Peri-Implant Mucosal Fenestration and Histologic Observation of Bone Xenograft Material 7-Years After Implant Installation: A Case Report.

Bone augmentation is often required before the installation of dental implants. Here, we report a case for a patient who previously received bone augmentation at the upper right jaw using a xenogenic graft, followed by successful implant installation. Seven years later, the patient presented with mucosal fenestration with bone exposure at the area and gave a history of a recent diagnosis of cutaneous lichen planus. Several attempts were made to manage the situation, and finally, we resorted to connective tissue graft placement at the site. A piece of bone was sent for histologic evaluation, where the results indicated the presence of un-resorbed graft material surrounded by inflammatory cells, with no evidence of bone formation in the area. The case presents histologic evidence for the lack of new bone formation using xenograft over the evaluation period. The case also shows lichen planus, a possible cause for oral complication for patients undergoing augmentation and implant installation.

Psammaplin A and Its Analogs Attenuate Oxidative Stress in Neuronal Cells through Peroxisome Proliferator-Activated Receptor γ Activation.

Psammaplins are sulfur containing bromotyrosine alkaloids that have shown antitumor activity through the inhibition of class I histone deacetylases (HDACs). The cytotoxic properties of psammaplin A (1), the parent compound, are related to peroxisome proliferator-activated receptor γ (PPARγ) activation, but the mechanism of action of its analogs psammaplin K (2) and bisaprasin (3) has not been elucidated. In this study, the protective effects against oxidative stress of compounds 1-3, isolated from the sponge Aplysinella rhax, were evaluated in SH-SY5Y cells. The compounds improved cell survival, recovered glutathione (GSH) content, and reduced reactive oxygen species (ROS) release at nanomolar concentrations. Psammaplins restored mitochondrial membrane potential by blocking mitochondrial permeability transition pore opening and reducing cyclophilin D expression. This effect was mediated by the capacity of 1-3 to activate PPARγ, enhancing gene expression of the antioxidant enzymes catalase, nuclear factor E2-related factor 2 (Nrf2), and glutathione peroxidase. Finally, HDAC3 activity was reduced by 1-3 under oxidative stress conditions. This work is the first description of the neuroprotective activity of 1 at low concentrations and the mechanism of action of 2 and 3. Moreover, it links for the first time the previously described effects of 1 in HDAC3 and PPARγ signaling, opening a new research field for the therapeutic potential of this compound family.

Ameliorative impacts of sinapic acid against mercuric chloride-induced renal toxicity: role of antioxidants and inflammatory cytokines.

Because of their beneficial properties, natural products, especially medicinal plants, are becoming increasingly popular worldwide and play a significant role in research. This study was aimed to evaluate the nephroprotective effect of sinapic acid against mercuric chloride-induced renal toxicity in mice. The mice were allocated to four groups named a normal group (G1), model group (G2; received HgCl2, 1 mg/kg bw), treatments groups (G3 and G4: received 50 and 100 mg/kg bw of sinapic acid together with HgCl2). Mice received HgCl2 remarkably showed alteration in all examined biochemical biomarkers (urea, creatinine, and bilirubin), and induced alteration in blood cell picture and anemia. HgCl2 intoxication decreased both systemic and renal antioxidant activity and induced over all oxidative stress as indicated by alteration in inflammation and oxidative stress associated markers. HgCl2 affected renal histology with leukocytic and inflammatory cell infiltration, fibrosis and tubular necrosis. Administration of sinapic acid (50 and 100 mg/kg bw) markedly restored the HgCl2-induced oxidative stress (serum and renal: MDA, GSH, CAT, SOD, and T-AOC), proinflammatory cytokines (serum and renal: TNF-α, IL-6, IL-1ß, and PGE2) and restored the changes on biochemical markers, and hematological parameters (hemoglobin, erythrocytes, platelets, and leukocytes). Taken together, the results of the present study disclose that sinapic acid has the potential to attenuate HgCl2-induced renal toxicity and may be an ideal choice against mercury poisoning.

Exploring the potential of drug repurposing for liver diseases: A comprehensive study.

