Sodium nitroprusside modulates oxidative and nitrosative processes in Lycopersicum esculentum L. under drought stress.

KEY MESSAGE: Sodium nitroprusside mediates drought stress responses in tomatoes by modulating nitrosative and oxidative pathways, highlighting the interplay between nitric oxide, hydrogen sulfide, and antioxidant systems for enhanced drought tolerance. While nitric oxide (NO), a signalling molecule, enhances plant tolerance to abiotic stresses, its precise contribution to improving tomato tolerance to drought stress (DS) through modulating oxide-nitrosative processes is not yet fully understood. We aimed to examine the interaction of NO and nitrosative signaling, revealing how sodium nitroprusside (SNP) could mitigate the effects of DS on tomatoes. DS-seedlings endured 12% polyethylene glycol (PEG) in a 10% nutrient solution (NS) for 2 days, then transitioned to half-strength NS for 10 days alongside control plants. DS reduced total plant dry weight, chlorophyll a and b, Fv/Fm, leaf water potential (ΨI), and relative water content, but improved hydrogen peroxide (H2O2), proline, and NO content. The SNP reduced the DS-induced H2O2 generation by reducing thiol (-SH) and the carbonyl (-CO) groups. SNP increased not only NO but also the activity of L-cysteine desulfhydrase (L-DES), leading to the generation of H2S. Decreases in S-nitrosoglutathione reductase (GSNOR) and NADPH oxidase (NOX) suggest a potential regulatory mechanism in which S-nitrosylation [formation of S-nitrosothiol (SNO)] may influence protein function and signaling pathways during DS. Moreover, SNP improved ascorbate (AsA) and glutathione (GSH) and reduced oxidized glutathione (GSSG) levels in tomato plants under drought. Furthermore, the interaction of NO and H2S, mediated by L-DES activity, may serve as a vital cross-talk mechanism impacting plant responses to DS. Understanding these signaling interactions is crucial for developing innovative drought-tolerance strategies in crops.

The Impact of Preoperative Dexamethasone Administration on Quality of Recovery Following Laparoscopic Sleeve Gastrectomy: A Prospective Observational Study.

INTRODUCTION: Recovery from anesthesia is complex and affected by multiple factors. In patient with obesity, the increased prevalence of anxiety and depressive disorders poses a challenge in achieving optimal patient satisfaction. Therefore, strategies to enhance the quality of recovery are crucial for this population. This study aimed to investigate whether administration of dexamethasone to patients undergoing laparoscopic sleeve gastrectomy (LSG) could improve recovery outcomes. METHODS: This prospective observational study was conducted at a tertiary university hospital in Samsun, Turkey. Thirty patients who received dexamethasone prior to LSG (group D) and 30 patients who did not (group C) were included with convenience sampling method. The quality of recovery was assessed using the Quality of Recovery 40 questionnaire (QoR-40). The primary outcome measure was the QoR-40 score at 24 h postoperatively. RESULTS: The dexamethasone group showed a significant improvement in QoR-40 scores (185.4 ± 6.0 vs. 172.0 ± 8.4, p < 0.001), exhibited reduced morphine consumption (11.8 ± 7.8 vs. 21.8 ± 10.9 mg, p < 0.001), opioid demand count (21.50 [9.50-49.00], p = 0.001), the number of patient used antiemetic drug (1 vs. 22, p < 0.001), and achieved earlier mobilization (3 [3-4] vs. 3 [3-4] h, p < 0.0001). However, no significant differences were observed between the two groups concerning intraoperative complications, postoperative wound infections, or time to discharge. CONCLUSIONS: In patients undergoing laparoscopic sleeve gastrectomy, preoperative dexamethasone administration was associated with improved the recovery quality after discharge and reduced early postoperative need for antiemetic medications.

Awake sternal fixation; comparison of technical details and early results with sternal fixation methods performed via general anaesthesia.

