Alleviating chromium-induced oxidative stress in Vigna radiata through exogenous trehalose application: insights into growth, photosynthetic efficiency, mineral nutrient uptake, and reactive oxygen species scavenging enzyme activity enhancement.

Trehalose serves as a crucial osmolyte and plays a significant role in stress tolerance. The influence of exogenously added trehalose (1 and 5 mM) in alleviating the chromium (Cr; 0.5 mM) stress-induced decline in growth, photosynthesis, mineral uptake, antioxidant system and nitrate reductase activity in Vigna radiata was studied. Chromium (Cr) significantly declined shoot height (39.33%), shoot fresh weight (35.54%), shoot dry weight (36.79%), total chlorophylls (50.70%), carotenoids (29.96%), photosynthesis (33.97%), net intercellular CO2 (26.86%), transpiration rate (36.77%), the content of N (35.04%), P (35.77%), K (31.33%), S (23.91%), Mg (32.74%), and Ca (29.67%). However, the application of trehalose considerably alleviated the decline. Application of trehalose at both concentrations significantly reduced hydrogen peroxide accumulation, lipid peroxidation and electrolyte leakage, which were increased due to Cr stress. Application of trehalose significantly mitigated the Cr-induced oxidative damage by up-regulating the activity of reactive oxygen species (ROS) scavenging enzymes, including superoxide dismutase (182.03%), catalase (125.40%), ascorbate peroxidase (72.86%), and glutathione reductase (68.39%). Besides this, applied trehalose proved effective in enhancing ascorbate (24.29%) and reducing glutathione content (34.40%). In addition, also alleviated the decline in ascorbate by Cr stress to significant levels. The activity of nitrate reductase enhanced significantly (28.52%) due to trehalose activity and declined due to Cr stress (34.15%). Exogenous application of trehalose significantly improved the content of osmolytes, including proline, glycine betaine, sugars and total phenols under normal and Cr stress conditions. Furthermore, Trehalose significantly increased the content of key mineral elements and alleviated the decline induced by Cr to considerable levels.

Prevalence of depression among diabetic patients attending the Armed Forces Hospital, Southern Region, Saudi Arabia: A prospective cross-sectional study.

Background: Depression associated with diabetes is one of major obstacles in diabetic patient management. This study aims to determine the prevalence of depression and its associated risk factors among diabetic patients of both types (I and II). Materials and Methods: A cross-sectional analytical study was conducted at Armed Forces Hospital, Southern Region, Kingdom of Saudi Arabia, among adult diabetic patients attending the diabetic center. An interview-validated questionnaire was utilized to collect data. It consists of three main parts: demographic data, diabetic assessment tool, and patient health questionnaire-9. Results: A total of 386 diabetic patients were included. The age of them ranged between 17 and 95 years with an arithmetic mean of 53.4 years and a standard deviation of ± 18.2 years. Almost two-thirds (62.2%) were males. The prevalence of depression among diabetic patients was 48.2%, mostly of mild (31.4%) or moderate severity (12.7%). Multivariate logistic regression analysis revealed that female diabetic patients were at almost double-fold risk of developing depression compared to males [adjusted odds ratio (AOR) =2.73, 95% confidence interval (CI): 1.70-4.38], P < 0.001. Also, type II diabetic patients were at almost double-fold risk of developing depression compared to type I diabetic patients (AOR = 2.07, 95% CI: 1.16-3.67), P = 0.013. Patients with history of any social issue with the family, relatives, or friends were at about three-fold risk of developing depression compared to those without such history (AOR = 3.45, 95% CI: 2.11-5.66), P < 0.001. Patients who reported compliance to diet were at higher risk for developing depression compared to their peers (AOR = 2.57, 95% CI: 1.25-5.28), P = 0.010, while those compliant to physical activity about 150 min/week or more were at significant lower risk to develop depression (AOR = 0.56, 95% CI: 0.35-0.89), P = 0.015. Patients with nephropathy or neuropathy were more likely to have depression compared to their counterparts (AOR = 2.52. 95% CI: 1.33-4.80, P = 0.005 and AOR = 1.80, 95% CI: 1.11-2.90, P = 0.016, respectively). Conclusion: Depression is a very prevalent problem affecting diabetic patients, particularly those of type II, female patients, and those with nephropathy or neuropathy. Therefore, regular screening of diabetic patients for depression and referral of severe cases to psychiatric care are highly warranted.