Drug repurposing involves the investigation of existing drugs for new indications. It offers a great opportunity to quickly identify a new drug candidate at a lower cost than novel discovery and development. Despite the importance and potential role of drug repurposing, there is no specific definition that healthcare providers and the World Health Organization credit. Unfortunately, many similar and interchangeable concepts are being used in the literature, making it difficult to collect and analyze uniform data on repurposed drugs. This research was conducted based on understanding general criteria for drug repurposing, concentrating on liver diseases. Many drugs have been investigated for their effect on liver diseases even though they were originally approved (or on their way to being approved) for other diseases. Some of the hypotheses for drug repurposing were first captured from the literature and then processed further to test the hypothesis. Recently, with the revolution in bioinformatics techniques, scientists have started to use drug libraries and computer systems that can analyze hundreds of drugs to give a short list of candidates to be analyzed pharmacologically. However, this study revealed that drug repurposing is a potential aid that may help deal with liver diseases. It provides available or under-investigated drugs that could help treat hepatitis, liver cirrhosis, Wilson disease, liver cancer, and fatty liver. However, many further studies are needed to ensure the efficacy of these drugs on a large scale.

Post-publication research integrity concerns in randomized clinical trials: A scoping review of the literature.

BACKGROUND: Post-publication handling of integrity concerns in randomized clinical trials (RCTs) is a contentious matter. OBJECTIVES: We undertook a scoping systematic review to map the literature regarding post-publication integrity issues in RCTs. SEARCH STRATEGY AND SELECTION CRITERIA: Following prospective registration (https://osf.io/pgxd8) we initially searched PubMed and Scopus but subsequently extended it to include the Cochrane Library, and Google Scholar databases without language, article type or publication time restriction until November 2022. Reviewers independently selected published articles covering any aspect of post-publication research integrity concerns in RCTs. DATA COLLECTION AND ANALYSIS: The study findings grouped within domains relating to issues concerning post-publication integrity were extracted in duplicate, verified by a third reviewer, and then tabulated. MAIN RESULTS: The initial search captured 3159 citations, of which 89 studies were included in the review. Cross-sectional studies constituted the majority of included studies (n = 34, 38.2%), followed by systematic reviews (n = 10, 11.2%), methodology reviews/studies (n = 9, 10.1%) and other types of descriptive studies (n = 8, 9.0%). A total of 21 articles (23.6%) covered the domain on general issues, 25 (28.1%) in the journal's instructions and policies domain, eight (9.0%) in the editorial and peer review domain, one (1.1%) in the correspondence and complaints (post-publication peer review) domain, 12 (13.5%) in the investigation for concerns domain, six (6.7%) in the post-investigation decisions and sanctions domain, none in the critical appraisal guidance domain, five (5.6%) in the integrity assessment in systematic reviews domain, and 26 (29.2%) in the recommendations for future research domain. A total of 12 of the selected articles (13.5%) covered two (n = 9) or three (n = 3) different domains. CONCLUSIONS: Various research integrity domains and issues covering post-publication aspects of RCT integrity were captured and gaps were identified, mostly related with the necessary implications for all stakeholders to improve research transparency. There is an urgent need for a multistakeholder consensus towards creating specific statements for addressing post-publication integrity concerns in RCTs.

Seasonal variation and concentration of PAHs in Lake Balaton sediment: A study on molecular weight distribution and sources of pollution.

The temporal and spatial variations of 16 Polycyclic Aromatic Hydrocarbons (PAHs) were examined at multiple sites around Lake Balaton from February 2023 to January 2024. The results indicated that the concentrations of PAHs in sediment were high during the winter months, 448.35 to 619.77 ng/g dry weight, and low during the summer months, 257.21 to 465.49 ng/g dry weight. The concentration of high molecular weight PAHs (HMWPAHs), consisting of 5-6 rings, was greater than that of low molecular weight PAHs (LMWPAHs), which had 2-3 rings. The total incremental lifetime cancer risk (ILCR) for both dermal and ingestion pathways was high for both adults and children during the four seasons, with the highest records as the following: winter > spring > summer > autumn. The ecological effects of the 16 PAHs were negligible except for acenaphthylene (Acy) and fluorene (Fl), which displayed slightly higher concentrations during the autumn and spring, respectively.

A Hollow TFG Condensate Spatially Compartmentalizes the Early Secretory Pathway.