OBJECTIVES: Isolated sternal fractures are rare pathologies that rarely require surgical fixation. Although different fixation techniques are used, it is routinely performed under general anaesthesia. In our study, we aimed to share the details of the awake sternal fixation technique performed in our clinic and to compare the early results with sternal fixation methods performed under general anaesthesia. METHODS: Between January 2009 and January 2023, 129 patients who were diagnosed with sternal fracture and who underwent investigations and follow-up in our clinic were evaluated retrospectively. Thirteen patients who underwent surgical fixation for isolated sternal fracture were included in the study. Patients were categorized according to fixation and anaesthetic technique; group 1: fixation with steel wire under general anaesthesia (n = 4), group 2: fixation with titanium plate-screw under general anaesthesia (n = 4) and group 3: fixation with awake titanium plate-screw with parasternal intercostal plane block (n = 5). Demographics, surgical indication, radiological findings, surgical incision, surgical time and hospital stay were statistically compared. RESULTS: The mean age of the patients included in the study was 55.15 ± 15.01 years and 84.6% (n = 11) were male. The most common reason for fixation was displaced fracture (53.8%). Fixation surgery was performed due to pain in 30.8% (n = 4) and non-union in 15.4% (n = 2) of the fractures. The mean duration of surgery were 98.75 ± 16.52, 77.5 ± 35 and 41 ± 14.74 min, respectively. Duration of surgery was significantly lower in group 3 compared to the other groups (P = 0.012). The hospital stay duration for group 1 was 6 days, group 2 was 4 days and group 3 was 1 day. A notable difference was observed among all groups (P = 0.019). CONCLUSIONS: Awake sternal fixation technique with titanium plate-screw system under superficial parasternal intercostal plane block is an easy and effective method for surgical treatment of isolated sternal fractures. This technique showed a direct positive effect on the duration of surgery and hospital stay.

Enhancement of soybean tolerance to water stress through regulation of nitrogen and antioxidant defence mechanisms mediated by the synergistic role of salicylic acid and thiourea.

Water stress (WS) poses a significant threat to global food and energy security by adversely affecting soybean growth and nitrogen metabolism. This study explores the synergistic effects of exogenous salicylic acid (SA, 0.5 mM) and thiourea (TU, 400 mg L-1), potent plant growth regulators, on soybean responses under WS conditions. The treatments involved foliar spraying for 3 days before inducing WS by reducing soil moisture to 50% of field capacity, followed by 2 weeks of cultivation under normal or WS conditions. WS significantly reduced plant biomass, chlorophyll content, photosynthetic efficiency, water status, protein content, and total nitrogen content in roots and leaves. Concurrently, it elevated levels of leaf malondialdehyde, H2O2, proline, nitrate, and ammonium. WS also triggered an increase in antioxidant enzyme activity and osmolyte accumulation in soybean plants. Application of SA and TU enhanced the activities of key enzymes crucial for nitrogen assimilation and amino acid synthesis. Moreover, SA and TU improved plant growth, water status, chlorophyll content, photosynthetic efficiency, protein content, and total nitrogen content, while reducing oxidative stress and leaf proline levels. Indeed, the simultaneous application of SA and TU demonstrated a heightened impact compared to their separate use, suggesting a synergistic interaction. This study underscores the potential of SA and TU to enhance WS tolerance in soybean plants by modulating nitrogen metabolism and mitigating oxidative damage. These findings hold significant promise for improving crop productivity and quality in the face of escalating water limitations due to climate change.

Cosmic radiation shielding property of boron reinforced continuous fiber nanocomposites produced by electrospinning.

Electrospinning, a cutting-edge production technique, is used to create boron-reinforced continuous fiber nanocomposites that shield space missions from cosmic radiation, a significant hazard. By incorporating boron, which is known for its exceptional neutron shielding properties, into the polymer matrix, a composite material that is flexible, lightweight, and highly resistant to radiation is produced. The results indicate that continuous fiber nanocomposites reinforced with boron, boric acid, or both have a high shielding efficiency against cosmic radiation. The adaptability and low weight of the manufactured nanocomposites make them ideal for space applications. While boric acid combines with PVA at the molecular level and alters the molecular chain structure of PVA, it is believed that elemental boron is only incorporated as particulates into the PVA polymer. It is known that both boric acid and elemental boron doped nanocomposites provide samples with a thickness of 10 microns with 13.56% neutron shielding and superior photon blocking ability.

