Radiographic Evaluation of the Gap between Cemented Post and Remaining Gutta-Percha in Endodontically Treated Teeth Performed by Undergraduate Students: A Retrospective Cross-Sectional Study.

The coronal seal in root canal-treated teeth may be compromised depending on the accuracy of post space preparation and post cementation along with remaining gutta-percha. Root canal treatment can be compromised by endotoxins released by the coronal bacteria as a result of microleakage. The study was conducted by undergraduate students to measure the gap between the cemented post and residual gutta-percha. In total, 217 endodontically treated teeth were evaluated with intraoral peri-apical radiographs. Based on the intraoral periapical radiographic examination in the CS-R4 program, Group I had no gap, Group II had a gap of >0 to 2 mm, and Group III had a gap of more than 2 mm between the end of the cemented post and the remaining gutta-percha. In total, 40% (n = 87) of the teeth had no gap, 59% (127) had a gap of >0 to 2 mm, and 1% (n = 3) had a gap of more than 2 mm between the cemented post end and remaining gutta. Chi square test revealed a significant difference in the gap between the post and remaining gutta-percha between males and females students (p < 0.001). In terms of the gap between the cemented post end and the residual gutta-percha, the root canal treated teeth with post and core by undergraduates were clinically acceptable.

Accuracy Comparison between Robot-Assisted Dental Implant Placement and Static/Dynamic Computer-Assisted Implant Surgery: A Systematic Review and Meta-Analysis of In Vitro Studies.

Background and Objectives: The present systematic review and meta-analysis undertake a comparison of studies that examine the accuracy of robot-assisted dental implant placement in relation to static computer-assisted implant surgery (SCAIS), dynamic computer-assisted implant surgery (DCAIS), and freehand procedures. This study aims to provide a comprehensive understanding of the precision of robot-assisted dental implant placement and its comparative efficacy in relation to other placement techniques. Methods: The guidelines recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to organize and compose this review. Four electronic databases (PubMed, Web of Science, Scopus, and Cochrane) were systematically searched for pertinent articles. Articles were selected following the inclusion and exclusion criteria. Qualitative and quantitative analyses of the selected articles were performed. Results: The initial electronic search resulted in 1087 hits. Based on the inclusion and exclusion criteria, five articles were selected for qualitative analysis, out of which three were considered for quantitative analysis. Three parameters were considered for accuracy evaluation (angular, coronal, and apical deviation). The mean angular deviation was -1.22 degrees (95% CI, -1.06--1.39), the mean coronal deviation was -0.15 mm (95% CI, -0.24--0.07), and the mean apical deviation was -0.19 mm (95% CI, -0.27--0.10). Conclusions: The robotic implant system was found to have significantly lower angular deviations and insignificantly lower coronal and apical deviations compared to DCAIS. Within the limitations of this review, it can be concluded that robot-assisted implant placement in resin models permits higher accuracy compared to DCAIS and SCAIS systems. However, due to the limited number of comparative studies with high heterogeneity, the findings of this review should be interpreted with caution. Further research is necessary to confirm the clinical application of robotics in implant surgery.

New-onset and relapsed liver diseases following COVID-19 vaccination: a systematic review.

