From algae to advancements: laminarin in biomedicine.

Laminarin, a complicated polysaccharide originating from brown algae, has emerged as a compelling candidate in the domain of biomedical research. This enigmatic molecule, composed of glucose units associated with both ß-1,3 and ß-1,6 glycosidic bonds, possesses an array of remarkable characteristics that render it auspicious for multifaceted biomedical applications. This review investigates the comprehensive potential of laminarin in the biomedical domain, emphasizing its remarkable biocompatibility, low cytotoxicity, and cell proliferation support. Laminarin's immunomodulatory attributes position it as an encouraging contender in immunotherapy and the development of vaccines. Moreover, its anti-inflammatory and antioxidant characteristics provide a promising avenue for combatting conditions associated with oxidative stress. In particular, laminarin excels as a drug delivery vehicle owing to its exceptional encapsulation capabilities emerging from its porous framework. Integrating pH and redox responsiveness in laminarin-based drug delivery systems is poised to redefine targeted therapies. Laminarin substantially contributes to tissue engineering by improving adhesion, migration of cells, and deposition of extracellular matrix. This augmentation magnifies the regenerative capability of tissue-engineered constructs, substantiated by the advancement of laminarin-based wound dressings and tissue scaffolds, marking considerable progress in the domain of wound healing and tissue regeneration. While laminarin exhibits substantial potential in biomedical applications, it remains in the initial phases of exploration. Comprehensive preclinical and clinical research is warranted to verify its effectiveness and safety across various applications. In essence, laminarin, a marine marvel, has the capability to remodel biomedical research, offering inventive solutions to complex difficulties.

Using Artificial Intelligence to Stratify Normal versus Abnormal Chest X-rays: External Validation of a Deep Learning Algorithm at East Kent Hospitals University NHS Foundation Trust.

Background: The chest radiograph (CXR) is the most frequently performed radiological examination worldwide. The increasing volume of CXRs performed in hospitals causes reporting backlogs and increased waiting times for patients, potentially compromising timely clinical intervention and patient safety. Implementing computer-aided detection (CAD) artificial intelligence (AI) algorithms capable of accurate and rapid CXR reporting could help address such limitations. A novel use for AI reporting is the classification of CXRs as 'abnormal' or 'normal'. This classification could help optimize resource allocation and aid radiologists in managing their time efficiently. Methods: qXR is a CE-marked computer-aided detection (CAD) software trained on over 4.4 million CXRs. In this retrospective cross-sectional pre-deployment study, we evaluated the performance of qXR in stratifying normal and abnormal CXRs. We analyzed 1040 CXRs from various referral sources, including general practices (GP), Accident and Emergency (A&E) departments, and inpatient (IP) and outpatient (OP) settings at East Kent Hospitals University NHS Foundation Trust. The ground truth for the CXRs was established by assessing the agreement between two senior radiologists. Results: The CAD software had a sensitivity of 99.7% and a specificity of 67.4%. The sub-group analysis showed no statistically significant difference in performance across healthcare settings, age, gender, and X-ray manufacturer. Conclusions: The study showed that qXR can accurately stratify CXRs as normal versus abnormal, potentially reducing reporting backlogs and resulting in early patient intervention, which may result in better patient outcomes.

Molecular docking and physicochemical studies of 1,3-benzodioxole tagged Dacarbazine derivatives as an anticancer agent.

Cancer, the biggest cause of death globally, remains a tough illness despite enormous advances in therapy. In the present study, 1,3-benzodioxole-tagged dacarbazine derivates were investigated as microtubule inhibitors in order to control cancer as microtubules are involved in cell proliferation. The tubulin protein was analyzed and its structure was validated by various protein validation tools. The binding potential of 1,3-benzodioxole-based dacarbazine-tagged derivatives with tubulin was checked using molecular docking software HEX 8.0 CUDA and AutoDock Vina. Swiss ADME online Web server and pkCSM are used for studying pharmacokinetic and pharmacological studies of compounds. The docking analysis ADME studies displayed that Compounds 1 and 2 bind effectively with the tubulin protein and showed potential properties to use as a potent anticancer drug.

Synthesis of Transition-Metal-Doped Nanocatalysts with Antibacterial Capabilities Using a Complementary Green Method.