Synergistic mitigation of nickel toxicity in pepper (Capsicum annuum) by nitric oxide and thiourea via regulation of nitrogen metabolism and subcellular nickel distribution.

Nickel (Ni) contamination hinders plant growth and yield. Nitric oxide (NO) and thiourea (Thi) aid plant recovery from heavy metal damage, but their combined effects on pepper (Capsicum annuum ) plant tolerance to Ni stress need more study. Sodium nitroprusside (0.1mM, SNP) and 400mgL-1 Thi, alone and combined, were studied for their impact on pepper growth under Ni toxicity. Ni stress reduces chlorophyll, PSII efficiency and leaf water and sugar content. However, SNP and Thi alleviate these effects by increasing leaf water, proline and sugar content. It also increased the activities of superoxide dismutase, catalase, ascorbate peroxidase and peroxidase. Nickel stress lowered nitrogen assimilation enzymes (nitrate reductase, nitrite reductase, glutamine synthetase, glutamate synthase and glutamate dehydrogenase) and protein content, but increased nitrate, ammonium and amino acid content. SNP and Thi enhanced nitrogen assimilation, increased protein content and improved pepper plant growth and physiological functions during Ni stress. The combined treatment reduced Ni accumulation, increased Ni in leaf cell walls and potentially in root vacuoles, and decreased Ni concentration in cell organelles. It effectively mitigated Ni toxicity to vital organelles, surpassing the effects of SNP or Thi use alone. This study provides valuable insights for addressing heavy metal contamination in agricultural soils and offers potential strategies for sustainable and eco-friendly farming practices.

Comparison of the effects of subcostal anterior quadratus lumborum block and thoracic paravertebral block in laparoscopic nephrectomy: a randomized study.

BACKGROUND: Thoracic paravertebral block (TPVB) may provide sufficient postoperative analgesia in laparoscopic nephrectomy (LSN) by ensuring ipsilateral somatic and visceral analgesia. However, there are serious reservations due to the complexity of the technique, and various complications thereof. Subcostal anterior quadratus lumborum block (S-QLB3) may be a safe alternative in LSN procedures. Therefore, this study aimed to compare the postoperative analgesic effects of TPVB and S-QLB3. METHODS: This prospective, randomized, double-blind study included 60 patients aged 18-70 years who were planned to undergo LSN. The patients were randomly assigned to receive either unilateral ultrasound-guided S-QLB3 or TPVB. The primary outcome was postoperative cumulative 24-h morphine consumption. In addition, numeric rating scale (NRS) scores at rest/activity and the American Pain Society Patient Outcome Questionnaire (APS-POQ-R-TR) scores were also evaluated. RESULTS: While postoperative cumulative 24-h morphine consumption was lower in the TPVB group compared to the other group (mean±SD, 12±3.4 mg vs. 15.4±7.8 mg, P=0.03), NRS pain scores at rest/activity were similar in both groups at all measurement points. Considering the postoperative APS-POQ-R-TR data, only the score related to the pain-daily activity relationship was high in the S-QLB3 group (median [Q1-Q3], 0 [0-1] vs. 2 [0-5], P=0.004), whereas there was no difference between the other scores. CONCLUSIONS: In this study, NRS and APS-POQ-R-TR scores were similar in the S-QLB3 and TPVB groups, whereas cumulative morphine consumption was modestly lower in the TPVB group. This suggested that S-QLB3 could be an alternative to TPVB in patients undergoing LSN.

Citric acid and hydrogen sulfide cooperate to mitigate chromium stress in tomato plants by modulating the ascorbate-glutathione cycle, chromium sequestration, and subcellular allocation of chromium.

