Green Synthesis of Zinc Oxide Nanoparticles from Althaea officinalis Flower Extract Coated with Chitosan for Potential Healing Effects on Diabetic Wounds by Inhibiting TNF-α and IL-6/IL-1ß Signaling Pathways.

Background: Diabetes Mellitus is a multisystem chronic pandemic, wound inflammation, and healing are still major issues for diabetic patients who may suffer from ulcers, gangrene, and other wounds from uncontrolled chronic hyperglycemia. Marshmallows or Althaea officinalis (A.O.) contain bioactive compounds such as flavonoids and phenolics that support wound healing via antioxidant, anti-inflammatory, and antibacterial properties. Our study aimed to develop a combination of eco-friendly formulations of green synthesis of ZnO-NPs by Althaea officinalis extract and further incorporate them into 2% chitosan (CS) gel. Method and Results: First, develop eco-friendly green Zinc Oxide Nanoparticles (ZnO-NPs) and incorporate them into a 2% chitosan (CS) gel. In-vitro study performed by UV-visible spectrum analysis showed a sharp peak at 390 nm, and Energy-dispersive X-ray (EDX) spectrometry showed a peak of zinc and oxygen. Besides, Fourier transforms infrared (FTIR) was used to qualitatively validate biosynthesized ZnO-NPs, and transmission electron microscope (TEM) showed spherical nanoparticles with mean sizes of 76 nm and Zeta potential +30mV. The antibacterial potential of A.O.-ZnO-NPs-Cs was examined by the diffusion agar method against Gram-positive (Staphylococcus aureus and Bacillus subtilis) and Gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa). Based on the zone of inhibition and minimal inhibitory indices (MIC). In addition, an in-silico study investigated the binding affinity of A.O. major components to the expected biological targets that may aid wound healing. Althaea Officinalis, A.O-ZnO-NPs group showed reduced downregulation of IL-6, IL-1ß, and TNF-α and increased IL-10 levels compared to the control group signaling pathway expression levels confirming the improved anti-inflammatory effect of the self-assembly method. In-vivo study and histopathological analysis revealed the superiority of the nanoparticles in reducing signs of inflammation and wound incision in rat models. Conclusion: These biocompatible green zinc oxide nanoparticles, by using Althaea Officinalis chitosan gel ensure an excellent new therapeutic approach for quickening diabetic wound healing.

Highly selective detection of 2,4-dinitrophenol by fluorescent NH2-MIL-125(Ti) via dual-parameter sensing technology.

The organic contaminant 2,4-dinitrophenol (2,4-DNP) is widely prevalent and poses significant risks to human health. Although numerous in-depth studies having been reported on the highly sensitive detection of 2,4-DNP, there are still challenges to its selective detection. Here, the fluorescence intensity ratio (I0/I) and emission peak shift (Δλ) were utilized for selective detection of 2,4-DNP by NH2-MIL-125(Ti). Notably, the emission peak of the NH2-MIL-125(Ti) suspension exhibited a remarkable red shift in the presence of 2,4-DNP (Δλ = 26 nm), accompanied by the blue shift or weak red shift of analogs, which provided a solid basis for selective detection of 2,4-DNP. Meanwhile, the I0/I ratio of the NH2-MIL-125(Ti) suspension exhibited a robust linear correlation with 2,4-DNP at the low concentration range (0-70 µM). The interaction of the analyte with NH2-MIL-125(Ti) was revealed to involve intermolecular charge transfer (ICT) and fluorescence resonance energy transfer (FRET) through XPS, FTIR, and UV-vis absorption spectroscopy. Additionally, we achieved the detection of 2,4-DNP using a smartphone by recognizing both the blue (B) values and the luminance (L) values. The obtained results demonstrated that the NH2-MIL-125(Ti) probe based on dual-parameter sensing technology exhibited excellent potential for selectively detecting 2,4-DNP in water environments, thereby offering significant prospects for its application in water quality assessment.

Unraveling the effects of zinc sulfate nanoparticles and potassium fertilizers on quality of maize and associated health risks in Cd contaminated soils under different moisture regimes.