A facile single-step wet chemical synthesis of a transition-metal-doped molybdate derivative was achieved via an Ocimum tenuiflorum extract-mediated green approach. The Synthesized nanomaterials of doped molybdate were characterized by optical and other spectroscopic techniques, which confirmed the size of nanocrystalline (~27.3 nm). The thermal stability of the nanomaterials confirmed through thermogravimetric analysis showed similarity with nanomaterials of Mn-ZnMoO4. Moreover, the nanoparticles displayed a non-toxic nature and showed antibactericidal activity. The impact of doping was reflected in band gap measurements; undoped ZnMoO4 showed relatively lower band gap in comparison to Mn-doped ZnMoO4. In the presence of light, ZnMoO4 nanomaterials a exhibited photocatalytic response to solochrome dark blue dye with a concentration of 50 ppm. OH- and O2*- radicals also destroyed the blue color of the dye within 2 min and showed potential antibactericidal activity towards both Gram-positive and Gram-negative bacteria, representing a unique application of the green-synthesized nanocatalyst.

Retention of Knowledge and Efficacy of a Hands-on Training Session in Oxygen Therapy for COVID-19 among Healthcare Workers.

Introduction: We conducted basic hands-on training in oxygen therapy and ventilatory management of coronavirus disease-2019 (COVID-19) patients to health care workers (HCWs) at our tertiary care hospital. We designed this study aiming to find out the impact of hands-on training in oxygen therapy for COVID-19 patients on the knowledge and degree of retention of this gained knowledge 6 weeks after the training session among HCWs. Materials and methods: The study was conducted after obtaining approval from the Institutional Ethics Committee. A structured questionnaire consisting of 15 multiple-choice questions was given to the individual HCW. This was followed by a structured 1-hour training session on "Oxygen therapy in COVID-19", following which the same questionnaire was given to the HCWs with the questions in a different order. After 6 weeks, the same questionnaire with questions in a different format was sent to the participants as a Google form. Results: A total of 256 responses were obtained for the pre-training test and post-training test. The median [IQR] pre-training test scores and post-training test scores were 8 [7-10] and 12 [10-13], respectively. The median retention score was 11 [9-12]. The retention scores were significantly higher than the pre-test scores. Conclusion: About 89% of the HCWs had a significant gain of knowledge. About 76% of the HCWs were able to retain knowledge, which also means the training program was successful. A definitive improvement in baseline knowledge was observed after 6 weeks of training. We propose conducting reinforcement training after 6 weeks of primary training to further augment retention. How to cite this article: Singh A, Salhotra R, Bajaj M, Saxena AK, Sharma SK, Singh D, et al. Retention of Knowledge and Efficacy of a Hands-on Training Session in Oxygen Therapy for COVID-19 among Healthcare Workers. Indian J Crit Care Med 2023;27(2):127-131.

Modulation of mTORC1 and IL-6 following mirror therapy and pregabalin in complex regional pain syndrome type 1.

Aim: The study was designed to evaluate the modulation of mTOR complex 1 (mTORC1) and IL-6 genes following the use of mirror therapy (MT) and pregabalin in complex regional pain syndrome type-1 patients. Materials & methods: Two groups of 20 patients: MT group received MT and pregabalin, control therapy group received pregabalin. Neuropathic pain symptom inventory (NPSI), numeric rating scale - pain, modified motor activity log, SF-12 questionnaire for quality of life and IL-6 and mTORC1 expression were evaluated. Results: Group MT demonstrated a statistically significant improvement in NPSI burning, NPSI allodynia and numeric rating scale pain scores, modified motor activity log and SF-12 scores. Significant downregulation of mTORC1 and IL-6 observed in both. Conclusion: MT is a significant adjunct to pregabalin in improving motor function, quality of life and alleviating pain in complex regional pain syndrome type 1. Clinical Trial Registration: CTRI/2019/01/017272 (ClinicalTrials.gov).

Complex regional pain syndrome is a form of long-term pain that involves an arm or a leg. It can develop after an injury, a surgery or a stroke. Although many drugs have been used for its treatment, the limited relief that these drugs produce along with their side effects have shifted focus to other physical and psychological modes of therapy. Mirror therapy is one such modality where the image of normal functioning limb seen in a mirror placed over the affected limb leads to pain relief in the affected limb. We have provided evidence that mirror therapy can reduce the pain of this syndrome and also decrease the levels of pain related genes in the body. This will help us to devise better treatment strategies for complex regional pain syndrome.