The study aimed to investigate the role of hydrogen sulfide (H2S) in regulating chromium stress (Cr-S) tolerance of tomato plants treated with citric acid (CA). Prior to the Cr treatment, tomato plants were foliar-fed with CA (100 µM) daily for 3 days. Subsequently, the plants were grown for another ten days in a hydroponic system in a 50 µM Cr (VI) solution. Chromium treatment reduced photosynthetic pigments and plant biomass, but boosted the levels of hydrogen peroxide (H2O2) malondialdehyde (MDA), H2S, phytochelatins (PCs), and glutathione (GSH), electrolyte leakage (EL), and antioxidant enzyme activity in tomato plants. However, the foliar spray of CA mitigated the levels of H2O2, MDA, and EL, promoted plant growth and chlorophyll content, enhanced antioxidant enzymes' activities, and increased H2S production in Cr-S-tomato plants. CA also increased the levels of GSH and PCs, potentially reducing the toxicity of Cr through regulated sequestration. Additionally, the application of sodium hydrogen sulfide (NaHS), a donor of H2S, improved CA-induced Cr stress tolerance. The addition of CA promoted Cr accumulation in root cell wall and leaf vacuoles to suppress its toxicity. To assess the involvement of H2S in CA-mediated Cr-S tolerance, 0.1 mM hypotaurine (HT), an H2S scavenger, was provided to the control and Cr-S-plants along with CA and CA + NaHS. HT reduced the beneficial effects of CA by decreasing H2S production in tomato plants. However, the NaHS addition with CA + HT inverted the adverse impacts of HT, indicating that H2S is required for CA-induced Cr-S tolerance in tomato plants.

Modified subcostal approach to anterior quadratus lumborum block for managing postoperative pain in patients undergoing open nephrectomy.

BACKGROUND: Quadratus lumborum block is a relatively new truncal block and different approaches to this block have been described. With a recent modification to the subcostal approach to the anterior quadratus lumborum block (QLB3), the injection point was moved further cranially and medially, thereby aiming to enhance the spread of the local anesthetic into the thoracic paravertebral space. Although the level of blockade achieved with this modification seems sufficient for open nephrectomy, the modification is still for clinical evaluation. In this retrospective study, we aimed to evaluate the effects of the modified subcostal QLB3 approach on postoperative analgesia. METHODS: All adult patients who received a modified subcostal QLB3 for postoperative analgesia following open nephrectomy between January 2021- 2022 were retrospectively evaluated. Accordingly, total opioid consumption and pain scores during rest/activity within the first 24 h after surgery were evaluated. RESULTS: A total of 14 patients underwent open nephrectomy were analyzed. Pain scores within the first 6 h postoperatively, particularly the dynamic numeric rating scale (NRS) scores (4-6.5/10), were high. The median (interquartile range) resting and dynamic NRS scores for the first 24 h were 2.75 (1.79) and 3.91 (1.67), respectively. The mean ± standard deviation IV-morphine equivalent dose for the first 24 h was 30.9 ± 10.9 mg. CONCLUSIONS: It was found that the modified subcostal QLB3 did not provide satisfactory analgesia in the early postoperative period. Further randomized studies that extensively investigate the postoperative analgesic efficacy are required to draw a stronger conclusion.

Alleviation of arsenic toxicity in pepper plants by aminolevulinic acid and heme through modulating its sequestration and distribution within cell organelles.