In vitro efficacy of Boswellia carterii resin extracts formulated as an emulsifiable concentrate against Tetranychus urticae and phytopathogenic fungi.

Contemporary agriculture heavily relies on pesticides for pest eradication and disease management. Consequently, current study was carried out to assess the acaricidal/antifungal efficacy of emulsifiable concentrate (10 % EC) derived from Boswellia carterii (B. carterii) against adult females of Tetranychus urticae (T. urticae), and five fungal pathogens. The meticulous examination of the chemical constitution of the crude extracts derived from the resin of B. carterii was conducted through the employment of the venerable technique known as Gas-Liquid Chromatography (GLC). The formulated petroleum-ether extract (FPEE) and formulated ethyl-acetate extract (FEAE) of B. carterii at a concentration of 10 mg ml-1 exhibited notable antioxidant activity with rates of 62.0 % and 90.8 %, respectively. In vitro, the FEAE exhibited potent inhibition against all the tested phytopathogenic fungi at different concentrations, whereas FPEE showed comparatively less efficacy. Interestingly, at 4000 ppm concentration, FEAE completely ceased the mycelial growth compared with the control. Moreover, following a span of 72 h of intervention, FPEE exhibited a greater degree of toxicity towards mature females of the T. urticae. This was evidenced by the LC50 value of 422.52 parts per million (ppm) for FPEE, which surpassed the LC50 value of 539.50 ppm observed for FEAE. In summary, the present study indicates that B. carterii resin formulated as an emulsifiable concentrate (10 % EC) can offer a natural and effective alternative for integrated pest management, thereby reducing reliance on synthetic pesticides and offering a more environmentally sustainable strategy for pest control.

Effect of Eco-Friendly Application of Bee Honey Solution on Yield, Physio-Chemical, Antioxidants, and Enzyme Gene Expressions in Excessive Nitrogen-Stressed Common Bean (Phaseolus vulgaris L.) Plants.

Excessive use of nitrogen (N) pollutes the environment and causes greenhouse gas emissions; however, the application of eco-friendly plant biostimulators (BSs) can overcome these issues. Therefore, this paper aimed to explore the role of diluted bee honey solution (DHS) in attenuating the adverse impacts of N toxicity on Phaseolus vulgaris growth, yield quality, physio-chemical properties, and defense systems. For this purpose, the soil was fertilized with 100, 125, and 150% of the recommended N dose (RND), and the plants were sprayed with 1.5% DHS. Trials were arranged in a two-factor split-plot design (N levels occupied main plots × DH- occupied subplots). Excess N (150% RND) caused a significant decline in plant growth, yield quality, photosynthesis, and antioxidants, while significantly increasing oxidants and oxidative damage [hydrogen peroxide (H2O2), superoxide (O2•-), nitrate, electrolyte leakage (EL), and malondialdehyde (MDA) levels]. However, DHS significantly improved antioxidant activities (glutathione and nitrate reductases, catalase, ascorbate peroxidase, superoxide dismutase, proline, ascorbate, α-tocopherol, and glutathione) and osmoregulatory levels (soluble protein, glycine betaine, and soluble sugars). Enzyme gene expressions showed the same trend as enzyme activities. Additionally, H2O2, O2•-, EL, MDA, and nitrate levels were significantly declined, reflecting enhanced growth, yield, fruit quality, and photosynthetic efficiency. The results demonstrate that DHS can be used as an eco-friendly approach to overcome the harmful impacts of N toxicity on P. vulgaris plants.

Black soybean (Glycine max (L.) Merr.): paving the way toward new nutraceutical.