BACKGROUND: Liver diseases post-COVID-19 vaccination is extremely rare but can occur. A growing body of evidence has indicated that portal vein thrombosis, autoimmune hepatitis, raised liver enzymes and liver injuries, etc., may be potential consequence of COVID-19 vaccines. OBJECTIVES: To describe the results of a systematic review for new-onset and relapsed liver disease following COVID-19 vaccination. METHODS: For this systematic review, we searched Proquest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses PRISMA guideline for studies on the incidence of new onset or relapsed liver diseases post-COVID-19 vaccination, published from December 1, 2020 to July 31, 2022, with English language restriction. RESULTS: Two hundred seventy-five cases from one hundred and eighteen articles were included in the qualitative synthesis of this systematic review. Autoimmune hepatitis (138 cases) was the most frequent pathology observed post-COVID-19 vaccination, followed by portal vein thrombosis (52 cases), raised liver enzymes (26 cases) and liver injury (21 cases). Other cases include splanchnic vein thrombosis, acute cellular rejection of the liver, jaundice, hepatomegaly, acute hepatic failure and hepatic porphyria. Mortality was reported in any of the included cases for acute hepatic failure (n = 4, 50%), portal vein thrombosis (n = 25, 48.1%), splanchnic vein thrombosis (n = 6, 42.8%), jaundice (n = 1, 12.5%), raised liver enzymes (n = 2, 7.7%), and autoimmune hepatitis (n = 3, 2.2%). Most patients were easily treated without any serious complications, recovered and did not require long-term hepatic therapy. CONCLUSION: Reported evidence of liver diseases post-COIVD-19 vaccination should not discourage vaccination against this worldwide pandemic. The number of reported cases is relatively very small in relation to the hundreds of millions of vaccinations that have occurred and the protective benefits offered by COVID-19 vaccination far outweigh the risks.

A Comparison in Patient Comfort Using Conventional Syringe and Needleless Jet Anesthesia Technique in Periodontal Surgery-A Split-Mouth Randomized Clinical Trial.

Background and Objectives: Periodontal surgery requires local anesthetic coverage to alleviate patient discomfort. Needles and injections can engender feelings of fear and anxiety in individuals. This study aimed to assess the level of comfort and anxiety in patients during the administration of local anesthesia using needleless jet anesthesia (JA) when compared to a conventional syringe (CS) in periodontal surgery. Method and Materials: 60 sites were designated for injection in a split-mouth design in 30 subjects who required periodontal surgery. Local anesthesia was administered in two appointments scheduled one week apart using either a JA system or a CS. The Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), and Beck's anxiety inventory were used to report the pain and anxiety levels while injecting local anesthesia. Statistical analysis of the results was performed using the Shapiro-Wilks test and Paired t-test. Results: Patients reported greater comfort with JA. The VAS and VRS values were statistically significant-(p = 0.003) and (p = 0.001), respectively. Patients showed fear and were nervous about receiving a local anesthetic using a CS. A few subjects experienced lingering pain with the CS, whereas greater comfort and no lingering soreness were reported post-operatively at the site of JA administration. Conclusions: This study provides the first comprehensive assessment of using JA for periodontal surgical procedures. Lower pain scores were consistently observed with the use of jet injectors. Patients were at ease and reported lesser anxiety and greater comfort with jet injectors, making it ideally suited for providing local anesthesia in periodontal surgery.

A descriptive study on reasons for prolonged hospital stay in a tertiary hospital in Singapore.

BACKGROUND: Our health care is facing with the challenges of bed crunch and increasing number of patients with prolonged hospital stay. AIMS: This study aimed to determine factors contributing to the prolonged hospital stay in a tertiary hospital in Singapore. METHODS: A random sample of 600 medical records of patients' staying in hospital for more than 21 days was retrieved. The reasons for their prolonged hospital stay were categorized into 'medically unfit' and 'medically fit'. RESULTS: The top three reasons for prolonged hospital stay among the 'medically unfit' group were ongoing medical treatment, surgical interventions and receiving intravenous chemotherapy/radiotherapy. The top three reasons for the 'medically fit' group were waiting for community hospital bed, waiting for a new caregiver and undecided on discharge disposition. CONCLUSION: The results inform health care stakeholders in planning measures to minimize the incidence of unnecessary prolonged hospitalization for optimal health care resource utilization. IMPLICATIONS OF NURSING MANAGEMENT: Ineffective discharge planning can lead to serious adverse outcomes such as hospital readmission and prolonged hospital stay. Patient navigators have a crucial role in facilitating safe, smooth and timely discharge of patients from acute care hospital to community. Understanding the reasons behind extended hospitalization is essential in order to better provide support.