To Assess the Effect of Septoplasty on Pulmonary Function Tests: A Prospective Study.

To assess the effect of septoplasty on pulmonary function test (PFT). 50 cases were chosen between the age group 18-50. All cases had nasal obstruction due to nasal septum deviation. Demographic data, detailed clinical examination including anterior and posterior rhinoscopy was performed. PFT values (fvc, fev1, fev1/fvc, fef25%, fef50%, fef75%, fif25%, fif50%, fif75%) were taken pre operatively and 1 month after the surgery by using Helios 401 spirometer. All the data were recorded and spss version 20.0 was used to analyse the data. Among 50 patient, most of the patients were males 78% (n = 39) and the rest were females (n = 11) 22%. The patient were in between 18 and 50 age group. The maximum patient belonged to age group 18-27 years (n = 25) 50% of the total patients. 38% (n = 19) were in the age group of 27-37 years. 12% (n = 6) of the patients were in age group of 37-50. Nasal obstruction was present in all patients (n = 50) followed by sneezing (56%), nasal discharge (42%), and headache (26%). Maximum number of patient had deviation of septum to the left (n = 28) 56% and the rest had to the right (n = 22) 44%. After the surgery there was improvement in PFT values in all types of patient with DNS, but statistical significance was seen in type II in fef25% and fif75% values (p < 0.05). In rest of the patients there was no statistical significant improvement seen. A favorable outcome was seen in PFT values after Septoplasty, thus signifying the effect of deviated nasal septum on lower airway.

Chondroitin sulfate-based composites: a tour d'horizon of their biomedical applications.

Chondroitin sulfate (CS), a natural anionic mucopolysaccharide, belonging to the glycosaminoglycan family, acts as the primary element of the extracellular matrix (ECM) of diverse organisms. It comprises repeating units of disaccharides possessing ß-1,3-linked N-acetyl galactosamine (GalNAc), and ß-1,4-linked D-glucuronic acid (GlcA), and exhibits antitumor, anti-inflammatory, anti-coagulant, anti-oxidant, and anti-thrombogenic activities. It is a naturally acquired bio-macromolecule with beneficial properties, such as biocompatibility, biodegradability, and immensely low toxicity, making it the center of attention in developing biomaterials for various biomedical applications. The authors have discussed the structure, unique properties, and extraction source of CS in the initial section of this review. Further, the current investigations on applications of CS-based composites in various biomedical fields, focusing on delivering active pharmaceutical compounds, tissue engineering, and wound healing, are discussed critically. In addition, the manuscript throws light on preclinical and clinical studies associated with CS composites. A short section on Chondroitinase ABC has also been canvassed. Finally, this review emphasizes the current challenges and prospects of CS in various biomedical fields.

Alginate as a Promising Biopolymer in Drug Delivery and Wound Healing: A Review of the State-of-the-Art.

Biopolymeric nanoparticulate systems hold favorable carrier properties for active delivery. The enhancement in the research interest in alginate formulations in biomedical and pharmaceutical research, owing to its biodegradable, biocompatible, and bioadhesive characteristics, reiterates its future use as an efficient drug delivery matrix. Alginates, obtained from natural sources, are the colloidal polysaccharide group, which are water-soluble, non-toxic, and non-irritant. These are linear copolymeric blocks of α-(1→4)-linked l-guluronic acid (G) and ß-(1→4)-linked d-mannuronic acid (M) residues. Owing to the monosaccharide sequencing and the enzymatically governed reactions, alginates are well-known as an essential bio-polymer group for multifarious biomedical implementations. Additionally, alginate's bio-adhesive property makes it significant in the pharmaceutical industry. Alginate has shown immense potential in wound healing and drug delivery applications to date because its gel-forming ability maintains the structural resemblance to the extracellular matrices in tissues and can be altered to perform numerous crucial functions. The initial section of this review will deliver a perception of the extraction source and alginate's remarkable properties. Furthermore, we have aspired to discuss the current literature on alginate utilization as a biopolymeric carrier for drug delivery through numerous administration routes. Finally, the latest investigations on alginate composite utilization in wound healing are addressed.

