High fibre and fluid intake increase the success of hypospadias surgery.

INTRODUCTION: Hypospadias is a congenital malformation of the urethral meatus in the ventral penis that requires surgery. Fibre and fluid intake can accelerate the healing process, act as an anti-inflammatory and support the success of surgery. Based on hypospadias objective scoring evaluation (HOSE) scoring, this study aims to determine whether a high-fibre diet and adequate fluid intake affect the outcome of hypospadias surgery. MATERIALS AND METHODS: This analytic observational study used a case-control study design on 104 post-operative hypospadias patients at Ulin and Siaga Hospital Banjarmasin from 2018 to 2023 with quota sampling. Data were collected using personal data forms with hypospadias objective scoring evaluation (HOSE) and semi-quantitativefood frequency questionnaire (SQ-FFQ), which were analysed using a multinomial logistic regression test. RESULTS: Patients with less-fibre-intake had a 99.10% lower chance of having an excellent surgical outcome than patients with moderate-fibre-intake (Adjusted Odds Ratio, Adj. OR: 0.009, 95% Confidence Intervals; 95%CI: 0.000, 0.249), and it was statistically significant. The study did not find any association between fluid intake and surgical outcome, this could be due to the fact that most of the patient had good fluid intake. CONCLUSION: The study found that high fibre intake increases the success of hypospadia surgery.

Effect of light and cytokinin on growth and curculin gene expression of Curculigo latifolia on in vitro culture.

Despite being valuable for producing a natural sweetener Curculin, Curculigo latifolia has a low growth and difficult to domestificate. So, to solve this problem, propagation on in vitro culture will be an alternative method to propagated this spesies under different cytokinins and light condition. Cytokinins and light has major role in organogenesis, growth and gene expression of many species. Thus, in this study, we aimed to improve the Curculigo latifolia growth on in vitro condition and expression of curculin gene by combining cytokinins addition and different light exposure. Four weeks seedlings were sub-cultured into medium (MS free hormone) containing 3 mg/L benzyladenine (BA) and various concentrations of meta-Topolin (mT) including 0.1 mg/L, 0.5 mg/L, and 5 mg/L. The cultures then incubated under different light types (red, blue, white LED lights and white fluorescence light) with 16-h light/ 18-h dark photoperiod for 14 weeks at 25 ± 2°C. Several parameters, including plant height, leaf number, chlorophyll contents, stomatal structure, and density and curculin expression, were observed every week. Unexpectedly, our results showed that C. latifolia growth displayed significant improvement when it was treated under white LED light without any additional cytokinins. In sum, white LED light further improves plantlets phenotype, such as plant height, leaf number, chlorophyll production, and stomatal number and structure, whereas, red LED light lead to a decreased phenotypes but increase the curculin gene expression.

Comparison of Outcomes Between All-Inside Single-Bundle and Double-Bundle Anterior Cruciate Ligament Reconstruction: A Retrospective Study.

Introduction: ACL rupture is the most common type of knee injury. The All-inside ACL reconstruction procedure features some distinguished components including closed-socket tunnels with less bone expulsion, double suspensory fixation, and smaller incisions. We aimed to compare the outcomes between the All-inside Single-bundle and the Double-bundle ACL reconstruction techniques. Materials and methods: This study was a retrospective study which analysed the patient-reported and the clinical outcomes on patients who underwent ACL reconstruction between January and December 2020 at Dr Kariadi General Hospital Semarang, Indonesia. We compared the patient-reported and the clinical outcomes at 6- and 12-month follow-ups between the All-inside Single-bundle and the Double-bundle groups. The patient-reported outcomes were determined using the IKDC and Tegner-Lysholm scores while the clinical outcomes included the measurement of Thigh Circumference, Single Hop test, Anterior Drawer test, Lachman test, Range of motion, and the patient's level of return to sport. Results: A total of 24 subjects were divided into two groups, namely the All-inside Single-bundle and the Double-bundle groups, consisting of 12 subjects in each group. Most of the subjects were male in both groups, including 9 (75%) subjects in the All-inside Single-bundle group, and 11 (91.67%) subjects in the Double-bundle group. The mean age of the subjects were 25.75±7.57 years old in the All-inside Single-bundle group, and 24.5±6.87 years old in the Double-bundle group. In terms of the side of the knee that suffered the most injuries in both groups were the right knees. The result of the patient-reported outcomes using IKDC and Tegner-Lysholm scores showed no statistically significant differences in both groups at 6- and 12-month follow-ups (p=0.864; p=0.293 and p=0.589; p=0.233, respectively). The results of clinical assessments at 6- and 12-month follow-ups also showed no statistically significant differences in both groups. Conclusion: Our study showed no significant differences in the patient-reported and the clinical outcomes between the All-inside Single-bundle and the Double-bundle ACL reconstruction techniques at 6- and 12-month follow-ups.

