Endoscopic Versus Microscopic Stapedotomy: A Randomized Clinical Trial.

OBJECTIVE: To determine the outcomes and complications of endoscopic versus microscopic stapes surgery in patients with otosclerosis. STUDY DESIGN: Randomized, single-blinded clinical trial. METHODS: Patients with otosclerosis who underwent either trans-canal microscopic or endoscopic stapedotomy at a tertiary care hospital were compared. Thirty-two patients were randomly divided into two groups using blocked randomization. Group A consisted of 16 patients who underwent trans-canal microscopic stapedotomy, and group B consisted of 16 patients who underwent trans-canal endoscopic stapedotomy. Postoperative vertigo, ear pain, and complications such as tympanic membrane perforation or chorda tympani nerve injury were evaluated. Three months postoperatively, patients were assessed for dysgeusia and hearing improvement. RESULTS: The mean pre-operative air-bone gap (ABG) in the microscopic and endoscopic groups was 32.81 ± 6.82 and 30.00 ± 7.96, respectively. The mean improvement in the ABG was 25.45 ± 11.21 dB in the microscopic group and 23.21 ± 10.68 dB in the endoscopic group. Although both techniques showed improvement in auditory outcomes (p-value <0.001), there were no statistical differences between the endoscopic and microscopic groups in the pre-operative, post-operative, and mean improvement of ABG (p-value >0.05). There were no significant differences between the two methods in chorda tympanic nerve injury, vertigo scores, and the mean operating time (p-value >0.05), but the mean pain score was higher in the microscopic group (2.56 ± 1.55 in the microscopic group versus 1.31 ± 0.70 in the endoscopic group) (p-value = 0.003). CONCLUSIONS: Endoscopic stapes surgery can be a preferable alternative to conventional microscopic stapedotomy, as it yields similar hearing outcomes and lower pain scores. LEVEL OF EVIDENCE: 2 Laryngoscope, 134:2395-2400, 2024.

Microfluidics combined with ionic gelation method for production of nanoparticles based on thiol-functionalized chitosan to adsorb Hg (II) from aqueous solutions.

This work aimed at producing nanoparticles (NPs) based on thiol-functionalized chitosan (CS) using capillary microfluidic (MF) device combined with ionic gelation method to adsorb mercury ion [Hg (II)] from aqueous solutions. In this line, CS was functionalized with epichlorohydrin/cysteaminium chloride (2.73 M ratio) followed by fabricating NPs via MF and bulk mixing (BM) methods. To characterize the morphology, zeta potential, functionality, structure, and magnetic property of the samples, a series of tests such as SEM, TEM, DLS, FTIR, XRD, and VSM were carried out, respectively. The obtained results showed that MF technique was able to produce NPs with a diameter as small as 18 ±â€¯3 nm, and a uniform shape compared to BM method. Thiol groups (-SH) functionalization on CS surface was confirmed by appearing a characteristic peak at 2579 cm-1. Also, the XRD patterns indicated the appropriate synthesis of Fe3O4 (magnetite), and no change in the structure of CS NPs in the presence of magnetite. Moreover, adding the magnetite to thiol-functionalized CS NPs led to suitable saturation magnetization about 26 emu/g to facilitate their separation using a magnetic field. To evaluate the performance of the nanoadsorbent, it has been exposed to Hg (II) in an aqueous solution which in turn the parameters optimization for the adsorption was done via Box-Behnken design (BBD) method, exhibiting the effect of adsorbent dose and the initial concentration of Hg (II) was much more significant than that of pH. Different concentrations of total dissolved solids up to 1000 mg/L had no adverse impact on the adsorption process confirmed by EDAX spectra. The least value of RMSE (5.023) and χ2 (0.3) were observed for Redlich-Peterson, Radke-Prausnitz, and UT isotherms. Maximum adsorption capacities calculated using Langmuir and UT models were 1192 mg/g and 1126 mg/g, respectively. Thermodynamic studies demonstrated that the nature of the adsorption process was spontaneous and endothermic. Recovery of nanoadsorbent was successfully carried out using HCl 0.5 mol/L. The adsorption studies revealed that the prepared nanoadsorbent is promising candidate used in mercury removal from a real wastewater potentially.

Role of l-arginine/SNAP/NO/cGMP/KATP channel signalling pathway in antinociceptive effect of α-terpineol in mice.

OBJECTIVES: The main purpose of this study was to assess the role of l-arginine/SNAP/NO/cGMP/KATP channel pathway in analgesic effects of α-terpineol in mice. METHODS: Male NMRI mice were pretreated intraperitoneally with NO precursor (l-arginine, 100 mg/kg), NO synthase inhibitor (l-NAME, 30 mg/kg), NO donor (SNAP, 1 mg/kg), guanylyl cyclase inhibitor (methylene blue, 20 mg/kg), PDE inhibitor (sildenafil, 0.5 mg/kg), KATP channel blocker (glibenclamide, 10 mg/kg) and naloxone (2 mg/kg) 20 min before the administration of α-terpineol. The formalin test was performed 20 min after the administration of α-terpineol, and nociceptive responses of mice were recorded during 30 min. KEY FINDINGS: A significant and dose-dependent antinociception was produced by α-terpineol (40 and 80 mg/kg) in both the phases of formalin test. The antinociceptive effect of α-terpineol was significantly potentiated by l-arginine in the second phase while significantly antagonized by l-NAME in both phases of formalin test. Also, SNAP and sildenafil non-significantly enhanced-while methylene blue significantly diminished-the antinociceptive effect of α-terpineol in both phases of formalin test. Glibenclamide significantly reversed the α-terpineol-induced antinociception, indicating the involvement of KATP channels in antinociceptive effect of α-terpineol. CONCLUSIONS: These results indicate that the antinociceptive effect of α-terpineol is mediated through l-arginine/SNAP/NO/cGMP/KATP channel pathway.