Aminolevulinic acid (ALA) is essential for chlorophyll and heme synthesis. However, whether heme interacts with ALA to elicit antioxidants in arsenic (As)-exposed plants is still unknown. ALA was applied daily to pepper plants for 3 days prior to beginning As stress (As-S). Then, As-S was initiated for 14 days by employing sodium hydrogen arsenate heptahydrate (0.1 mM AsV). Arsenic treatment decreased photosynthetic pigments (chl a by 38% and chl b by 28%), biomass by 24%, and heme by 47% content, but it elevated contents of malondialdehyde (MDA) by 3.3-fold, hydrogen peroxide (H2O2) by 2.3-fold, glutathione (GSH), methylglyoxal (MG), and phytochelatins (PCs) and electrolyte leakage (EL) by 2.3-fold along with enhanced subcellular As concentration in the pepper plant's roots and leaves. The supplementation of ALA to the As-S-pepper seedlings enhanced the amount of chlorophyll, heme content, and antioxidant enzyme activity as well as plant growth, while it reduced the levels of H2O2, MDA, and EL. ALA boosted GSH and phytochelates (PCs) in the As-S-seedlings by controlling As sequestration and rendering it harmless. The addition of ALA enhanced the amount of As that accumulated in the root vacuoles and reduced the poisonousness of the soluble As in the vacuoles. The ALA treatment facilitated the deposition and fixation of As in the vacuoles and cell walls, thereby reducing the transport of As to other cell organelles. This mechanism may have contributed to the observed decrease in As accumulation in the leaves. The administration of 0.5 mM hemin (H) (a source of heme) significantly enhanced ALA-induced arsenic stress tolerance. Hemopexin (Hx, 0.4 µg L-1), a heme scavenger, was treated with the As-S plants along with ALA and ALA + H to observe if heme was a factor in ALA's increased As-S tolerance. Heme synthesis/accumulation in the pepper plants was reduced by Hx, which counteracted the positive effects of ALA. Supplementation of H along with ALA + Hx reversed the negative effects of Hx, demonstrating that heme is required for ALA-induced seedling As-S tolerance.

Gibberellic acid mitigates nickel stress in soybean by cell wall fixation and regulating oxidative stress metabolism and glyoxalase system.

It is broadly known that excessive concentration of nickel (Ni) causes venomous effects on plant health as well as food security. The underlying gibberellic acid (GA) mechanism to overcome Ni-induced stress is still unclear. Our outcomes represented the potential role of gibberellic acid (GA) to boost the soybean stress tolerance mechanism against Ni toxicity. GA elevated the seed germination, plant growth, biomass indices, and photosynthetic machinery as well as relative water contents under Ni-induced stress in soybean. We found that the GA lowered the Ni uptake, and distribution in the soybean plants, as well as GA, can decrease the Ni fixation in the root cell wall by lowering the hemicelluloses content. However, it reduces the MDA level, over-generation of ROS, electrolyte leakage, and methylglyoxal contents by up-surging the level of antioxidant enzyme, and glyoxalase I and glyoxalase II activities. Furthermore, GA regulates the antioxidant-related (CAT, SOD, APX, and GSH) and phytochelatins (PCs) genes expression to sequester the excessive Ni to the vacuoles and efflux the Ni outer the cell. Hence, less Ni was translocated toward shoots. Overall, GA augmented cell wall Ni elimination, and the antioxidant defense mechanism possibly upgraded the soybean tolerance against Ni stress.

Nitric oxide and hydrogen sulfide work together to improve tolerance to salinity stress in wheat plants by upraising the AsA-GSH cycle.

The participation of nitric oxide (NO) in wheat plant tolerance to salinity stress (SS) brought about by hydrogen sulphide (H2S) via modifying the ascorbate-glutathione (AsA-GSH) cycle was studied. The SS-plants received either 0.2 mM sodium hydrosulfide (NaHS; H2S donor), or NaHS plus 0.1 mM sodium nitroprusside (SNP; a NO donor) through the nutrient solution. Salinity stress decreased plant growth, leaf water status, leaf K+, and glyoxalase II (gly II), while it elevated proline content, leaf Na+ content, oxidative stress, methylglyoxal (MG), glyoxalase I (gly I), the superoxide dismutase, catalase and peroxidase activities, contents of endogenous NO and H2S. The NaHS supplementation elevated plant development, decreased leaf Na+ content and oxidative stress, and altered leaf water status, leaf K+ and involved enzymes in AsA-GSH, H2S and NO levels. The SNP supplementation boosted the positive impact of NaHS on these traits in the SS-plants. Moreover, 0.1 mM cPTIO, scavenger of NO, countered the beneficial effect of NaHS by lowering NO levels. SNP and NaHS + cPTIO together restored the beneficial effects of NaHS by increasing NO content, implying that NO may have been a major factor in SS tolerance in wheat plants induced by H2S via activating enzymes connected to the AsA-GSH cycle.