Black soybean (BS) is a nutritious legume that is high in proteins, essential amino acids, dietary fiber, vitamins, minerals, anthocyanins, phenolic acids, isoflavones, and flavones. Traditional approaches for extracting BS bioactive compounds are commonly employed because they are simple and inexpensive, but they use toxic solvents and have lower yields. As a result, new extraction techniques have been developed, such as microwave, ultrasound, and enzyme-assisted extraction. Modern approaches are less harmful to the environment, are faster, and produce higher yields. The major anthocyanin in the BS seed coat was discovered as cyanidin-3-O-glucoside, accounting for nearly 75% of the total anthocyanins. BS and its seed coat also contains phenolic acids (p-hydroxybenzoic, gallic, vanillin, syringic acid), isoflavones (daidzein, glycitein and genistein), flavones, flavonols, flavanones, and flavanols. Bioactive compounds present in BS exhibit antioxidant, anti-cancerous, anti-diabetic, anti-obesity, anti-inflammatory, cardio and neuroprotective activities. The characterization and biological activity investigation of these bioactive compounds has provided researchers and food manufacturers with valuable information for developing functional food products and nutraceutical ingredients. In this review, the nutritional makeup of BS is reviewed, and the paper seeks to provide an insight of bioactive compound extraction methods as well as bioactive compounds identified by various researchers. The biological activities of BS extracts and their potential applications in food products (noodles), biodegradable films (pH sensitive film), and therapeutic applications (wound healing and anti-inflammation) are also discussed in the study. Therefore, BS have enormous potential for use in developing functional foods and nutraceutical components. This is the first review of its sort to describe and explain various extraction methodologies and characterization of bioactives, as well as their biological activity recorded in diverse works of literature, making it possible for food manufacturers and scientists to get a quick overview.

Treatment of Post-Burn Leucoderma With Superficial Dermabrasion Followed by Suction Blister Epidermal Grafting: A Clinical Prospective Study.

Post-burn leucoderma patients remain the most challenging to treat because they have two distinct issues: textural changes and hypopigmentation that must be managed simultaneously. A variety of surgical techniques have been used with variable outcome. This prospective study evaluated the efficacy of superficial dermabrasion followed by suction blister epidermal grafting (SBEG) in post-burn leucoderma treatment. Twenty patients, 15 females and 5 males, ages ranging from 18 to 52 years, all having post-burn leucoderma ranging from 10 to 36 months, were included. The recipient sites were prepared by superficial dermabrasion. The Chinese cupping device was used for blister induction. Blister formation times, as well as the number of blisters, were noted. Complications, extent of the repigmentation, treatment efficacy and color matching were recorded. The mean time taken for blister formation was 91.75±10.29 min. The number of blisters harvested for each case ranged from 2 to 9. Regarding complications, 1 had partial graft loss, 3 developed perigraft halo at the recipient site, and all patients had temporary hyperpigmented circular macules at the donor sites. After a mean follow up period of 8.5±1.73 months, repigmentation percentage ranged from 40 to 100% with good color matching. Treatment efficacy was excellent in 3 cases (15%), good in 12 cases (60%), fair in 4 cases (20%), and poor in 1 case (5%). As regards patient satisfaction, 15 patients (75%) were satisfied, while 5 patients (25%) weren't. Combined superficial dermabrasion and SBEG appears to be a simple and cost-effective surgical treatment modality for localized post-burn leucoderma.

L'hypochromie post-brûlure reste l'une des séquelles les plus compliquées à traiter car elle relève de deux problèmes distincts : les modifications qualitatives de la peau et l'hypopigmentation qui doivent être traitées simultanément. De nombreuses techniques chirurgicales ont été utilisées, avec des résultats variables. Cette étude prospective évalue l'efficacité de la dermabrasion superficielle suivie de greffes épidermiques prélevées sur des phlyctènes induites mécaniquement (SBEG) dans le traitement de l'hypochromie post brûlure. Nous avons inclus 20 patients, 15 femmes et 5 hommes, âgés de 18 à 52 ans, présentant tous une hypochromie post-brûlure datant de 10 à 36 mois. Les sites receveurs étaient préparés par dermabrasion superficielle. Nous avons utilisé des ventouses chinoises pour créer les phlyctènes. La durée nécessaire à leur formation ainsi que le nombre de phlyctènes ont été notés. Les complications, le degré de repigmentation, l'efficacité du traitement et la justesse de la teinte ont été enregistrées. La durée nécessaire à la formation des phlyctènes a été de 91.75±10.29 min.. Le nombre de phlyctènes prélevées pour chaque cas allait de 2 à 9. En ce qui concerne les complications, un patient a présenté une lyse partielle de la greffe, trois patients ont présenté des halos autour de la greffe au site receveur et tous les patients ont présenté des macules circulaires hyperpigmentées transitoires au site donneur. Après un suivi moyen de 8.5±1.73 mois, nous avons obtenu entre 40 et 100% de repigmentation avec une teinte correcte. L'efficacité du traitement a été jugée excellente dans trois cas (15%), bonne dans 12 cas (60%), moyenne dans quatre cas (20%) et mauvaise dans un cas (5%). 15 patients ont été satisfaits (75%) alors que cinq patients ont été déçus (25%). L'association d'une dermabrasion superficielle et de greffes épidermiques prélevées sur des phlyctènes induites mécaniquement (SBEG) semble être une technique chirurgicale simple et peu coûteuse pour le traitement des hypochromies post- brûlure localisées.