Cubosomes as an emerging platform for drug delivery: a review of the state of the art.

Lipid-based drug-delivery nanoparticles, including non-lamellar-type, mesophasic nanostructured materials of lyotropic liquid crystals (LLCs), have been a topic of interest for researchers for their applications in the encapsulation of biopharmaceutical drugs as well as their controlled and targeted release. Cubosomes, derived from LLCs, are self-assembled cubic-phase bicontinuous crystalline nanoparticulate colloidal dispersions. Their lipid bilayers are arranged in 3D space such that they have an uninterrupted, regular cubic symmetrical surface, separated by two interconnected aqueous channels. Thus, they have a large surface area involving numerous internal segments, giving them a definitive advantage over lamellar liposomes in facilitating the efficient entrapment and sustained release of active therapeutic substances. This Review focuses on the unique properties of cubosomes, such as their ability to encapsulate hydrophobic, hydrophilic, and amphiphilic bioactive substances, which make them attractive for the encapsulation and release of therapeutic molecules, including large biomolecules. Controlled drug release via functionalization has demonstrated cubosomes as a potential vehicle for various administration routes. Their self-assembling properties make their production uncomplicated, with two major manufacturing methods: the top-down and bottom-up methods. Cubosomes are formed when amphiphilic lipids, such as monoolein, monolinolein, phytantriol, etc., self-assemble into non-lamellar bicontinuous cubic phases in excess water. In this Review, we have endeavored to outline the composition, preparation techniques, drug-encapsulation approaches, and drug-loading and -release mechanisms of cubosomes. Furthermore, the prospective routes for cubosomes, their challenges, and future potentialities are addressed.

An Otorhinolaryngologists Perspective on Using Face Masks by Health Care Professionals Based on an Online Survey.

Acute respiratory infections pose a constant threat to society and health care professionals. The effectiveness of face masks covering mouth and nose in reducing aerosol spread and curbing respiratory infection acquisition is well-studied. Despite enough beneficial evidence in favour of wearing masks, general population and the health care workers needs to be convinced to wear it and often enforcement is required for the same. This study was designed to study various barriers perceived and experienced with poor mask usage among hospital staff from an otorhinolaryngological perspective. An online survey was conducted to study the awareness of health care professionals and other hospital staff about advantages and disadvantages of mask use. Total 100 questionnaire based responses were obtained using this method. The participants included the ministerial staff, nursing and paramedical staff and faculty and residents of various medical and surgical specialties. The data thus collected was analyzed to identify the perceived benefits and limitations in mask usage. The participants wore surgical mask more commonly (50%) as compared to N95 respirator and cloth mask. 58% of the participants were using masks due to professional need. Majority (40%) used masks for a period ranging from 4 to 8 h in a day. Most of the participants realized that the masks offered protection from aerosols (90%) and more than 60% also mentioned that it helped in avoiding touching the face inadvertently. 62% participants complained of fogging of vision while wearing masks and approximately 50% reported pain due to tight elastic bands, difficulty breathing through mask and excessive sweating in the masked area In non-pharmaceutical measures to contain the aerosol-associated pandemics, face masks play an important precautionary role. It is cheap, easy to use and protects against respiratory infections, pollution and allergies. Certain minor issues like fogging of spectacles, and difficulty breathing through mask may need revisions in mask fabric and design.

Modulation of signal transduction gene expression following pulsed radiofrequency in dorsal root ganglia and pregabalin therapy.

Introduction: A randomized controlled study was conducted to assess modulation of signal transduction genes (PKA, PKC and ERK) following integrated multimodal approach encompassing pulsed radiofrequency treatment (PRF) of dorsal root ganglion and pregabalin in thoracic postherpetic neuralgia (PHN). Clinical variables such as pain intensity and quality of life were also explored. Material & methods: A total of 40 Patients of PHN were recruited. 20 patients randomly assigned to each of the two groups, group PP administered PRF with pregabalin and group SP administered pregabalin alone. Results: Significant downregulation of PKA and ERK observed in group PP at end of 10th week (p < 0.05). A significantly positive correlation demonstrated between Visual analog scale scores and signal transduction genes expression in PHN patients. Conclusion: Downregulation of all three signal transduction genes was observed following the integrated multimodal approach; however, significant downregulation was observed with PKA and ERK only. A positive correlation observed between signal transduction gene expression and visual analog scale scores signify their role in the pathogenesis of PHN.