The role of pentoxifylline in preventing contrast-induced nephropathy in coronary angiography/intervention - systematic review, meta-analysis, and meta-regression of randomized controlled trials.

OBJECTIVE: This systematic review and meta-analysis aimed to synthesize the latest evidence on pentoxifylline effect on the contrast-induced nephropathy (CIN) and whether the quality evidence is sufficient to make a definite conclusion MATERIALS AND METHODS: We performed a systematic literature search on topics that assesses pentoxifylline and CIN in coronary angiography/intervention up until 01 April 2021 using PubMed, Scopus, Embase, and hand-sampling. Primary outcome was CIN defined as ≥0.5 mg/dL or 25% rise in the SCr 48 h after procedure. RESULTS: There were a total of 1142 subjects from 6 studies. There was no difference between pentoxifylline and control group in terms of serum creatinine at baseline (p=0.46) and after the procedure (p=0.33). The incidence of CIN was 51/571 (8.9%) in the pentoxifylline group and 61/571 (10.7%) in the control group. Pentoxifylline was not significantly associated with increase or decrease in the risk of CIN (RR 0.84 [0.59, 1.19], p=0.32; I2: 0%, p=0.89). Subgroup analysis for elective studies showed a non-significant result (RR 0.77 [0.47, 1.27], p=0.31; I2: 0%). Meta-regression analysis showed that the association between pentoxifylline and mortality was not affected by age (p=0.994), gender (reference: male, p=0.562), hypertension (p=0.336), diabetes (p=0.536), baseline serum creatinine (p=0.344), contrast used (p=0.431), and CIN incidence (p=0.521). GRADE Approach showed a low certainty of evidence for the effect estimate of pentoxifylline on CIN. CONCLUSIONS: Our meta-analysis showed that pentoxifylline was not associated with the risk of CIN with low certainty of evidence. Hence, larger, multicentre, double-blind randomized controlled trials are required.

The effect of trimetazidine on contrast-induced nephropathy in patients undergoing coronary angiography and/or percutaneous coronary intervention - A systematic review and meta-analysis.

OBJECTIVE: In this study, we aimed to evaluate whether the trimetazidine administration before CAG and/or PCI reduces the incidence of contrast-induced nephropathy (CIN). We also aimed to evaluate the factors affecting the effect and the certainty of the evidence. MATERIALS AND METHODS: A systematic literature search was performed to obtain studies that assess trimetazidine's effect on the incidence of CIN in CAG/PCI patients up until 21 January 2021 through PubMed, Embase, and Scopus. The main outcome is CIN, defined as the increase in serum creatinine level ≥ 0.5 mg/dL (44.2 mmol/L) or > 25% of the baseline value 48-72 h after contrast media (CM) administration. RESULTS: This systematic review and meta-analysis includes seven studies involving a total of 1590 patients. The prevalence of CIN was 11% [8%, 14%]. CIN's prevalence was 6% [4%, 8%] in the trimetazidine group and 16% [12%, 20%] in the control group. Trimetazidine use is associated with a lower incidence of CIN (RR 0.46 [0.34, 0.63], p<0.001; I2: 0%) with a high certainty of evidence, with an absolute risk reduction of 78 fewer per 1000. Subgroup analysis in patients with renal insufficiency showed that trimetazidine lowers the risk of CIN (RR 0.40 [0.26, 0.61], p<0.001; I2: 0%). The CIN reducing effect of trimetazidine was not significantly influenced by the age (p=0.960), body mass index (p=0.816), hypertension (p=0.595), diabetes (p=0.362), ejection fraction (p=0.261), baseline serum creatinine (0.579), and contrast media volume (p=0.958). CONCLUSIONS: Trimetazidine administration decreases the risk of CIN in patients undergoing CAG/PCI.