Evaluation of the Fungicidal Effect of Some Commercial Disinfectant and Sterilizer Agents Formulated as Soluble Liquid against Sclerotium rolfsii Infected Tomato Plant.

Globally, root rot disease of tomato plants caused by Sclerotium rolfsii is a severe disease leading to the death of infected plants. The effect of some commercial antiseptics and disinfectant agents, such as chloroxylenol (10%), phenic (10%) and formulated phenol (7%) on the control of root rot pathogen and its impact on growth and chemical constituents of tomato seedlings cv. Castle Rock were investigated in vitro and in vivo. The antifungal activity was measured in vitro following the poisoned food technique at different concentrations of 1000, 2000, 3000 and 4000 µL/L. Disinfectant agents and atrio (80%) were tested in vivo by soaking 20-day-old tomato seedlings in four concentrations of 125, 250, 500 and 1000 µL/100 mL water for 5 min and thereafter planting in soil infested by S. rolfsii. Fresh and dry weight, shoot and root length, and chemical constituents of tomato seedlings infected by S. rolfsii were investigated at 35 days after planting (DAP). Experimental results indicated that chloroxylenol (10%) was the most effective on fungus in vitro, recorded an effective concentration (EC50 = 1347.74 µL/L) followed by phenic (10%) (EC50 = 1370.52 µL/L) and formulated phenol (7%) (EC50 = 1553.59 µL/L). In vivo, atrio (80%) and disinfectant agents at different concentrations significantly (p ≤ 0.05) reduced disease incidence, increased shoot and root lengths and increased dry and fresh weight. Additionally, it significantly increased chlorophyll a, chlorophyll b, total carotenoids, total carbohydrates, total proteins, and total phenols. The highest reduction of root rot incidence and increase tomato growth parameters, as well as chemical compositions, were recorded on tomato seedlings treated with atrio (80%) as well as formulated phenol (7%) at different concentrations, followed by chloroxylenol (10%) at 125 and 250 µL/100 mL, whereas phenic (10%) was found to be the least effective treatment. Therefore, the application of formulated phenol (7%) could be commercially used to control tomato root rot diseases and increase the quality and quantity of tomato plants since it is promising against the pathogen, safe, and less expensive than fungicides.

Pharmacological basis of the putative therapeutic effect of Topical Vitamin D3 on the experimental model of atopic dermatitis in mice.

OBJECTIVE: The aim of the study was to explore the effect of topical vitamin D3 in atopic dermatitis (AD) induced by ovalbumin (OVA) in contrast with topical betamethasone in mice. MATERIALS AND METHODS: 35 BALB/c adult male mice, weighing between 25-30 gm were used to induce AD by topically sensitizing the dorsal surface of the skin with the OVA patch. Subsequently, treatments were performed in each group by application of vitamin D3 cream (0.0003%), betamethasone cream (0.1%), or vehicles (QV cream) on the skin. RESULTS: Remarkably, vitamin D3 had a marked improvement in the skin of OVA-induced AD mice. Additionally, vitamin D3 revealed a considerable diminution in the levels of IgE, IL-5, filaggrin, and epidermal thickness, whereas a significant augmentation in the levels of IL-4 and IL-13 was observed when compared with the control group, and histopathological studies had further confirmed these findings. CONCLUSIONS: This study essentially highlighted the anti-inflammatory effect of vitamin D3 by effective alteration in the immunological components responsible for AD. Moreover, this pioneer experimental work represents a new paradigm and sheds a light on the importance of vitamin D3 in the implications of AD. A comprehensive creative approach is crucial to concretely establish and further corroborate vitamin D3 for this therapeutic role.