In the early secretory pathway, endoplasmic reticulum (ER) and Golgi membranes form a nearly spherical interface. In this ribosome-excluding zone, bidirectional transport of cargo coincides with a spatial segregation of anterograde and retrograde carriers by an unknown mechanism. We show that at physiological conditions, Trk-fused gene (TFG) self-organizes to form a hollow, anisotropic condensate that matches the dimensions of the ER-Golgi interface. Regularly spaced hydrophobic residues in TFG control the condensation mechanism and result in a porous condensate surface. We find that TFG condensates act as a molecular sieve, enabling molecules corresponding to the size of anterograde coats (COPII) to access the condensate interior while restricting retrograde coats (COPI). We propose that a hollow TFG condensate structures the ER-Golgi interface to create a diffusion-limited space for bidirectional transport. We further propose that TFG condensates optimize membrane flux by insulating secretory carriers in their lumen from retrograde carriers outside TFG cages.

Familial Hemophagocytic Lymphohistiocytosis (FHLH) Perforin Deficiency: A Case Study and Literature Review.

Hemophagocytic lymphohistocytosis (HLH) is a severe and fatal immunological disorder that is either primary (i.e., familial) or secondary (i.e., acquired). The primary type comprises autosomal recessive disorders with gene mutations related to natural killer cells and cytotoxic T-cells, whereas the secondary type is related to other pathological causes, such as Epstein-Barr virus, bacterial or fungal infection, autoimmune conditions or autoinflammatory diseases, metabolic disorders, and cancer. In this report, we discuss a 37-day-old male who was brought to the emergency room with fever, decreased activity, and hepatosplenomegaly, with a strong family history of unknown cause of death for three siblings who died at the ages of one to two months. A whole exome sequencing confirmed the clinical diagnosis of familial HLH due to mutation in the PRF1 gene. We note the special importance of genetic counselling and antenatal screening or early neonatal screening in families affected by HLH, as this case highlights the importance of early diagnosis and intervention of primary HLH.

Reflections on the Saudi FDA Regulatory Experience with Smart GxP Inspections.

Smart GxP inspections have gained increasing attention due to the COVID-19 pandemic, which, understandably, made it challenging for regulatory authorities to conduct on-site inspections. Smart GxP inspections are an oversight approach developed by the SFDA to enable remote compliance assessments of establishments. In this type of inspection, appropriate technical methods and tools (such as livestreaming video) are used without requiring the presence of inspectors onsite, ensuring efficient utilization of resources and the efficiency of inspection process. The objective of this research is to examine and document the shared encounters involving remote inspections and evaluations carried out by SFDA from 2020 to 2022. This will be achieved through the evaluation of the accuracy of document evaluation and the extent to which the objectives of smart GxP inspections were met. Data were collected from local and international smart inspections reports conducted by SFDA between 2020 and 2022, covering medical device manufacturers, pharmaceutical manufacturing sites, warehouses, accreditation offices, scientific offices, and food manufacturing facilities. The results indicate that smart GxP inspections were effective in achieving visit objectives, showing a high degree of document evaluation accuracy. The findings of this study support the use of smart GxP inspections as a valuable alternative to on-site inspections, offering a practical solution to regulatory compliance during the pandemic and beyond. Although the SFDA recognizes the usefulness of smart inspections in upholding regulatory oversight in the face of various challenges, it does not endorse the complete replacement of conventional on-site inspection methods. The SFDA acknowledges significant limitations associated with the current technological resources used in remote regulatory assessments, and these limitations will be explored in the relevant sections.

Retrospective analysis of pediatric sepsis and the burden of antimicrobial resistance in Duhok, Kurdistan Region of Iraq.

Introduction: Sepsis is a life-threatening complication in pediatric patients. This study primarily aimed to investigate sepsis-causing bacteria and their antimicrobial resistance profile and check the change in the antimicrobial resistance trend for some selected bacteria. In addition, we evaluated the incidence of sepsis, the related mortality rate, and the effectiveness and outcome of the treatment regimes in sepsis pediatric patients. Methods: A retrospective analysis was conducted on 4-year data (2018-2021) collected from three intensive care units at the Hevi Pediatric Teaching Hospital. Sepsis screening involved clinical detection and confirmation by blood culture. Results: A total of 520 out of 1,098 (47.35%) blood samples showed positive microbial growth. A decrease in sepsis rate was observed during the COVID-19 pandemic. Coagulase-negative Staphylococci (CoNS) and Klebsiella pneumonia were the most commonly isolated bacteria. A notable variation in the antimicrobial resistance trend was observed among sepsis-causing bacteria. The empirical sepsis treatment recommended by the WHO was ineffective, as certain bacteria exhibited 100% resistance to every antibiotic tested. The mortality rate significantly increased from 1.3% in 2018 to 16.5% in 2021. Discussion: The antimicrobial resistance profile of sepsis causing bacteria is of concerns, indicating a potentially serious situation. Thus, to avoid treatment failure, the monitoring of antimicrobial resistance in pediatric patients is essential.