This study investigated the interactive effects of zinc sulfate nanoparticles (ZnSO4 NPs) and potassium fertilizers (SOP and MOP) on growth and quality of maize (Zea mays L.) under different moisture regimes in cadmium contaminated soils. It seeks to identify how these two different sources of nutrients interact to improve the quality of maize grains and fodder production to ensure food safety and food security under abiotic stresses. The experiment was conducted in a greenhouse under two moisture regimes including M1 (non-limiting regime, 20-30 %) and M2 (water-limiting, 10-15 %) at Cd contamination of 20 mg kg-1. The results showed that ZnSO4 NPs combined with potassium fertilizers significantly increased the growth and proximate composition of maize in Cd contaminated soil. Moreover, applied amendments significantly alleviated the stress induced in maize by improving the growth. The greatest increase in maize growth and quality was observed when ZnSO4 NPs were applied in combination with SOP (K2SO4). The results also showed that the interactive effects of ZnSO4 NPs and potassium fertilizers significantly affected the Cd bioavailability in soil and concentration in plants. It was observed that MOP (KCl) enhanced the Cd bioavailability in soil due to presence of Cl anion. In addition, the application of ZnSO4 NPs combined with SOP fertilizer reduced the concentration of Cd in maize grain and shoot, and significantly reduced the probable health risks to humans and cattle. It suggested that this strategy could help to reduce Cd exposure through food consumption and therefore ensure food safety. Our findings suggest that ZnSO4 NPs and SOP can be used synergistically to improve maize crop production and development of agricultural practices in areas affected by Cd contamination. Moreover, by understanding the interactive effects of these two sources of nutrients, this research could help in the management of areas affected by heavy metals contamination. ENVIRONMENTAL IMPLICATION: The application of zinc and potassium fertilizers can increase the biomass of maize, minimize abiotic stresses, and improve the nutritional value of the crop in Cd contaminated soils; this is particularly true when zinc sulfate nanoparticles and sulfate of potash (K2SO4) are used in conjunction. This form of fertilizer management can lead to a greater, more sustainable yield of maize under contaminated soils, which could have a major impact on global food supply. Remediation coupled with agro-production (RCA) not only improves the effectiveness of the process but will also encourage farmers to take part in soil remediation by easy management.

Latent Tuberculosis Infection (LTBI) as a predictor of coronary artery disease: A systematic review and meta-analysis.

Background: A converging epidemic of Latent tuberculosis infection (LTBI) is observed over past two decades. LTBI is a state of persistent immune stimulation by Mycobacterium tuberculosis but with no active clinical manifestation. Also, there has been as increasing trend for incidence of cardiovascular problems in patients suffering from latent TB infection. Reportedly, the risk of coronary artery disease spikes up to 1.52 times in patient with latent TB infection. Considering the fact that cardiovascular diseases account to be leading cause of death globally, we found a dire need to investigate the role of Latent TB infection in producing coronary artery disease and unveil this unconventional relationship. Purpose: We aim to conduct a meta-analysis to evaluate Latent TB infection as a predictor for coronary artery disease (CAD). Methods: A systemic search was conducted on electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to 24th June 2022. Studies meeting predefined inclusion criteria underwent statistical analysis on Review Manager 5.4.1. We calculated odds ratio (OR) with 95% confidence intervals (CI) and graphically represented it through fixed-effect forest plot. Heterogeneity of I2>75% and p-value of p < 0.05 was considered to be significant. Results: Pooled analysis of four selected studies showed that patient with Latent TB infection significantly developed Coronary Artery Disease (OR = 2.15 [1.48, 3.12]; p < 0.0001; I 2  = 0%). Conclusions: Latent TB infection can be a potential useful predictor for Coronary Artery Disease. However, there is need for further investigation on a greater number of studies before this can truly become clear.

Impact of LULC on debris flow using linear aggression model from Gilgit to Khunjerab with emphasis on urban sprawl.

In this research, the impact of land use and land cover (LULC) on debris flow was evaluated in the Gilgit to Khunjerab region. Two events have been done: (i) LULC stimulations for 2026 and 2030 using the MOLUSCE plugin and (ii) debris flow susceptibility mapping using linear aggression model. The evaluation of LULC on debris flow susceptibility is based on two scenarios: (i) existing (2010, 2014, 2018, 2022) LULC scenarios and (ii) stimulated (2026, 2030) LULC scenarios. The linear aggression model has 16 contributing factors to developing the debris flow susceptibility mapping. The main contributing components in debris flow susceptibility mapping are slope and LCCS. According to the linear aggressiveness model, debris flow susceptibility grows as the LULC changes, and the high susceptibility zones' share increases. For the current years 2010, 2014, 2018, and 2022, as well as the stimulated years 2026 and 2030, the model had high success rates (> 90.0%) and prediction rates (> 85.0%). The findings backed up prior research and suggested that the impact of LULC will grow in the future.