Moringa (Moringa oleifera Lam.) polysaccharides: Extraction, characterization, bioactivities, and industrial application.

Owing to numerous biological activities of different parts of Moringa oleifera Lam., various studies have been carried out to isolate and explore the activities of its various bioactive compounds including polysaccharides. Polysaccharides of M. oleifera have been reported to possess a variety of biofunctionalities including antihyperlipidemic, anti-diabetic, immunomodulatory, antihypertensive and gastrointestinal protection. In addition to bioactive polysaccharides, the gum exudated by stem of this plant is of commercial importance with wide range of applications in pharmaceutical industries. Various extraction and purification methods as well as combination of methods have been used to isolate and purify moringa polysaccharides. Studies suggest that extraction methods influence the structure of polysaccharides and thus their biological activity. This review summarizes all the available literature to provide updated information related to extraction, purification, modification, structural characterization, bioactivities and potential applications of moringa polysaccharides. This review will provide novel insights for future research and applications of moringa polysaccharides.

Guava (Psidium guajava L.) seed: A low-volume, high-value byproduct for human health and the food industry.

Guava processing industries generate peel and seeds as primary waste fractions. Guava seeds obtained after fruit processing possess untapped potential in the field of food science due to the presence of a diversity of nutritional and bioactive compounds. Along with offering a detailed understanding of the nutritional attributes of guava seeds, the present review comprehensively elaborates on the therapeutic activities of their bioactive compounds, their techno-functional properties, and their other edible and nonedible applications. The limited molecular and biochemical mechanistic studies outlining the antioxidant, immunomodulatory, anticancer, antimicrobial, neuroprotective and antidiabetic activities of guava seeds available in the literature are also extensively discussed in this review. The use of guava seed constituents as food additives and food functional and structural modulators, primarily as fat reducers, emulsifiers, water and oil holding agents, is also conceptually explained. Additional human intervention and molecular mechanistic studies deciphering the effects of guava seeds on various diseases and human health are warranted.

Assessment of attitude and hesitancy toward vaccine against COVID-19 in a Pakistani population: A mix methods survey.

Objective: The objective of this study was to assess the attitude and hesitancy toward vaccine against COVID-19 in a Pakistani Population. Materials and methods: A mix-method, prospective study was conducted and adults (aged ≥18 years) residing in Pakistan were invited to participate. The questionnaire was prepared, hosted in Google Forms and circulated through electronic platforms and was also available to be done in in-person. Data was compiled from 15th September to 30th November 2020. Results: The response rate was 80%. A total of 1003 participants were included in the final analysis. Of them, 75% completed survey questionnaire online, while remaining 25% responded in-person. The mean age of the participants was 29.62 ± 10.47 years. The majority of participants were females; 60.9% (n = 611). 57.02% (n = 572) of the participants were employed at the time of survey. Overall, 70.68% (n = 709) of the participants had previous experience of vaccines such as the flu vaccine Only 4.9% (n = 49) participants thought that they will be seriously ill from COVID-19 within six months and 39% (n = 392) participants were confident that they will get COVID-19. A total of 71.29% of the participants reported they would consider getting vaccinated once available. There was statistical association between gender and getting vaccinated (P < 0.001). Conclusion: This study demonstrated that majority of the participants showed positive attitude toward considering COVID-19 vaccine. However awareness with informed knowledge of efficacy, possible adverse effects and cost would be of added great value to increase the real response of Pakistani population toward COVID-19 vaccination.