A Sustainable Banana Peel Activated Carbon for Removing Pharmaceutical Pollutants from Different Waters: Production, Characterization, and Application.

Due to the growing concerns about pharmaceutical contamination and its devastating impact on the economy and the health of humans and the environment, developing efficient approaches for removing such contaminants has become essential. Adsorption is a cost-effective technique for removing pollutants. Thus, in this work, banana peels as agro-industrial waste were utilized for synthesizing activated carbon for removing pharmaceuticals, namely amoxicillin and carbamazepine from different water matrices. The chemically activated carbon by phosphoric acid (H3PO4) was carbonized at temperatures 350 °C, 450 °C and 550 °C. The material was characterized by several techniques such as scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDS), Fourier transform infrared spectroscopy (FTIR), Boehm titration, point of zero charge (pHPZC), BET surface area (SBET), the proximate and ultimate analyses, X-ray powder diffraction (XRD), and thermos-gravimetric analysis (TGA). The SEM of banana peel activated carbon (BPAC) depicted a semi-regular and heterogeneous morphology, characterized by an abundance of pores with diverse forms and sizes. Boehm titration revealed an increase in the amounts of acidic groups by 0.711 mmol/g due to activation by H3PO4. FTIR recorded different peaks suggesting significant modifications in the spectroscopic characteristics of the BPAC surface due to the successful activation and adsorption of the pollutant molecules. The pHpzc of BPAC was calculated to be 5.005. The SBET surface area dramatically increased to 911.59 m2/g after the activation. The optimum conditions were 25 °C, a materials dosage of 1.2 g/L, a saturation time of 120 min, a pollutants mixture of 25 mg/L, and a pH of 5. Langmuir exhibits a slightly better fit than Freundlich with a low value of the residual sum of squares (SSE) and the data were better fitted to the pseudo-second-order kinetic. Furthermore, the efficacy of BPAC in eliminating pharmaceuticals from Milli Q water, lake water, and wastewater was successfully investigated over the seven cycles. The results of the present work highlighted a potential usage of agro-industrial waste in eliminating organic micropollutants while exhibiting sustainable management of this waste.

Bridging the Gap in Understanding Bone Metastasis: A Multifaceted Perspective.

The treatment of patients with advanced cancer poses clinical problems due to the complications that arise as the disease progresses. Bone metastases are a common problem that cancer patients may face, and currently, there are no effective drugs to treat these individuals. Prostate, breast, and lung cancers often spread to the bone, causing significant and disabling health conditions. The bone is a highly active and dynamic tissue and is considered a favorable environment for the growth of cancer. The role of osteoblasts and osteoclasts in the process of bone remodeling and the way in which their interactions change during the progression of metastasis is critical to understanding the pathophysiology of this disease. These interactions create a self-perpetuating loop that stimulates the growth of metastatic cells in the bone. The metabolic reprogramming of both cancer cells and cells in the bone microenvironment has serious implications for the development and progression of metastasis. Insight into the process of bone remodeling and the systemic elements that regulate this process, as well as the cellular changes that occur during the progression of bone metastases, is critical to the discovery of a cure for this disease. It is crucial to explore different therapeutic options that focus specifically on malignancy in the bone microenvironment in order to effectively treat this disease. This review will focus on the bone remodeling process and the effects of metabolic disorders as well as systemic factors like hormones and cytokines on the development of bone metastases. We will also examine the various therapeutic alternatives available today and the upcoming advances in novel treatments.

Imposter Phenomenon and Its Predictors in Saudi ENT Specialists: A Cross-Sectional Study.