Developing a Newborn Resuscitation Telemedicine Program: A Comparison of Two Technologies.

BACKGROUND: Early work has demonstrated the feasibility and acceptance of newborn resuscitation telemedicine programs (NRTPs). The technology requirements for providing this type of emergency telemedicine service are unclear. INTRODUCTION: We hypothesized that during NRTP consults, a wired telemedicine cart would provide a more reliable and higher-quality user experience than a consumer-grade wireless tablet. MATERIALS AND METHODS: In this retrospective observational study, six spoke sites used consumer-grade wireless tablets during preintervention and wired coder/decoder (CODEC)-based telemedicine carts during postintervention. Both technologies used the same videoconferencing software. After the telemedicine consult, providers completed surveys assessing connection reliability, user satisfaction, and audio and video quality using a 1-5 Likert scale. RESULTS: Preintervention, users completed 99 consults and 95 surveys. Postintervention, users completed 73 consults and 192 surveys. Successful connection on first attempt was significantly improved with the wired cart compared with the wireless tablet (82.7% vs. 69.5%, p = 0.01), and the percentage of consults complicated by an unplanned disconnection was reduced (6.4% vs. 14.7%, p = 0.02). User satisfaction and video and audio quality ratings were significantly higher for the wired cart. DISCUSSION: The wired telemedicine cart increased connection reliability, which is important given the critical nature and long duration of NRTP consults. Audio-video quality was also improved, allowing for better visualization of the neonate and communication with the care team. CONCLUSIONS: Consumer-grade wireless tablets did not meet the program's technical requirements. Wired telemedicine carts improved reliability, user satisfaction, and audio-video quality. Wired carts may not fully meet NRTP requirements because of cart size and limited mobility.

Dengue fever in renal transplant patients: a systematic review of literature.

BACKGROUND: Dengue fever in renal transplanted patients has not been studied well, and we review all the literature about episodes dengue fever in renal transplant patients. METHODS: The aim was to describe clinico-pathological characteristics, immunosuppressive protocols, need renal outcome and mortality. PubMed, LILACS, Google Scholar and Research Gate were searched for "Dengue" and "Renal/Kidney Transplantation" with no date limits. Hits were analyzed by two researchers separately. RESULTS: Fever, myalgia, arthralgia and headache was significantly lower than normal population, while pleural effusions and ascites were observed more. Incidence of severe dengue is significantly higher among transplant patients in this review, as well as they had a significantly higher mortality (8.9% vs 3.7%, p = 0.031). Age, period after transplantation and immunosuppressive profile had no effect on disease severity, mortality or graft out come. Presence of new bleeding complications and ascites was associated with more severe disease (p < 0.001 and p = 0.005), death (p = 0.033) or graft loss (p = 0.035). Use of tacrolimus was associated with new bleeding complications (p = 0.027), and with ascites (p = 0.021), but not with thrombocytopenia. 25% of patients with primary disease fail to mount an IgG response by 15 weeks of the illness. 58.9% had graft dysfunction during illness. Postoperative transplanted patients were at risk of severe disease and unfavorable outcome. CONCLUSIONS: The physical and laboratory findings in dengue fever in renal transplanted patients differ from the general population. Some degree of graft dysfunction is common during the illness, but only a minority develops graft failure.

Augmenting granular activated carbon with natural clay for multicomponent sorption of heavy metals from aqueous solutions.

