerly known as Reflex Sympathetic Dystrophy (RSD), after spraining his ankle while wrestling. Aggressive pain control, using medications and sympatholytic blocks, with physical therapy and rehabilitation, led to the resolution of his painful condition. This prevented the disease from possibly progressing to a full-blown case of CRPS I (RSD) that is very challenging to treat.