Background Impostor syndrome (IS) is characterized by an ongoing disbelief in the authenticity of one's accomplishments, attributing success to luck rather than to one's own ability or hard work. The syndrome has detrimental consequences in both personal and career aspects and is closely linked to emotional exhaustion, stress, and depressive symptoms. This study aimed to determine the prevalence of IS among otolaryngologists practicing in Saudi Arabia. Methods We performed a cross-sectional survey from August to October 2022 that targeted both practicing otolaryngologists and those still in their training phase in Saudi Arabia. The survey, delivered via email, tapped into the Saudi Commission for Health Specialties (SCFHS) database to reach all registered otolaryngologists. The survey tool comprised questions on demographic details and employed the Clance Impostor Phenomenon (IP) Scale to evaluate the presence of IS. Results Out of 80 respondents, males (n = 46) were 57.5%, and 18.8% were consultants (n =15). The study found a 27.5% prevalence rate of IS among the surveyed otolaryngologists (n =80), with a mean score of 56.79 ± 12.98. In terms of severity, 62.5% (n = 50) had a moderate level of IS, 25.0% (n = 20) had high IS, and 5.0% (n = 4) had intense IS. It was significantly more common with resident otolaryngologists as compared to consultants (X2 = 7.476, df = 3; p = 0.048), but there was no significant association in terms of gender (X2=3.418, df =1; p = 0.064), type of hospital (X2= 6.351, df = 3; p = 0.096), or fellowship subspecialty (X2= 2.291, df = 4; p = 0.681). Conclusions The study detected that 36.9% of otolaryngologists (n = 17) experienced IS, with trainees being more susceptible than consultants and fellows. Further investigations to explore the scope and underlying reasons are recommended.

Exploring the Antimicrobial, Antioxidant, and Antiviral Potential of Eco-Friendly Synthesized Silver Nanoparticles Using Leaf Aqueous Extract of Portulaca oleracea L.

Herein, the prospective applications of green fabricated silver nanoparticles (Ag-NPs) within the biomedical field were investigated. The leaf aqueous extract of Portulaca oleracea L., a safe, cheap, and green method, was used to fabricate Ag-NPs. The maximum plasmon resonance of synthesized NPs has appeared at 420 nm. The various biomolecules present in the plant extract to assemble spherical Ag-NPs with sizes of 5-40 nm were analyzed using Fourier transform infrared and transmission electron microscopy. The Ag was the major content of the formed Ag-NPs with an atomic percent of 54.95% and weight percent of 65.86%, as indicated by EDX. The crystallographic structure of synthesized NPs was confirmed by the diffraction of the X-ray. The dynamic light scattering exhibits the homogeneity and mono-dispersity nature with a polydispersity index of 0.37 in the colloidal fluid and a zeta potential value of -36 mV. The synthesized Ag-NPs exhibited promising antimicrobial efficacy toward various prokaryotic and eukaryotic pathogenic microorganisms with low MIC values of 12.5 µg mL-1 and 6.25 µg mL-1, respectively. Additionally, the P. oleracea-formed Ag-NPs showed optimistic antioxidant activity assessed by DPPH and H2O2 assay methods with the highest scavenging percentages of 88.5 ± 2.3% and 76.5 ± 1.7%, respectively, at a concentration of 200 µg mL-1. Finally, the biosynthesized Ag-NPs showed high antiviral properties toward the hepatitis A virus and Cox-B4 with inhibition percentages of 79.16 ± 0.5% and 73.59 ± 0.8%, respectively. Overall, additional research is essential to explore the Ag-NP-based aqueous extract of P. oleracea for human health. In the current investigation the use of synthesized Ag-NPs as antimicrobial, antioxidant, and antiviral agents to protect against pathogenic microbes, degenerative diseases caused by various oxidative stresses, and deadly viruses is recommended.

Quantifying the association of sperm DNA fragmentation with assisted reproductive technology outcomes: An umbrella review.