The involvement of hydrogen sulphide in melatonin-induced tolerance to arsenic toxicity in pepper (Capsicum annuum L.) plants by regulating sequestration and subcellular distribution of arsenic, and antioxidant defense system.

Melatonin (MT) and hydrogen sulphide (H2S) are recognised as vital biomolecules actively taking part in plant defence systems as free radical scavengers and antioxidants against a myriad of biotic and abiotic stressors. However, it has been yet unknown in plants subjected to arsenic (As) toxicity whether or not H2S interacts with MT to regulate endogenous antioxidant defence system. Prior to beginning As stress (As-S) treatments, MT (0.10 mM) was applied externally to plants daily for three days. AsS was then started for two weeks with As(V) (0.1 mM as Na2HAsO4·7H2O). The treatment of As reduced plant biomass (24.4%) and chlorophyll a (51.7%), chlorophyll b (25.9%), while it increased subcellular As in roots and leaves, levels of glutathione (GSH), hydrogen peroxide (H2O2), malondialdehyde (MDA), methylglyoxal (MG), H2S and phytochelatins (PCs) in pepper plants. In As-stressed pepper plants, the application of MT increased plant biomass (16.3%), chlorophyll a (52.7%), chlorophyll b (28.2%), antioxidant enzymes' activities, and H2S accumulation, while it lowered the concentrations of MDA and H2O2. In As-treated plants, GSH and phytochelatins (PCs) were increased by MT by regulating As sequestration to make it harmless. The addition of MT increased As accumulation in the vacuoles of roots and caused the soluble fraction of As in vacuoles to become less toxic to vital organelles. MT-induced tolerance to As stress was further enhanced using NaHS, a source of H2S. Hypotaurine (0.1 mM HT), a H2S scavenger, was applied to the control and As-stressed plants together with MT and MT + NaHS to determine whether H2S was implicated in MT-induced increased As-S tolerance. By reducing H2S generation in pepper plants, HT counteracted the beneficial effects of MT, whereas the addition of NaHS to MT + HT restored the negative effects of HT, proving that H2S is necessary for the pepper plants As-stress tolerance caused by MT.

The participation of nitric oxide in hydrogen sulphide-mediated chromium tolerance in pepper (Capsicum annuum L) plants by modulating subcellular distribution of chromium and the ascorbate-glutathione cycle.

The promising response of chromium-stressed (Cr(VI)-S) plants to hydrogen sulphide (H2S) has been observed, but the participation of nitric oxide (NO) synthesis in H2S-induced Cr(VI)-S tolerance in plants remains to be elucidated. It was aimed to assess the participation of NO in H2S-mediated Cr(VI)-S tolerance by modulating subcellular distribution of Cr and the ascorbate-glutathione (AsA-GSH) cycle in the pepper seedlings. Two weeks following germination, plants were exposed to control (no Cr) or Cr(VI)-S (50 µM K2Cr2O7) for further two weeks. The Cr(VI)-S-plants grown in nutrient solution were supplied with 200 µM sodium hydrosulphide (NaHS, donor of H2S), or NaHS plus 100 µM sodium nitroprusside (SNP, a donor of NO). Chromium stress suppressed plant growth and leaf water status, while elevated proline content, oxidative stress, and the activities of AsA-GSH related enzymes, as well as endogenous H2S and NO contents. The supplementation of NaHS increased Cr accumulation at root cell walls and vacuoles of leaves as soluble fraction to reduce its toxicity. Furthermore it limited oxidative stress, improved plant growth, modulated leaf water status, and the AsA-GSH cycle-associated enzymes' activities, as well as it further improved H2S and NO contents. The positive effect of NaHS was found to be augmented on those parameters in the CrS-plants by the SNP supplementation. However, 0.1 mM cPTIO, the scavenger of NO, inverted the prominent effect of NaHS by decreasing NO content. The supplementation of SNP along with NaHS + cPTIO reinstalled the positive effect of NaHS by restoring NO content, which suggested that NO might have a potential role in H2S-induced tolerance to Cr(VI)-S in pepper plants by stepping up the AsA-GSH cycle.