Multicomponent adsorption of Cd, Cr, Cu, Pb and Zn onto date palm pits based granular activated carbon (GAC) augmented with highly active natural clay at different proportion was investigated. The effects of the initial pH and the adsorbents mixed ratio on the removal selectivity sequence of the metals evaluated. Batch adsorption experiments were undertaken at initial pH 2, 6 and 12. At initial pH 2, both the percent removal and the metals adsorptive capacity decreased with increasing GAC to clay ratio (from 0 to 1) with the percentage removal of Cd, Zn and Cr ions dropping from 68, 81, 100% to 43, 57 and 70%, respectively. At both pH 6 and 12, the percentage removals and adsorption capacities of all the heavy metal ions are higher than at pH 2. Selectivity sequences for pH 2, 6 and 12 followed the order Pb > Cr > Cu > Zn > Cd; Pb > Cr > Cu > Cd > Zn and Cd > Cr > Cu > Pb > Zn, respectively. The adsorption trends were analyzed in relation to point of zero charge and ξ-potential and the metals ions speciation at different pH. These results will help better understand the feasibility of augmenting GAC with natural clay minerals during fixed bed column test which is more beneficial for practical industrial applications.

Incidental Detection of Synchronous Benign Hepatic and Splenic Hemangiomas on 18 F-PSMA PET/CT.

ABSTRACT: A 51-year-old man with biochemical failure after brachytherapy for prostatic adenocarcinoma (PSA 5 µg/L rising to 6.45 µg/L) underwent a PSMA PET/CT scan. The scan revealed focal 18 F-PSMA activity at the right apex suggestive of local residual or recurrent disease. In addition, 18 F-PSMA images demonstrated 2 focal 18 F-PSMA-avid liver and spleen lesions; both lesions were further evaluated by abdominal MRI, and the final radiological diagnosis was synchronous hepatic and splenic hemangiomas.

The association between internet addiction and sleep quality among medical students in Saudi Arabia.

BACKGROUND: Sleep is one of the fundamental human needs, essential for maintaining a high quality of life and mental and physical well-being across all age groups. Poor sleep quality often stems from negative lifestyle habits, including excessive internet usage. Therefore, it is important to determine the prevalence of internet gaming disorder among youth in Saudi Arabia and to examine the relationship between internet addiction levels and sleep quality. METHODS: Data were collected from 338 medical students in the southern region of Saudi Arabia (mean age = 21.2 years, standard deviation = 3.29 years). Participants completed an online questionnaire comprising the Internet Addiction Test (IAT) and the Pittsburgh Sleep Quality Index (PSQI). Data analysis employed iterations, chi-square tests, Pearson correlation coefficients, and ANOVA. RESULTS: The results revealed that 21% of the participants exhibited severe internet addiction, while 31% displayed moderate internet addiction. Furthermore, the findings indicated a positive correlation between sleep quality and the severity of internet addiction. Sleep quality symptoms explained 75% of the variance in Internet addiction scores, even after controlling for demographic variables. Additional bivariate analyses revealed that individuals who spent six or more hours online daily were more likely to experience symptoms of poor sleep quality and exhibit a higher severity of internet addiction. Additionally, Men were more susceptible to developing internet addiction compared to women. Moreover, students with internet addiction tended to have lower academic achievements. CONCLUSION: These findings, while exploratory, offer valuable insights into potential interventions, strategies, and programs for mitigating internet addiction and enhancing sleep quality among medical college students.

De Winter syndrome in action: Captured on defibrillator.

De Winter syndrome, though rare, demands heightened clinical suspicion. Recognizing its electrocardiographic subtleties is crucial, as prompt diagnosis allows for life-saving interventions such as percutaneous coronary intervention or thrombolysis.

Aortic Aneurysm Mimicking Inferior ST-Elevation Myocardial Infarction: A Case Report.

Here, we report a rare case of a 22-year-old female presenting with recurrent chest pain mimicking inferior ST-elevation myocardial infarction (STEMI) but ultimately attributed to an aortic aneurysm. Despite facing initial challenges in diagnosis, such as normal troponin levels and temporary electrocardiogram (ECG) changes, advanced imaging showed a large mass in the chest pressing on the right coronary artery. Prompt multidisciplinary intervention, including surgical resection of the aneurysm, led to successful management and improved outcomes. This case highlights the importance of considering unusual etiologies in atypical presentations of myocardial infarction, necessitating comprehensive evaluation and collaboration among various specialties for optimal patient care.