Objetivo: El objetivo de este estudio fue evaluar la actitud y la renuencia hacia la vacuna frente a la COVID-19 en una población paquistaní. Materiales y métodos: Se realizó un estudio prospectivo de método mixto, invitándose a participar a personas adultas (edad ≥18 años) residentes en Paquistán. Se preparó el cuestionario, que se alojó en Google Forms y se hizo circular a través de plataformas electrónicas, pudiendo realizarse también de manera personal. Los datos se recopilaron desde el 15 de septiembre al 30 de noviembre de 2020. Resultados: La tasa de respuesta fue del 80%. El análisis final incluyó un total de 1.003 participantes, de los cuales el 75% completó el cuestionario-encuesta online, mientras que el 25% respondió en persona. La edad media de los participantes fue de 29,62 ± 10,47 años. La mayoría de los participantes eran mujeres: el 60,9% (n = 611). El 57,02% (n = 572) de los participantes tenía empleo en el momento de la encuesta. En general, el 70,68% (n = 709) de los participantes tenía experiencia previa sobre vacunas tales como la vacuna frente a la gripe. Solo el 4,9% (n = 49) de los participantes pensaba que padecerían la COVID-19 de forma grave en el plazo de seis meses, y el 39% (n = 392) de los participantes estaba seguro de que se contagiaría de dicha enfermedad. El 71,29% de los participantes reportó que consideraría recibir la vacuna una vez que se dispusiera de la misma. Existió una asociación estadística entre el sexo y el ser vacunado (P< 0,001). Conclusión: Este estudio demostró que la mayoría de los participantes mostró una actitud positiva hacia la consideración de la vacuna frente a la COVID-19. Sin embargo, la concienciación sobre el conocimiento informado de la vacuna, los posibles efectos adversos y el coste supondrían un gran valor añadido al incremento de la respuesta real de la población paquistaní hacia la vacuna frente a la COVID-19.

Onion (Allium cepa L.) peels: A review on bioactive compounds and biomedical activities.

Huge quantities of byproducts/wastes generated in onion processing are usually discarded, but they are excellent sources of bioactive compounds and phytochemicals. However, with growing interest in the sustainable use of resources and the circular economy to reduce adverse impacts on the environment, food processing wastes such as onion peel/skin can be extracted and employed as inputs in developing or reformulating nutrient supplements, and pharmacological drugs. This review highlights major bioactive components, especially total phenolics, total flavonoid, quercetin and its derivatives present in onion peel/skin and their therapeutic applications as cardioprotective, neuroprotective, antiobesity, antidiabetic, anticancer and antimicrobial agents. The present review emphasized that onion peel is one of the important agricultural by-products which is rich in bioactive compounds and can be utilized as health promoting ingredient especially in pharmacological and biomedical fields. Thus, with increasing burden of life style disorders/non-communicable diseases, finding suitable natural alternative for their treatment is one major concern of the researchers and onion peel and its extract can be exploited as a prime ingredient.

From high to low malaria transmission in Zanzibar-challenges and opportunities to achieve elimination.

BACKGROUND: Substantial global progress in the control of malaria in recent years has led to increased commitment to its potential elimination. Whether this is possible in high transmission areas of sub-Saharan Africa remains unclear. Zanzibar represents a unique case study of such attempt, where modern tools and strategies for malaria treatment and vector control have been deployed since 2003. METHODS: We have studied temporal trends of comprehensive malariometric indices in two districts with over 100,000 inhabitants each. The analyses included triangulation of data from annual community-based cross-sectional surveys, health management information systems, vital registry and entomological sentinel surveys. RESULTS: The interventions, with sustained high-community uptake, were temporally associated with a major malaria decline, most pronounced between 2004 and 2007 and followed by a sustained state of low transmission. In 2015, the Plasmodium falciparum community prevalence of 0.43% (95% CI 0.23-0.73) by microscopy or rapid diagnostic test represented 96% reduction compared with that in 2003. The P. falciparum and P. malariae prevalence by PCR was 1.8% (95% CI 1.3-2.3), and the annual P. falciparum incidence was estimated to 8 infections including 2.8 clinical episodes per 1000 inhabitants. The total parasite load decreased over 1000-fold (99.9%) between 2003 and 2015. The incidence of symptomatic malaria at health facilities decreased by 94% with a trend towards relatively higher incidence in age groups > 5 years, a more pronounced seasonality and with reported travel history to/from Tanzania mainland as a higher risk factor. All-cause mortality among children < 5 years decreased by 72% between 2002 and 2007 mainly following the introduction of artemisinin-based combination therapies whereas the main reduction in malaria incidence followed upon the vector control interventions from 2006. Human biting rates decreased by 98% with a major shift towards outdoor biting by Anopheles arabiensis. CONCLUSIONS: Zanzibar provides new evidence of the feasibility of reaching uniquely significant and sustainable malaria reduction (pre-elimination) in a previously high endemic region in sub-Saharan Africa. The data highlight constraints of optimistic prognostic modelling studies. New challenges, mainly with outdoor transmission, a large asymptomatic parasite reservoir and imported infections, require novel tools and reoriented strategies to prevent a rebound effect and achieve elimination.