Is percutaneous gastrostomy tube insertion contraindicated in adult peritoneal dialysis patients? A single-centre experience of three successful cases: It is time to revisit.

Percutaneous endoscopic gastrostomy (PEG) tube placement in adults who are already established on peritoneal dialysis (PD) remains challenging due to the limited experience and data in this area which lacks clear guidance. Given the fact that peritoneal dialysis is one of the relative contraindications for PEG tube insertion, and PEG tube on its own is a risk for peritonitis, how to overcome these obstacles and utilize the advantage of PEG tube for feeding malnourished PD patients remains uncertain. Here we report our unique successful experience of treating three adult peritoneal dialysis patients in whom the PEG tube was inserted successfully with no complications. To the best of our knowledge, this is the first successful case series in the literature for treating adult prevalent PD patients by PEG tube placement.

Skin Cancer Detection: A Review Using Deep Learning Techniques.

Skin cancer is one of the most dangerous forms of cancer. Skin cancer is caused by un-repaired deoxyribonucleic acid (DNA) in skin cells, which generate genetic defects or mutations on the skin. Skin cancer tends to gradually spread over other body parts, so it is more curable in initial stages, which is why it is best detected at early stages. The increasing rate of skin cancer cases, high mortality rate, and expensive medical treatment require that its symptoms be diagnosed early. Considering the seriousness of these issues, researchers have developed various early detection techniques for skin cancer. Lesion parameters such as symmetry, color, size, shape, etc. are used to detect skin cancer and to distinguish benign skin cancer from melanoma. This paper presents a detailed systematic review of deep learning techniques for the early detection of skin cancer. Research papers published in well-reputed journals, relevant to the topic of skin cancer diagnosis, were analyzed. Research findings are presented in tools, graphs, tables, techniques, and frameworks for better understanding.

Fluoride sensing performance of fluorescent NH2-MIL-53(Al): 2D nanosheets vs. 3D bulk.

Due to their ultra-thin morphology, larger specific surface area and more exposed active sites, two-dimensional (2D) metal-organic framework (MOF) nanosheets can break the limitations of three-dimensional (3D) MOFs in sensitivity, response speed and the limit of detection for sensing applications. In this work, fluorescent NH2-MIL-53(Al) nanosheets were developed as a fluoride detection sensor compared with the 3D bulk counterpart. The morphological and structural characteristics of the obtained products were systematically characterized, and the favourable chemical and fluorescence stability of the NH2-MIL-53(Al) nanosheets were explored. The fluorescent NH2-MIL-53(Al) nanosheets showed high sensitivity, fast response speed (as short as 10 seconds), low limit of detection (15.2 ppb), and wide linear detection range (5-250 µM), and all performances were better than those of their bulk counterpart. In addition, the sensing mechanism was investigated to be based on the transformation of the NH2-MIL-53(Al) framework that induced the release of fluorescent ligands, resulting in an exceptionally enhanced fluorescence. This work highlights the advantages of 2D MOF nanosheets in fluorescence sensing applications.

Highly fluorescent scandium-tetracarboxylate frameworks: selective detection of nitro-aromatic compounds, sensing mechanism, and their application.

Recently, exploring new luminescent metal-organic frameworks (LMOFs) to selectively detect nitro-aromatic compounds (NACs) has been a hot topic of research. Simultaneously, it is still a challenging issue to understand the sensing mechanism of luminescent MOFs interacting with NACs at the molecular level. In this work, highly fluorescent Sc-tetracarboxylate frameworks (Sc-EBTC) have been successfully synthesized through a solvothermal method. The as-prepared Sc-EBTC crystals have good thermal stability, chemical stability as well as strong fluorescence (λex = 320 nm and λem = 400 nm), and they can detect various NACs rapidly (as short as 30 s), selectively and efficiently by the "turn-off" fluorescence mechanism. The detection limits of Sc-EBTC toward 2,4-DNP and 4-NP are quantified to be 5.71 ppb and 6.26 ppb, respectively. Furthermore, to better understand the sensing mechanism, we attempt to use solid-state NMR and X-ray photoelectron spectroscopy to vividly characterize the charge transfer caused by the interaction between NAC molecules and the MOF at the molecular level. Additionally, test strips were made successfully for the practical detection of the NACs. This study demonstrates that the MOF constructed from the H4EBTC ligands might be a promising candidate for the detection of trace NACs.