Combined application of asparagine and thiourea improves tolerance to lead stress in wheat by modulating AsA-GSH cycle, lead detoxification and nitrogen metabolism.

Lead (Pb), like other heavy metals, is not essentially required for optimal plant growth; however, plants uptake it from the soil, which poses an adverse effect on growth and yield. Asparagine (Asp) and thiourea (Thi) are known to assuage the negative impacts of heavy metal pollution on plant growth; however, combined application of Asp and Thi has rarely been tested to discern if it could improve wheat yield under Pb stress. Thus, this experimentation tested the role of individual and combined applications of Asp (40 mM) and Thi (400 mg/L) in improving wheat growth under lead (Pb as PbCl2, 0.1 mM) stress. Lead stress significantly reduced plant growth, chlorophyll contents and photosystem system II (PSII) efficiency, whereas it increased Pb accumulation in the leaves and roots, leaf proline contents, phytochelatins, and oxidative stress related attributes. The sole or combined application of Asp and Thi increased the vital antioxidant biomolecules/enzymes, including reduced glutathione (GSH), ascorbic acid (AsA), ascorbate peroxsidase (APX), catalase (CAT), superoxide dismutase (SOD), glutathione S-transferase (GST), dehydroascorbate reductase (DHAR), and glutathione reductase (GR). Furthermore, the sole or the combined application of Asp and Thi modulated nitrogen metabolism by stimulating the activities of nitrate and nitrite reductase, glutamate synthase (GOGAT) and glutamine synthetase (GS). Asp and Thi together led to improve plant growth and vital physiological processes, but lowered down Pb accumulation compared to those by their sole application. The results suggest that Asp and Thi synergistically can improve wheat growth under Pb-toxicity.

Erector spinae plane block versus its combination with superficial parasternal intercostal plane block for postoperative pain after cardiac surgery: a prospective, randomized, double-blind study.

BACKGROUND: We aimed to compare the effectiveness of bilateral erector spinae plane (ESP) block and superficial parasternal intercostal plane (S-PIP) + ESP block in acute post-sternotomy pain following cardiac surgery. METHODS: Forty-seven patients aged between 18 and 80 years of age with American Society of Anesthesiologists class II-III due to undergo median sternotomy for cardiac surgery were included in this prospective, randomized, double-blinded study. Following randomization into two groups, one group received bilateral ultrasound-guided ESP and the other S-PIP plus ESP block. Morphine consumption within the first 24 h after surgery was the primary outcome of the study while NRS scores at rest, NRS scores when coughing, time taken until extubation, use of rescue analgesic, presence of nausea/vomiting, length of hospital and intensive care unit (ICU) stay, and patient satisfaction were secondary outcome measures. RESULTS: Morphine use up to 24 h following surgery was statistically significantly different between the ESP block and ESP + S-PIP block groups (18.63 ± 6.60 [15.84-21.41] mg/24 h vs 14.41 ± 5.38 [12.08-16.74] mg/24 h, p = 0.021). The ESP + S-PIP block group had considerably reduced pain scores compared to the ESP block group across all time points. Rescue analgesics were required in 21 (87.5%) patients in the ESP block group and seven (30.4%) in the ESP + S-PIP group (p < 0.001). PONV, length of stay in the ICU and hospital, and time to extubation were similar between groups. CONCLUSIONS: In open cardiac surgery, the combination of ESP and S-PIP blocks lowers pain scores and postoperative morphine requirement of patients. TRIAL REGISTRATION: Clinicaltrials Registration No: NCT05191953, Registration Date: 14/01/2022.