Risk of inferior alveolar nerve injury with coronectomy vs surgical extraction of mandibular third molars-A comparison of two techniques and review of the literature.

The removal of mandibular third molar teeth is one of the most common oral surgical procedures. In a significant number of patients, it carries a degree of associated morbidity, including damage to the inferior alveolar nerve (IAN). For this reason, practitioners desire the most up-to-date guidance on the most appropriate technique, informed by the best available evidence that will produce the lowest incidence of iatrogenic complications. The aim of this study was to perform a systematic review comparing the effect of coronectomy vs complete surgical extraction of mandibular third molar teeth on the risk of IAN injury and other complications in adults. Studies were identified through Embase (1980-2016) and Ovid MEDLINE (1946-2016) database searches. Search terms included coronectomy, partial root removal, deliberate vital root retention, odontectomy, surgical removal, surgical extraction, complete tooth extraction and extract. Limits of the study included humans, English language and randomised controlled trials (RCTs). Only RCTs comparing IAN damage associated with surgical extraction of mandibular third molars vs coronectomy were included. From our database searches, we identified two unique RCTs matching the inclusion criteria. Both evaluated patients who had specific radiographic signs of intimate relationships with the IAN. Upon detailed analysis, the studies were noted to exhibit a high risk of bias in many categories, thereby rendering their results inconclusive. Although evidence from two RCTs suggests that coronectomy can reduce the risk of IAN injury compared to surgical removal of high-risk mandibular third molars, the quality of evidence is insufficient to provide definitive conclusions regarding the preferred technique.

El priapismo en la Leucemia Mieloide Crónica Hallazgos radiológicos en casos de Leucemia Mieloide Crónica que se presentaron con priapismo / 7 PRIAPISM IN CHRONIC MYELOID LEUKEMIA : IMAGING FINDINGS IN CASES OF CHRONIC MYELOID LEUKEMIA WHO PRESENTED WITH PRIAPISM

El priapismo es una emergencia urológica que debe ser diagnosticada y tratada apropiadamente. Específicamente en casos conocidos de leucemia el pene turgente doloroso debe hacer surgir la sospecha de priapismo de primera movida y el Doppler peneano debe ser la mera línea de modalidad de imágenes. Esta información debe ser transmitida al paciente y al departamento clínico emergentológico

Priapism is an urological emergency and must be diagnosed and treated appropriately. Specifically in known cases of leukemia painful turgid penis should raise suspicion of priapism in first hand and penile Doppler should be the first line of imaging modality. This information should be forwarded to patient and emergency department clinician

Correlation between Serum Hyaluronic Acid with Steatosis, Non alcoholic Steato-hepatitis and Fibrosis in Patients with Chronic Hepatitis C Virus Infection.

Background: Hyaluronic acid (HA) is an attractive potential marker for noninvasive diagnosis of liver fibrosis instead of liver biopsy for both patients and physicians. Aim: To assess the role of HA for diagnosing the progression of steatosis to steato-hepatitis (SH) and fibrosis in patients with Chronic Hepatitis C virus (HCV) infection. Methods: 90 patients with chronic HCV infection, 77 (85.6%) males and 13 (14.4%) females, were included. Blood samples were collected for routine laboratory investigations, liver function tests and serum HA measurements. A liver biopsy was taken for histopathological examination. Results: Steatosis was found in 37 patients (41.1%), fibrosis in 29 patients (32.2%) and SH in 51 patients (56.7%). The mean serum HA for all patients was 86.4±48.2 ng/L. HA levels were significantly higher in patients with fibrosis (95.6±53 vs 54.5±3.5) and SH (88.7±52 vs 49.9±12) than those without (P value = 0.001and 0.001 respectively). HA levels were also significantly higher in patients with an advanced degree of fibrosis, SH and steatosis as compared to those with mild degrees (P value = 0.000, 0.001 and 0.01 respectively). Positive correlations were found between serum HA and the degree of fibrosis, SH and steatosis (P value =0.000 and r = + 0.758, 0.701and 0.727 respectively). The mean HA cut off value for the diagnosis of fibrosis and SH was taken to be 70 and 60 ng/L providing a diagnostic accuracy of 94.1% and 91.6% respectively. Conclusion: Serum HA level is a good noninvasive marker for the diagnosis of fibrosis and steato-hepatitis in patients with chronic HCV infection.