Epidemiology, clinical presentation, and outcome of mpox: A study of 381 cases in Saudi Arabia.

Objectives: There are limited data on the clinical and epidemiological aspects of mpox in Saudi Arabia. This study investigates the characteristics of Mpox cases from May to September 2023. Methods: A total of 381 cases of Mpox were included in this study, diagnosed based on a combination of clinical symptoms and laboratory testing. Results: The majority of mpox cases were males (91.1%), with a mean age of (±SD) of 32.4 (±8.3) years; 356 (93.4%) did not report travel, 277 (72.7%) denied engaging in extra-marital sex, and 379 (99.5%) were not linked to secondary cases. Fever was reported in 371 (97.4%), whereas headache was present in 314 (82.4%). Cough (1.3%) and conjunctivitis (0.5%) were rare. The most commonly affected areas in terms of lesions were the palms and soles (297 cases, 78%), followed by the genitals (206 cases, 54%), face (198 cases, 52%), and mouth (160 cases, 42%). Of the 1325 identified contacts, 1134 (85.5%) were hospital contacts, and 191 (14.5%) were community contacts, and 393 (29.6%) were high-risk contact. Of the high-risk contacts, 284 (72.3%) accepted post-exposure vaccination. The genotyped samples were all subclade IIb (formerly the West Africa clade). Conclusions: This study provides valuable insights into mpox characteristics in Saudi Arabia. The genome of monkeypox virus belonged to subclade IIb of the West Africa clade. Further analysis of the global tree sublineage is needed.

Clinicopathological characteristics and chronology of p53 expression in the development of gastric cancer.

BACKGROUND/AIMS: The present study was aimed to investigate the correlation between selected clinicopathological characteristics and p53 protein overexpression, in Indian gastric cancer patients. METHODOLOGY: Here, we studied specimens from 103 patients with gastric carcinomas and cases were categorized by AJCC-TNM classification. The p53 expression was analyzed in all the specimens by immunohistochemistry (IHC) and was correlated with the clinicopathological characteristics of the patients as well as etiological factors for gastric cancer. The cases were considered p53 overexpressed if more than 25% of the tumor cells were found to be expressing this protein. RESULTS: We found significant association of p53 overexpression with the gender (p = 0.004) and histology grades (p = 0.001). However, p53 overexpression was not found to be significantly associated with other clinicopathological characteristics like age, cell differentiation, stage and location and various etiological factors. CONCLUSIONS: Our observation showed that IHC-based detection of altered expression of p53 protein in gastric carcinomas may play an important role for diagnosing the progression of gastric carcinoma, even in the early stages.

Coupled electrokinetics-adsorption technique for simultaneous removal of heavy metals and organics from saline-sodic soil.

In situ remediation technologies for contaminated soils are faced with significant technical challenges when the contaminated soil has low permeability. Popular traditional technologies are rendered ineffective due to the difficulty encountered in accessing the contaminants as well as when employed in settings where the soil contains mixed contaminants such as petroleum hydrocarbons, heavy metals, and polar organics. In this study, an integrated in situ remediation technique that couples electrokinetics with adsorption, using locally produced granular activated carbon from date palm pits in the treatment zones that are installed directly to bracket the contaminated soils at bench-scale, is investigated. Natural saline-sodic soil, spiked with contaminant mixture (kerosene, phenol, Cr, Cd, Cu, Zn, Pb, and Hg), was used in this study to investigate the efficiency of contaminant removal. For the 21-day period of continuous electrokinetics-adsorption experimental run, efficiency for the removal of Zn, Pb, Cu, Cd, Cr, Hg, phenol, and kerosene was found to reach 26.8, 55.8, 41.0, 34.4, 75.9, 92.49, 100.0, and 49.8%, respectively. The results obtained suggest that integrating adsorption into electrokinetic technology is a promising solution for removal of contaminant mixture from saline-sodic soils.