The association between serum prealbumin and poor outcome in COVID-19 - Systematic review and meta-analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the association between the prealbumin and severity and mortality in COVID-19. MATERIALS AND METHODS: We performed a systematic literature search from PubMed, Embase, and Scopus databases up until 2 February 2021. The primary outcome was the poor outcome, a composite of mortality and severity. Severe COVID-19 was defined as COVID-19 that fulfill the criteria for severe pneumonia or patients with acute respiratory distress syndrome/disease progression/need for intensive care unit or mechanical ventilation. The effect estimates were a mean difference between patients with and without a poor outcome in mg/dL and odds ratio (OR) per 1 mg/dL decrease in prealbumin level. The effect estimates were reported with their 95% confidence interval (95% CI). RESULTS: Nine studies comprising of 2104 patients were included in this systematic review and meta-analysis. Patients with poor outcome have lower prealbumin level (mean difference -71.48 mg/dL [95% CI -93.74, -49.22], p<0.001; I2: 85.9%). Every 1 mg/dL decrease in prealbumin level was associated with 1% increase in poor outcome (OR 0.992 [0.987, 0.997], p=0.004, I2: 81.7%). Meta-regression analysis showed that the association between the prealbumin level and poor outcome varies with gender (male) (coefficient: 3.50, R2: 100%, p<0.001), but not age, diabetes, hypertension, and chronic kidney disease. CONCLUSIONS: Low serum prealbumin was associated with poor outcomes in patients with COVID-19.

Levels of lead and other metals in human blood: suggestive relationships, determining factors.

Epidemiological studies on metal levels in blood were carried out. Evidence suggested the existence of a different trend in serum-iron levels in relation to blood lead levels in nonoccupationally exposed males (negative trend) and females (positive trend). There was a positive relation between blood lead levels and blood manganese levels in children and occupationally exposed male workers. Blood metal levels increased with age in young children. There was evidence for an influence of socioeconomic class on blood lead levels in children. A direct and an indirect effect of smoking was found on blood lead levels and on the activity of delta-aminolevulinic acid dehydratase activity in erythrocytes in adult nonoccupationally exposed females.

Angiodysplasia of colon revisited: pathologic demonstration without the use of intravascular injection technique.

The recognition of angiodysplasia either at the time of surgery or at the time of routine gross and microscopic examination has often been difficult. Until now the primary methodology used in defining the lesion has been the intravascular injection of radiopaque dyes and other compounds. This technique, however, is prohibitively time consuming and expensive, and does not encourage routine use in surgical pathology practice. We report two cases of angiodysplasia, both occurring in unlikely areas, in which the pathologic lesion was demonstrated without the use of an intravascular injection technique. One case involved 35 cm of proximal transverse colon and the other involved 23 cm of colon distal to the ileocecal valve. A simple method of demonstrating angiodysplasia by intraluminal formalin fixation (37% concentrated, unbuffered), with tying of both resected ends for 3 hours, followed by dissection of the mucosa from the muscle wall, is described. Areas of ectatic, pericryptal, thin-walled blood vessels with adjacent dilated, engorged submucosal veins are readily seen on gross direct inspection highlighted by transillumination. Histologic sections taken from these areas show early lesions of angiodysplasia characterized by ectatic, engorged submucosal veins and some dilated venules and capillaries in the mucosal lamina propria.