Pharmacists' self-perceptions in relation to the 'Advanced Pharmacy Practice Framework'.

BACKGROUND: The Australian Pharmacy Practice Framework was developed by the Advanced Pharmacy Practice Steering Committee and endorsed by the Pharmacy Board of Australia in October 2012. The Steering Committee conducted a study that found practice portfolios to be the preferred method to assess and credential Advanced Pharmacy Practitioner, which is currently being piloted by the Australian Pharmacy Council. Credentialing is predicted to open to all pharmacists practising in Australia by November 2015. OBJECTIVE: To explore how Australian pharmacists self-perceived being advanced in practice and how they related their level of practice to the Australian Advanced Pharmacy Practice Framework. METHOD: This was an explorative, cross-sectional study with mixed methods analysis. Advanced Pharmacy Practice Framework, a review of the recent explorative study on Advanced Practice conducted by the Advanced Pharmacy Practice Framework Steering Committee and semi-structured interviews (n = 10) were utilized to create, refine and pilot the questionnaire. The questionnaire was advertised across pharmacy-organizational websites via a purposive sampling method. The target population were pharmacists currently registered in Australia. RESULTS: Seventy-two participants responded to the questionnaire. The participants were mostly female (56.9%) and in the 30-40 age group (26.4%). The pharmacists self-perceived their levels of practice as either entry, transition, consolidation or advanced, with the majority selecting the consolidation level (38.9%). Although nearly half (43.1%) of the participants had not seen the Framework beforehand, they defined Advanced Pharmacy Practice similarly to the definition outlined in the Framework, but also added specialization as a requirement. Pharmacists explained why they were practising at their level of practice, stating that not having more years of practice, lacking experience, or postgraduate/post-registration qualifications, and more involvement and recognition in practice were the main reasons for not considering themselves as an Advanced Pharmacy Practitioner. To be considered advanced by the Framework, pharmacists would need to fulfill at least 70% of the Advanced Practice competency standards at an advanced level. More than half of the pharmacists (64.7%) that self-perceived as being advanced managed to fulfill 70% or more of these Advanced Practice competency standards at the advanced level. However, none of the self-perceived entry level pharmacists managed to match at least 70% of the competencies at the entry level. CONCLUSION: Participants' self-perception of the term Advanced Practice was similar to the definition in the Advanced Pharmacy Practice Framework. Pharmacists working at an advanced level were largely able to demonstrate and justify their reasons for being advanced practitioners. However, pharmacists practising at the other levels of practice (entry, transition, consolidation) require further guidance regarding their advancement in practice.

Health related quality of life (HRQoL) after cystectomy: comparison between orthotopic neobladder and ileal conduit diversion.

INTRODUCTION: Radical cystectomy and urinary diversion carries a high morbidity. Quality of life and body image are important considerations for urinary diversion (UD). We wanted to conduct a systematic review of literature to see which form UD offers a better quality of life (QoL). METHODS: We searched MEDLINE, Pubmed, EMBASE, CINAHL and the Cochrane library for studies using the following key words: 'quality of life' and 'ileal conduit', 'orthotopic neobladder', 'continent diversion' and 'urinary diversion'. All English language articles on UD surgery were included in the original search from 1990 to 2014. To improve the quality of evidence, we stratified our inclusion criteria into studies that report on QoL in both forms of UD using at least one validated questionnaire. RESULTS: Twenty-one studies (2285 patients) were included in our study all of which used at least one validated tool. The most frequently used tools were the SF-36, EORTC QLQ-C30 and FACT BL (10, 8, 5 studies respectively). None of the studies were randomised and only 4 studies were prospectively designed. Sixteen studies reported no difference in QoL between the two types of urinary diversion and four studies reported a better QoL with orthotopic neobladder of which 2 studies had younger and fitter patients. On the other hand, one study reported a better QoL in ileal conduit patients. CONCLUSION: Orthotopic neobladder urinary diversion shows a marginally better quality of life scores compared to ileal conduit diversion especially when considering younger and fitter patients.