Integrated electrokinetics-adsorption remediation of saline-sodic soils: effects of voltage gradient and contaminant concentration on soil electrical conductivity.

In this study, an integrated in situ remediation technique which couples electrokinetics with adsorption, using locally produced granular activated carbon from date palm pits in the treatment zones that are installed directly to bracket the contaminated soils at bench-scale, is investigated. Natural saline-sodic clay soil, spiked with contaminant mixture (kerosene, phenol, Cr, Cd, Cu, Zn, Pb, and Hg), was used in this study to investigate the effects of voltage gradient, initial contaminant concentration, and polarity reversal rate on the soil electrical conductivity. Box-Behnken Design (BBD) was used for the experimental design and response surface methodology (RSM) was employed to model, optimize, and interpret the results obtained using Design-Expert version 8 platform. The total number of experiments conducted was 15 with voltage gradient, polarity reversal rate, and initial contaminant concentration as variables. The main target response discussed in this paper is the soil electrical conductivity due to its importance in electrokinetic remediation process. Responses obtained were fitted to quadratic models whose R (2) ranges from 84.66% to 99.19% with insignificant lack of fit in each case. Among the investigated factors, voltage gradient and initial contaminant concentration were found to be the most significant influential factors.

Effect of three different preparation designs on the marginal adaptation of indirect overlay restoration fabricated from lithium disilicate ceramic material: An in-vitro comparative study.

Objectives: Marginal adaptation is considered one of the key factors influencing the success of indirect restorations. This study aimed to estimate the marginal fit of lithium disilicate overlays with three distinct preparation designs before and after cementation. Methods: Thirty maxillary first premolars were divided into the hollow chamfer design (HCD) group, butt-joint design (BJD) group, and conventional occlusal box design (COD) group (n = 10 each). The samples were scanned using an intra-oral scanner, and overlays were fabricated using computer-assisted design and milled on a computer-assisted machine. The finished restorations were luted using a self-adhesive resin RelyX Ultimate. The marginal gap was assessed using a digital microscope with 230X magnification power. Statistical analysis was conducted using analysis of variance and post hoc (Bonferroni correction) tests, assuming a significance level of 5%. Results: The HCD and BJD groups recorded significantly lower marginal gap, (11.39 ± 0.72, 16.29 ± 0.75) and (11.59 ± 0.75, 16.93 ± 0.65) respectively, than the COD group (24.57 ± 1.18, 34.45 ± 1.09) both pre- and post-cementation. Conclusion: This study demonstrated that modification of tooth preparation plays a significant role in the marginal adaptation of the lithium disilicate overlays. The gap was smaller with the HCD and BJD than with the COD, with a statistically significant difference.

Enhanced Transdermal Delivery of Acyclovir via Hydrogel Microneedle Arrays.

Hydrogel microneedles represent a promising approach to deliver drug molecules across skin into systemic circulation in a sustained release manner and without any polymer residue within skin. Acyclovir is an antiviral drug used for the treatment of several viral infections. However, the oral administration of acyclovir may cause gastrointestinal tract (GIT) disturbances with low bioavailability and poor patient compliance due to its requirement of five daily administrations to produce the desired effect. Therefore, it is thought that the preparation of hydrogel microneedle arrays containing acyclovir would improve the bioavailability and patient compliance by reducing the frequency of administration to once daily as well as overcome the GIT side effects associated with oral administration. A mixture of PEG 10,000 Da and PMVE/MA co-polymer 1,980,000 Da at a ratio of 1:3 (7.5%:22.5% w/w) with Na2CO3 3% w/w was found to produce the optimum hydrogel microneedle array formulation (F8) which showed suitable needle formation with an appropriate mechanical strength and excellent insertion ability, high drug content, sufficient swelling property and a sustained drug release over a period of 24 hours. The Ex vivo permeation study across human skin has demonstrated that the permeation of acyclovir from F8 hydrogel microneedle array was significantly (P≤ 0.05) increased by 39 times in comparison with microneedle-free film (control). The microneedle array has delivered 75.56% ± 4.2 of its loading dose over 24 hours, while the control film was only able to deliver 1.94% ± 0.14 of the total loading dose during the same period. Accordingly, these findings propose the potential application of hydrogel microneedle arrays for the transdermal delivery of acyclovir in a sustained release manner over 24 hours.