BACKGROUND: Systematic reviews and meta-analyses are instrumental in shaping clinical practice. However, their findings can sometimes be marred by discrepancies and potential biases, thereby diluting the strength of the evidence presented. Umbrella reviews serve to comprehensively assess and synthesise these reviews, offering a clearer insight into the quality of the evidence presented. In the context of the relationship between sperm DNA fragmentation (SDF) and assisted conception outcomes, there is a divergence in the literature. Some reviews suggest a clear cause-and-effect linkage, whereas others present conflicting or inconclusive results. OBJECTIVES: In this umbrella review we aimed to synthesise the evidence collated in systematic reviews and meta-analyses summarising the association of SDF with assisted reproductive technology (ART) outcomes. SEARCH STRATEGY: After preregistration (https://doi.org/10.17605/OSF.IO/6JHDP), we performed a comprehensive search of the PubMed, Scopus, Cochrane Library, Web of Science and Embase databases. We conducted a search for systematic reviews on the association between SDF and ART without any restrictions on language or publication date. SELECTION CRITERIA: Systematic reviews and meta-analyses assessing the association between SDF and ART outcomes were eligible. DATA COLLECTION AND ANALYSIS: We assessed the quality of the included reviews using AMSTAR 2 and ROBIS, and determined the degree of overlap of primary studies between reviews estimating the corrected covered area (CCA), adjusted for structural missingness. We evaluated the most recent reviews assessing the association of SDF with live birth, pregnancy, miscarriage, implantation, blastulation and fertilisation. The synthesis of evidence was harmonised across all included quantitative syntheses, re-estimating the odds ratio (eOR) in random-effects meta-analyses with 95% confidence intervals (95% CIs) and 95% prediction intervals (95% PIs). We categorised the evidence strength into convincing, highly suggestive, suggestive, weak or nonsignificant, according to the meta-analysis re-estimated P-value, total sample size, I2 statistic for heterogeneity, small study effect, excess significance bias and the largest study significance. MAIN RESULTS: We initially captured and screened 49 332 records. After excluding duplicate and ineligible articles, 22 systematic reviews, 15 of which were meta-analyses, were selected. The 22 reviews showed a moderate degree of overlap (adjusted CCA 9.2%) in their included studies (overall n = 428, with 180 unique studies). The 15 meta-analyses exhibited a high degree of overlap (adjusted CCA = 13.6%) in their included studies (overall n = 274, with 118 unique studies). AMSTAR 2 categorised the quality of evidence in 18 reviews as critically low and the quality of evidence in four reviews as low. ROBIS categorised all the reviews as having a high risk of bias. The re-estimated results showed that the association of SDF with live birth was weak in one and nonsignificant in four meta-analyses. Similarly, the association of SDF with pregnancy, miscarriage, implantation, blastulation and fertilisation was also weak or nonsignificant. The association of high SDF with different ART outcomes was also weak or nonsignificant for different interventions (IVF, ICSI and IUI) and tests. CONCLUSIONS: This umbrella review did not find convincing or suggestive evidence linking SDF with ART outcomes. Caution should be exercised in making any claims, policies or recommendations concerning SDF.

A novel and sustainable composite of L@PSAC for superior removal of pharmaceuticals from different water matrices: Production, characterization, and application.

This study endeavors to develop cost-effective environmentally friendly technology for removing harmful residual pharmaceuticals from water and wastewater by utilizing the effective adsorption of pistachio shell (PS) biochar and the degradation potency of laccase immobilized on the biochar (L@PSAC). The carbonatization and activation of the shells were optimized regarding temperature, time, and NH4NO3/PS ratio. This step yielded an optimum PS biochar (PSAC) with the highest porosity and surface area treated at 700 °C for 3 h using an NH4NO3/PS ratio of 3% wt. The immobilization of laccase onto PSAC (L@PSAC) was at its best level at pH 5, 60 U/g, and 30 °C. The optimum L@PSAC maintained a high level of enzyme activity over two months. Almost a complete removal (>99%) of diclofenac, carbamazepine, and ciprofloxacin in Milli-Q (MQ) water and wastewater was achieved. Adsorption was responsible for >80% of the removal and the rest was facilitated by laccase degradation. L@PSAC maintained effective removal of pharmaceuticals of ≥60% for up to six treatment cycles underscoring the promising application of this material for wastewater treatment. These results indicate that activated carbon derived from the pistachio shell could potentially be utilized as a carrier and adsorbent to efficiently remove pharmaceutical compounds. This enzymatic physical elimination approach has the potential to be used on a large-scale.

Evaluation of stability of (1R,2 S)-(-)-2-methylamino-1-phenyl-1-propanol hydrochloride in plasma and urine samples-inoculated with Escherichia coli using high-performance liquid chromatography (HPLC).