People who had nerve pain after recovering from a herpes attack (postherpetic neuralgia) were treated with pulsed radiofrequency (PRF) treatment of the dorsal root ganglion, which involves stimulating a nerve cluster at the base of the spine with radio waves, along with oral pregabalin therapy, or with pregabalin alone. Certain pain genes such PKA, PKC and ERK were found to be suppressed after the combined treatment with PRF and pregabalin. The suppression of these genes was also associated with the self-reported pain scores of the participants in the study.

Pneumothorax in Critically Ill COVID-19 Patients in the Indian Subcontinent.

Background and aims: To explore the incidence and risk factors, as well as mortality, in critically ill COVID-19 patients who developed pneumothorax (PTX) and/or pneumomediastinum (PNM). Methods: A retrospective cohort study was undertaken to analyse data of all patients with moderate to severe COVID-19 disease who were either RTPCR positive or had a clinico-radiological diagnosis. The exposure group consisted of COVID-19 patients who presented with PTX/PNM, whereas the non-exposure group consisted of patients who did not develop PTX and/or PNM during the stay. Results: Incidence of PTX/PNM was observed to be 1.9% among critically ill COVID-19 patients. 94.4% (17/18) of patients in the PTX group received positive pressure ventilation (PPV); the majority of these patients were on non-invasive ventilation when they developed PTX/PNM; only one patient was receiving conventional oxygen therapy. COVID-19 patients who developed PTX/PNM had 2.7 times higher mortality. A mortality rate of 72.2% was observed in COVID-19 patients who developed PTX/PNM. Conclusion: Development of PTX/PNM in critically ill COVID-19 patients is associated with more severe disease involvement, and institution of PPV is an additional risk factor. Significantly high mortality was observed following PTX/PNM in critically ill COVID-19 patients and is an independent marker of poor prognosis in COVID-19 disease.

Ectopic thyroid in left parotid gland with an orthotopic thyroid gland: A rare case scenario.

Benign ectopic thyroid tissue within the parotid gland is very rare with only one case reported till date in the world literature. We report a case of ectopic thyroid in the left parotid gland with an orthotopic thyroid in an elderly female, who was presented to us with the simultaneous onset of right-sided thyroid swelling and left parotid swelling for 6 months. Fine-needle aspiration cytology (FNAC) was done from both the swellings and a diagnosis of Hurthle cell neoplasm metastasizing to the left parotid gland was initially made. However, histopathological examination along with the immunohistochemistry (IHC) panel proved it to be an ectopic thyroid in the parotid. The case is being documented here for its rarity as well as an unusual presentation so that the readers are aware of this entity and the complete workup required to prevent diagnostic pitfalls.

Pseudocyst in Neck: A Case Report on Rare Complication of Ventriculoperitoneal Shunt.

INTRODUCTION: Ventriculoperitoneal shunt is a common neurosurgical procedure, for the definitive management of hydrocephalus. Shunt failures may occur due to various causes but are usually due to infections in adults and catheter occlusion in the paediatric population. Case Report. The 13-year-old girl presented with a right lateral neck swelling. In detailed history, she was found to be an old case of ventriculoperitoneal shunt. The clinical examination and radiological investigation revealed proximal dislodgment of the stent from the cranium, causing persistent cerebrospinal fluid (CSF) leak and pseudocyst formation in the neck. CONCLUSION: The case highlights CSF pseudocyst formation as a rare differential for lateral neck swellings.

Perioperative "stress dose" of corticosteroid: Pharmacological and clinical perspective.

Various exogenous steroid preparations have been in use for a wide range of indications. We, as an anesthesiologist often encounters a surgical patient receiving chronic steroid therapy. Perioperative use of steroid is associated with major complications such as full-blown adrenal crisis in the perioperative period due to the secondary adrenal insufficiency. Henceforth, comes the role of the perioperative "stress-dose" of steroids to mitigate this rare but potentially fatal complication. There have been opposing views regarding the need and the appropriate dosage of the perioperative steroids. The present review discusses the changing concept of perioperative "stress dose" of corticosteroids, its pharmacokinetics, clinical relevance, and the related controversies such as the need and the appropriate dose.