Xanthohumol ameliorates cardiac injury induced by sepsis in a mice model: role of toll-like receptor 4.

Sepsis, a life-threatening condition arising from infection, often results in multi-organ failure, including cardiac dysfunction. This study investigated Xanthohumol, a natural compound, and its potential mechanism of action to enhance heart function following sepsis. A total of twenty-four adult male Swiss albino mice were allocated randomly to one of four equal groups (n=6): sham, CLP, vehicle Xanthohumol the same amount of DMSO injected IP 10 minutes before the CLP, and Xanthohumol group (0.4 mg/kg of Xanthohumol administered IP before the CLP process). Toll-like receptor 4, pro-inflammatory mediators, anti-inflammatory markers, oxidative stress indicators, apoptosis markers, and serum cardiac damage biomarkers were measured in the cardiac tissue using ELISA. Data with normal distribution were analyzed using t-test and ANOVA tests (p<0.05). In comparison to the sham group, the sepsis group had significantly higher levels of TLR-4, IL-6, TNF-α, MIF, F2-isoprostane, caspase-3, cTn-I, and CK-MB, while the pre-treated group with Xanthohumol had significantly lower levels (p<0.05) of these markers than the sepsis group. Bcl-2 showed no significant difference in Xanthohumol pre-treated group relative to the sepsis group, while IL-10 was significantly elevated. Xanthohumol dramatically reduced cardiac tissue injury (p<0.05) relative to the CLP group. By blocking the downstream signal transduction pathways of TLR-4 and NF-kB, Xanthohumol was shown to lessen cardiac damage in male mice during CLP-induced polymicrobial sepsis.

Effect of Sulforaphane on cardiac injury induced by sepsis in a mouse model: Role of toll-like receptor 4.

As sepsis is associated with a 50% increase in mortality, sepsis-induced cardiomyopathy has become a critical topic. A multidisciplinary approach is required for the diagnosis and treatment of septic cardiomyopathy. This study looked at Sulforaphane, a natural product that aims to evaluate cardiac function after sepsis, and its likely mechanism of action. Twenty-four adult male Swiss albino mice were randomly divided into 4 equal groups (n=6): sham, CLP, vehicle Sulforaphane (the same amount of DMSO injected IP one hour before the CLP), and Sulforaphane group (one hour before the CLP, a 5mg/kg dose of Sulforaphane was injected). Cardiac tissue levels of toll-like receptor 4 (TLR-4), pro-inflammatory mediators, anti-inflammatory markers, oxidative stress markers, apoptosis markers, and serum cardiac damage biomarkers were assessed using ELISA. Statistical analyses, including t-tests and ANOVA tests, were performed with a significance level of 0.05 for normally distributed data. Compared to the sham group, the sepsis group had significantly elevated levels of TLR-4, IL-6, TNF-α, MIF, F2-isoprostane, caspase-3, cTn-I, and CK-MB (p<0.05). In contrast, the Sulforaphane pre-treated group demonstrated significantly lower levels of these markers (p<0.05). Additionally, Bcl-2 levels were significantly reduced (p<0.05) in the Sulforaphane group. Sulforaphane administration also significantly attenuated cardiac tissue injury (p<0.05). The findings suggest that Sulforaphane can decrease heart damage in male mice during CLP-induced polymicrobial sepsis by suppressing TLR-4/NF-kB downstream signal transduction pathways.