Bio-inspired porous helical carbon fibers with ultrahigh specific surface area for super-efficient removal of sulfamethoxazole from water.

Helical carbon fibers (HCFs) are a new kind of fascinating carbon material, and have caused much attention for their distinctive features, diversified novel properties, and applications. However, the application of HCFs still faces a series of barriers, especially in the repetitive preparation of HCFs. In this paper, we initially report the synthesis of the HCFs with ultrahigh specific surface area (3089 m2 g-1) by a bio-template process using the high purified spiral vessels (SVs) as the template. The helical structure with the ultrahigh specific surface area can efficaciously shorten the pathway for antibiotics diffusion, and the high content of nanopores (1 to 3 nm) not only guarantees the accessibility of the surface for antibiotics storage but also easily provides approachable channels for antibiotics transmission. The highest adsorption capacity for sulfamethoxazole (SMX) is 1091 mg/g at pH 6.0 ± 0.1 with a stable temperature of 20 °C when the initial SMX concentration is 80 mg/L. This study motivates a new bio-inspired design for preparing the high purified HCFs with a simple bio-template method. The results show that the porous HCFs are a new kind of ultrahigh adsorption material for the removal of SMX in aqueous solution and can be used in new technological applications.

Comparative Analysis of Eleven Healthcare-Associated Outbreaks of Middle East Respiratory Syndrome Coronavirus (Mers-Cov) from 2015 to 2017.

Since its emergence in 2012, 2,260 cases and 803 deaths due to Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported to the World Health Organization. Most cases were due to transmission in healthcare settings, sometimes causing large outbreaks. We analyzed epidemiologic and clinical data of laboratory-confirmed MERS-CoV cases from eleven healthcare-associated outbreaks in the Kingdom of Saudi Arabia and the Republic of Korea between 2015-2017. We quantified key epidemiological differences between outbreaks. Twenty-five percent (n = 105/422) of MERS cases who acquired infection in a hospital setting were healthcare personnel. In multivariate analyses, age ≥65 (OR 4.8, 95%CI: 2.6-8.7) and the presence of underlying comorbidities (OR: 2.7, 95% CI: 1.3-5.7) were associated with increased mortality whereas working as healthcare personnel was protective (OR 0.07, 95% CI: 0.01-0.34). At the start of these outbreaks, the reproduction number ranged from 1.0 to 5.7; it dropped below 1 within 2 to 6 weeks. This study provides a comprehensive characterization of MERS HCA-outbreaks. Our results highlight heterogeneities in the epidemiological profile of healthcare-associated outbreaks. The limitations of our study stress the urgent need for standardized data collection for high-threat respiratory pathogens, such as MERS-CoV.

Augmentation with potential endophytes enhances phytostabilization of Cr in contaminated soil.

The contamination of soil with heavy metals is a major environmental problem worldwide. The combined use of plants and their associated microbes has gained popularity in recent years for their potential to remediate heavy metal-contaminated soil. In the current study, the effect that augmentation of soil with plant growth-promoting endophytes has on the phytostabilization of chromium (Cr)-contaminated soil was investigated. Three potential endophytic bacterial strains (Enterobacter sp. HU38, Microbacterium arborescens HU33, and Pantoea stewartii ASI11) were inoculated individually as well as in combination to Leptochloa fusca and Brachiaria mutica vegetated in Cr-contaminated soil. The accumulation of Cr in the root and shoot of the plants was determined. Moreover, bacterial persistence in the rhizosphere and endosphere was determined. Augmentation with potential endophytes significantly increased root length (24-45%), shoot height (39-64%), chlorophyll content (20-55%), and the overall biomass (32-61%) of the plants. Although L. fusca and B. mutica showed potential to accumulate Cr in their root and shoot, endophytic augmentation increased uptake, translocation, and accumulation of Cr in the roots and shoots of both plant species. However, L. fusca showed more potential to phytostabilize Cr as compared to B. mutica. Furthermore, the potential endophytes showed more survival and persistence within the roots than in the rhizosphere and shoot interior. This study provides useful evidence of endophyte-assisted phytoremediation to be the most sustainable and affordable approach for in situ remediation of Cr-contaminated soil.