Comparison of Ketamine, Dexmedetomidine and Lidocaine in Multimodal Analgesia Management Following Sleeve Gastrectomy Surgery: A Randomized Double-Blind Trial.

PURPOSE: The aim of this study was to compare the effects of ketamine, dexmedetomidine, and lidocaine infusions added to the multimodal analgesia regimen on pain scores and analgesic requirement in laparoscopic sleeve gastrectomy. DESIGN: A prospective randomized double-blind trial. Seventy-three patients aged 18 to 65 years (ASA II-III) undergoing laparoscopic sleeve gastrectomy were included. The patients were divided into 3 groups. Intravenous (IV) ketamine (0.5 mg/kg/h), dexmedetomidine (0.5 mcg/kg/h), and lidocaine (2 mg/kg/h) were administered to Groups K, D and L, respectively. Postoperative infusions were continued for 12 hours. METHODS: Visual Analog Scale (VAS) scores (during rest and movement) in the admission to postanesthesia care unit, 1, 3, 6, 12, 24, 48 hours, and on day 15 were assessed postoperatively. Rescue analgesia requirement, the number of patients with nausea, retching, and vomiting, time to mobilization, and hospital length of stay (LOS) were recorded. FINDINGS: VASrest values during all measurements in the first 24 hours, and VASmovement values in the first 6 hours and at 24 hours were lower in Group L when compared to Group K and Group D (P < .001, P < .001, P = .008, respectively). VASrest at 48 hours and VASmovement at 12 and 48 hours were lower in Group L when compared to Group K (P = .044, P = .001 and P = .011, respectively). There was no statistically significant difference between Group D compared to the other two groups at these times (P > .05). The requirement of rescue analgesia on postoperative day 1 was significantly higher in Group K (P < .001). Hospital LOS was shorter in Group L than in the other groups (P = .002). CONCLUSIONS: IV lidocaine added to multimodal analgesia provided better pain control in the early postoperative period compared to dexmedetomidine and ketamine and decreased the hospital LOS.

Cerebral Oximetry after Low Pressure versus Standard Pressure Pneumoperitoneum in Laparoscopic Nephrectomy.

OBJECTIVE: To evaluate whether pneumoperitoneum pressure lower than the standard pressure would allow higher cerebral oxygen saturation (rSO2) during laparoscopic nephrectomy (LN). STUDY DESIGN: Randomised controlled trial. PLACE AND DURATION OF STUDY: Ondokuz Mayis University Hospital, Samsun, Turkey, from January to November 2020. METHODOLOGY: Sixty-two patients (aged 18-65 years; ASA I-III) scheduled for LN were equally divided into a low-pressure (LP; 8 mmHg) and standard-pressure (SP; 14 mmHg) group. Mechanical ventilator settings were adjusted to maintain 32-37 mmHg ETCO2 and >96% SpO2 throughout the surgery. The rSO2 was evaluated by near-infrared spectroscopy before and one minute after induction and then every five minutes until patient transfer to the recovery unit. Oxygen and carbon dioxide partial pressures, pH, and haemoglobin, recorded at five minutes after induction, five and 30 minutes after insufflation, and 10 minutes after desufflation, were examined for correlations with rSO2. RESULTS: Both groups had similar rSo2, arterial blood gas, and haemoglobin values at all measurement times. The LP group showed no differences between the preoperative values and the values obtained at the different time points. In contrast, the SP group showed significant differences between the preoperative and the measured values (except at 25, 30, and 35 minutes) (p = 0.001). Four patients (12.9%) in both groups showed cerebral desaturation. The rSO2 values were moderately correlated with the CO2 and haemoglobin values. CONCLUSION: Low insufflation pressure offered no advantages over standard pressure in terms of haemodynamics, arterial blood gases, cerebral oxygen saturation during LN, and CO2 insufflation did not change rSO2 levels. Key Words: Pneumoperitoneum, Spectroscopy, Oximetry, Nephrectomy, Surgery, Laparoscopic nephrectomy.