Role of dexamethasone in the para-vertebral block for pediatric patients undergoing aortic coarctation repair. randomized, double-blinded controlled study.

BACKGROUND: Surgery for aortic coarctation requires special care during anesthesia due to severe pain during the lateral thoracotomy incision, intraoperative hemodynamic instability and the need for large doses of intra- and postoperative analgesics and vasodilators. Additionally, the postoperative care of patients is very important. AIMS: We aimed to compare ultrasound-guided paravertebral block performed using bupivacaine alone and bupivacaine with dexamethasone in terms of the intra- and postoperative analgesic requirements and hemodynamics, postoperative complications and ICU stay. STUDY DESIGN: This was a prospective, randomized, controlled, double-blinded study. METHODS: Fifty patients aged four to 12 months scheduled for aortic coarctation surgery were randomly divided into two equal groups (n = 25). Patients in group D (dexamethasone) received 0.5 mg/kg bupivacaine 0.25% mixed with 0.1 mg/kg dexamethasone diluted with isotonic saline and those in group C (control) received 0.5 mg/kg bupivacaine 0.25% diluted with isotonic saline (total volume 15 ml in each group). Intraoperative fentanyl consumption and hemodynamics (heart rate, arterial blood pressure) at baseline, 1 min after induction, at skin incision, after 30 min, after clamping, after declamping and at the end of the surgery were recorded, along with the objective pain score (OPS) immediately postoperatively and at 4 h, 8 h, 12 h and 24 h postoperatively and the time to the first request for pethidine. The intra- and postoperative vasodilator doses, time to extubation, ICU stay duration and postoperative complications were also recorded. RESULTS: The postoperative OPS was significantly lower at 12 and 24 h in group D than in group C. The time to the first request for analgesia was significantly longer in group D than in group C (3.9 ± 2.23 vs 8.6 ± 0.69). Additionally, the time to extubation was significantly shorter in group D. CONCLUSION: The use of dexamethasone as an adjuvant in ultrasound-guided paravertebral block in paediatric patients undergoing surgery for aortic coarctation increased the duration of postoperative analgesia with a prolonged time to the first request for analgesics It was also associated with a decreased incidence of postoperative complications. TRIAL REGISTRATION: Trial registration number: NCT03074773 . (Prospectively registered). The initial registration date was 9/3/2017.

Facile synthesis of magnetic disinfectant immobilized with silver ions for water pathogenic microorganism's deactivation.

One-pot synthesis of a new magnetic disinfectant was achieved through the polymerization of thiourea and formaldehyde in the presence of magnetite nanoparticles (MTUF). The obtained magnetic chelating resin was loaded with Ag(I) ions. This material was tested as a disinfectant for water pathogenic microorganism's deactivation. The toxicity of MTUF before and after Ag(I) loading was estimated. The antimicrobial activity tests of MTUF-Ag were carried out against Escherichia coli, Salmonella Typhimurium, and Pseudomonas aeruginosa as examples of Gram-negative bacteria; Listeria monocytogenes, Staphylococcus aureus, Enterococcus faecalis, and Bacillus subtilis as examples of Gram-positive bacteria; and Candida albicans as representative for fungi. The results showed that the minimum inhibitory dosage (MID) of MTF-Ag against Escherichia coli, Salmonella Typhimurium, Listeria monocytogenes, Staphylococcus aureus, and mixed culture were 1.5, 2.0, 1.0, 1.5, and 1.5 mg/mL, respectively, after 40 min of contact time. While C. albicans was more resistant to the magnetic disinfectant, only three log reductions were done at 2.5 mg/mL. The studied MTUF-Ag was successfully tested for water and wastewater pathogenic microorganism's deactivation. It can be concluded that MTUF-Ag could be a good candidate for water disinfection.

Application of nanometal oxides in situ in nonwoven polyester fabric for the removal of bacterial indicators of pollution from wastewater.

The objective of this study is to investigate and assess the use of in situ deposit nanosilver (nAg2O) or nanocopper oxides (nCuO) into nonwoven polyester fabric (NWPF) as a safe and effective antibacterial filter of pollution from domestic wastewater. The bactericidal effect of both nAg2O and nCuO was examined against Gram-negative bacteria (Escherichia coli, Salmonella typhi) and Gram-positive bacteria (Enterococcus faecalis, Staphylococcus aureus) using agar diffusion disk method. In addition, the capability of nAg2O and nCuO as disinfectants for secondary treated domestic wastewater was investigated as a case study. Transmission electron microscope (TEM) confirmed the formation of nAg2O and nCuO particles with average particle sizes of 15 and 41 nm, respectively. Disk diffusion results showed that nAg2O had a higher bactericidal effect than nCuO. Moreover, the disinfection of secondary treated wastewater using 1.27 mg/cm(3) of nAg2O in the nonwoven fabric was capable of hindering 99.6% and 91.7% of total and fecal coliforms within 10 minutes with a residual value of 18 and 15 MPN-index/100 mL, respectively. The residual total and fecal coliform concentrations were far less than that stated in the national and international limits for wastewater reuse in agriculture purpose.