Strengthening health security at the Hajj mass gatherings: characteristics of the infectious diseases surveillance systems operational during the 2015 Hajj.

BACKGROUND: Hajj is one of the largest and the most ethnically and culturally diverse mass gatherings worldwide. The use of appropriate surveillance systems ensures timely information management for effective planning and response to infectious diseases threats during the pilgrimage. The literature describes infectious diseases prevention and control strategies for Hajj but with limited information on the operations and characteristics of the existing Hajj infectious diseases surveillance systems. METHOD: We reviewed documents, including guidelines and reports from the Saudi Ministry of Health's database, to describe the characteristics of the infectious diseases surveillance systems that were operational during the 2015 Hajj, highlighting best practices and gaps and proposing strategies for strengthening and improvement. Using Pubmed and Embase online search engines and a combination of search terms including, 'mass gatherings' 'Olympics' 'surveillance' 'Hajj' 'health security', we explored the existing literature and highlighted some lessons learnt from other international mass gatherings. RESULTS: A regular indicator-based infectious disease surveillance system generates routine reports from health facilities within the Kingdom to the regional and central public health directorates all year round. During Hajj, enhanced indicator-based notifiable diseases surveillance systems complement the existing surveillance tool to ensure timely reporting of event information for appropriate action by public health officials. CONCLUSION: There is need to integrate the existing Hajj surveillance data management systems and to implement syndromic surveillance as an early warning system for infectious disease control during Hajj. International engagement is important to strengthen Hajj infectious diseases surveillance and to prevent disease transmission and globalization of infectious agents which could undermine global health security.

Kikuchi disease.

Kikuchi-Fujimoto Disease or Necrotizing Lymphadenitis is a rare, benign, self-limiting disease. It usually effects young females in the third decade of life. The most common presentation is cervical lymphadenopathy, though the etiology of the disease is still controversial. Clinical findings, histological diagnosis and immunohistochemistry help in diagnosis. Once diagnosed, steroids have been found to alleviate symptoms in patients with systemic manifestations. Antibiotics should not be prescribed until infective element is identified. We report the case of a female patient who presented with tender cervical lymphadenopathy. She was diagnosed on excision biopsy of one of her lymph nodes. Anti-inflammatory drugs were started but the disease relapsed briefly after. Her symptoms have improved remarkably after initiation of steroid therapy, since her relapse.

Pharmacological importance of an ethnobotanical plant: Capsicum annuum L.

Capsicum annuum L., a fruit plant from tropical and subtropical regions, contains a range of essential nutrients and bioactive compounds which are known to exhibit a range of bioactivities including free radical scavenging (antioxidant), antimicrobial, antiviral, anti-inflammatory and anticancer. This review aims to give a comprehensive overview of the literature published on pharmacological behaviours of C. annuum L.

Castleman disease.

Castleman and Towne described a disease presenting as a mediastinal mass resembling thymoma. It is also known as "giant lymph node hyperplasia", "lymph node hamartoma", "angiofollicular mediastinal lymph node hyperplasia", and "angiomatous lymphoid hyperplasia". The pathogenesis is unknown, but the bulk of evidence points toward faulty immune regulation, resulting in excessive B-lymphocyte and plasma-cell proliferation in lymphatic tissue. In addition to the mediastinal presentation, extrathoracic involvement in the neck, axilla, mesentery, pelvis, pancreas, adrenal gland, and retroperitoneum also have been described. There are 2 major pathologic variations of Castleman disease: (1) hyaline-vascular variant, the most frequent, characterized by small hyaline-vascular follicles and capillary proliferation; and (2) the plasma-cell variant, in which large lymphoid follicles are separated by sheets of plasma cells. The hyaline-vascular cases usually are largely asymptomatic, whereas the less common plasma-cell variant may present with fever, anemia, weight loss, and night sweats, along with polyclonal hypergamma-globulinemia. Castleman disease is a rare lymphoproliferative disorders. Few cases have been described world widely. In this article we reviewed the classification, pathogenesis, pathology, radiological features and up to date treatment with special emphasis on the role of viral stimulation, recent therapeutic modalities and the HIV-associated disease.