The preservation of drug stability in biological evidence during the processes of collection and storage poses a substantial obstacle to the progress of forensic investigations. In conjunction with other constituents, the microorganisms present in the samples play a vital role in this investigation. The present investigation employed the high-performance liquid chromatography (HPLC) technique to assess the stability of (1R,2 S)-(-)-2-methylamino-1-phenyl-1-propanol hydrochloride in plasma and urine samples that were inoculated with Escherichia coli. These samples were subjected to storage conditions of 37 °C for 48 h and - 20 °C for a duration of 6 months. Minimal inhibitory concentration (MIC) and Minimal bactericidal concentration (MBC) of MPPH against E. coli were determined using microdilution method. The stability of MPPH in plasma and urine samples inoculated with E. coli was investigated using HPLC method. The results showed the MIC and MBC of MPPH were 87.5 ± 25 ppm and 175 ± 50 ppm, respectively. While MPPH remained stable in plasma for 48 h at 37 °C, it showed a notable decrease of about 11% in stability when stored in urine for the same period and temperature. From the beginning of the first month, a decrease in the stability of the compound appeared in all samples that were stored at - 20 °C, and the decrease reached 7% for plasma samples and about 11% for urine samples. The decrease in the stability reached its peak in the sixth month, reaching more than 30% and 70% of plasma and urine samples preserved at - 20 °C. This work concluded that E. coli can negatively affect the stability of MPPH in plasma and urine samples. This may lead to incorrect conclusions regarding the analysis of biological samples in criminal cases.

Factors affecting duration of stay in the intensive care unit after coronary artery bypass surgery and its impact on in-hospital mortality: a retrospective study.

BACKGROUND: Different risk factors affect the intensive care unit (ICU) stay after cardiac surgery. This study aimed to evaluate these risk factors. PATIENTS AND METHODS: A retrospective analysis was conducted on clinical, operative, and outcome data from 1070 patients (mean age: 59 ± 9.8 years) who underwent isolated coronary bypass grafting CABG surgery with cardiopulmonary bypass. The outcome variable was prolonged length of stay LOS in the CICU stay (> 3 nights after CABG). RESULTS: Univariate predictors of prolonged ICU stays included a left atrial diameter of > 4 cm (P < 0.001),chronic obstructive airway disease COPD (P = 0.005), hypertension (P = 0.006), diabetes mellitus (P = 0.009), having coronary stents (P = 0.006), B-blockers use before surgery (either because the surgery was done on urgent or emergency basis or the patients have contraindication to B-blockers use) (P = 0.005), receiving blood transfusion during surgery (P = 0.001), post-operative acute kidney injury (AKI) (P < 0.001), prolonged inotropic support of > 12 h (P < 0.001), and ventilation support of > 12 h (P < 0.001), post-operative sepsis or pneumonia (P < 0.001), post-operative stroke/TIA (P = 0.001), sternal wound infection (P = 0.002), and postoperative atrial fibrillation POAF (P < 0.001). Multivariate regression revealed that patients with anleft atrial LA diameter of > 4 cm (AOR 2.531, P = 0.003), patients who did not take B-blockers before surgery (AOR 1.1 P = 0.011), patients on ventilation support > 12 h (AOR 3.931, P = < 0.001), patients who developed pneumonia (AOR 20.363, P = < 0.001), and patients who developed post-operative atrial fibrillation (AOR 30.683, P = < 0.001) were more likely to stay in the ICU for > 3 nights after CABG. CONCLUSION: Our results showed that LA diameter > 4 cm, patients who did not take beta-blockers before surgery, on ventilation support > 12 h, developed pneumonia post-operatively, and developed POAF were more likely to have stays lasting > 3 nights. Efforts should be directed toward reducing these postoperative complications to shorten the duration of CICU stay, thereby reducing costs and improving bed availability.

Statin use and clinical outcomes in hospitalized COVID-19 patients: A retrospective analysis in Riyadh, Saudi Arabia.

OBJECTIVES: To investigate the relationship between statin use and coronavirus disease-19 (COVID-19) severity. METHODS: This was a retrospective study of adult patients with confirmed COVID-19 who were hospitalized at Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia. The study was carried out from July - September 2020. Antecedent statin use was evaluated using medication information available in the electronic medical records. RESULTS: In this retrospective study, we collected data from 689 patients hospitalized with COVID-19. Among the patients, 56.2% of them were non-Saudi and 67.3% were males. The mean age of the patients was 53.7 years. The most common comorbidities among patients with COVID-19 at admission were hypertension (65.2%) and diabetes mellitus (65%). Among these patients, 155 (22.5%) patients received statins during hospitalization and 79.7% of them received corticosteroids. Receiving statins significantly increased the risk of intensive care unit's admission by 1.64 times, intubation by 1.76 times, developing complications by 2.48 times, and mortality by 3.16 times. CONCLUSION: Statins are associated with a higher risk of mortality and morbidity among patients hospitalized for COVID-19.