Castleman disease / 대한혈액학회지

Castleman and Towne described a disease presenting as a mediastinal mass resembling thymoma. It is also known as "giant lymph node hyperplasia", "lymph node hamartoma", "angiofollicular mediastinal lymph node hyperplasia", and "angiomatous lymphoid hyperplasia". The pathogenesis is unknown, but the bulk of evidence points toward faulty immune regulation, resulting in excessive B-lymphocyte and plasma-cell proliferation in lymphatic tissue. In addition to the mediastinal presentation, extrathoracic involvement in the neck, axilla, mesentery, pelvis, pancreas, adrenal gland, and retroperitoneum also have been described. There are 2 major pathologic variations of Castleman disease: (1) hyaline-vascular variant, the most frequent, characterized by small hyaline-vascular follicles and capillary proliferation; and (2) the plasma-cell variant, in which large lymphoid follicles are separated by sheets of plasma cells. The hyaline-vascular cases usually are largely asymptomatic, whereas the less common plasma-cell variant may present with fever, anemia, weight loss, and night sweats, along with polyclonal hypergamma-globulinemia. Castleman disease is a rare lymphoproliferative disorders. Few cases have been described world widely. In this article we reviewed the classification, pathogenesis, pathology, radiological features and up to date treatment with special emphasis on the role of viral stimulation, recent therapeutic modalities and the HIV-associated disease.

Childhood vitiligo: a long-term study of localized vitiligo treated by noncultured cellular grafting.

Segmental type was the second most commonly reported in childhood vitiligo. No significant difference has been reported in the prevalence of childhood and adult focal vitiligo. However, the prevalence of segmental vitiligo has been found to be higher in children compared with that in adults. All available medical and phototherapy options are limited by adverse effects or unsatisfactory efficacy. Surgical techniques may be preferred but are not recommended for children as they are time consuming and associated with technical difficulties. In a retrospective review, 25 children aged 4 to 16 years were treated by autologous, noncultured cellular grafting performed under sedation supplemented with local anaesthesia and were followed up for a period of 9 to 54 months postgrafting. Repigmentation was graded as excellent with 95% to 100% pigmentation, good with 65% to 94%, fair with 25% to 64%, and poor with 0% to 24% of the treated area. In the segmental group, eight (62%) showed excellent, two (15%) good, one (8%) fair, and two (15%) poor pigmentation, which was retained until the end of the respective follow-up period. In the focal group, nine (75%) showed excellent, and one (8%) each showed good, fair, and poor pigmentation, which was retained until the end of the respective follow-up period. Noncultured cellular grafting may be considered to treat childhood localized vitiligo.

Effect of single oral dose of sodium rabeprazole on the intragastric pH & volume in patients undergoing elective surgery.

BACKGROUND & OBJECTIVE: While evaluating the effectiveness of drugs used for the prophylaxis of acid aspiration of gastric contents, the impact of duodeno-gastric reflux on gastric contents has not been studied earlier. This study was carried out to evaluate the effect of preanaesthetic oral administration of sodium rabeprazole on pH and volume of gastric contents in adult patients undergoing elective surgery by excluding cases contaminated with duodeno-gastric refluxate. METHODS: The patients in group C (control) in the triple blind placebo controlled trial received placebo while group S sodium rabeprazole 20 mg orally at 2100 h, a night before elective surgery. Next day, gastric contents were aspirated with a large bore, multi-orifices gastric tube passed through an endotracheal tube placed blindly in oesophagus after tracheal intubation and analyzed for the presence of bile salts, pH and volume. The pH and volume of gastric contents were the primary and duodeno-gastric reflux secondary outcome measures of the study. RESULTS: The pH and volume of group S-2 were 3.97+/-1.78 and 9.48+/-8.39 ml respectively compared with 1.90+/-0.47 and 19.60+/-18.56 ml of group C-2. Sodium rabeprazole, after excluding contaminated cases with duodeno-gastric refluxate, significantly increased the pH (P<0.001), decreased the volume of gastric contents (P<0.005) and the proportion of the patients (30.76 vs 2.63%) considered at risk compared with placebo (P<0.001) according to the criteria defined (pH < 2.5 and volume > 25 ml). Thirty nine samples (33.33%) out of 117 were contaminated with duodenal contents. Duodenogastric reflux significantly (P<0.001) affected pH and volume of gastric in both groups C-1 vs C-2 and S-1 vs S-2. INTERPRETATION & CONCLUSION: Sodium rabeprazole 20 mg given orally a night before surgery provided adequate prophylaxis for acid aspiration syndrome at the time of induction of anaesthesia and duodeno-gastric reflux significantly affected both the pH and volume of gastric contents.