Acute erythroleukemia: evaluation of 48 cases with reference to classification, cell proliferation, cytogenetics, and prognosis.

We evaluated 48 archival cases of acute erythroleukemia and divided them into 3 groups: M6a, corresponding to the traditional French-American-British M6 category; M6b, which is pure erythroleukemia; and M6c, in which myeloblasts and pronormoblasts each account for more than 30% of cells by the French-American-British exclusion criteria. No significant differences were noted among the subtypes for ratio of males to females; age; or exposure to toxins, alcohol, or both. However, compared with the patients in the M6a group, patients in the M6b and M6c groups demonstrated a statistically significant increase in cytogenetic aberrations, proliferation markers (proliferating cell nuclear antigen and Ki67), and ringed (type III) sideroblasts. Marked survival differences were noted between the M6a (30.1 +/- 29.5 months) and M6b (3.15 +/- 4.2 months) groups, with patients in the M6c group demonstrating an intermediate prognosis (10.5 +/- 12.7 months). Chemotherapeutic regimens induced remission in all treated patients in the M6a and M6c groups but did not appear to affect the M6b group. However, the patients in the M6c group remained in remission for a significantly shorter period of time than did patients in the M6a group. Overall, survival appeared to depend on the ratio of pronormoblasts to myeloblasts at diagnosis and demonstrated a rapid decline with increasing pronormoblast and decreasing myeloblast counts. We must, therefore, devise chemotherapeutic regimens that target both blastic components of this disease.

Renal function of workers with low-level cadmium exposure.

The influence of occupational exposure to cadmium on renal function was examined in 27 male cadmium workers from plants with second-degree usage of cadmium. The levels of cadmium in the blood and urine and various protein concentrations in the urine and serum were determined. The urinary levels of beta 2-microglobulin, retinol-binding protein, and N-acetyl-beta-D-glucosaminidase were statistically significantly increased in workers with urinary cadmium levels above 50 nmol/l. SDS-PAGE electrophoresis with silver staining is probably a sensitive indicator of the early effects of cadmium on protein excretion. The currently recommended biological exposure limits may have to be lowered.

Exposure of dentists and assistants to mercury: mercury levels in urine and hair related to conditions of practice.

A study of 162 dentists' and their assistants' mercury levels in hair and urine, and of questionnaire items regarding mercury consumption, revealed some striking relations. The mercury concentrations in both hair (Hg-H) and urine (Hg-U) were somewhat higher in the dentists than the assistants. There was no relation between concentrations in hair and urine. The method of condensation of amalgam was positively related to Hg-U; the vibration method was negatively related. Hg-U was also positively related to number of fillings and hours in own practice. The relation of Hg-U to ventilation in the surgery applied only to the dentists.

Comparison of Outcomes Between All-Inside SingleBundle and Double-Bundle Anterior Cruciate Ligament Reconstruction: A Retrospective Study

@#Introduction: ACL rupture is the most common type of knee injury. The All-inside ACL reconstruction procedure features some distinguished components including closed-socket tunnels with less bone expulsion, double suspensory fixation, and smaller incisions. We aimed to compare the outcomes between the All-inside Single-bundle and the Double-bundle ACL reconstruction techniques. Materials and methods: This study was a retrospective study which analysed the patient-reported and the clinical outcomes on patients who underwent ACL reconstruction between January and December 2020 at Dr Kariadi General Hospital Semarang, Indonesia. We compared the patientreported and the clinical outcomes at 6- and 12-month follow-ups between the All-inside Single-bundle and the Double-bundle groups. The patient-reported outcomes were determined using the IKDC and Tegner-Lysholm scores while the clinical outcomes included the measurement of Thigh Circumference, Single Hop test, Anterior Drawer test, Lachman test, Range of motion, and the patient’s level of return to sport. Results: A total of 24 subjects were divided into two groups, namely the All-inside Single-bundle and the Double-bundle groups, consisting of 12 subjects in each group. Most of the subjects were male in both groups, including 9 (75%) subjects in the All-inside Single-bundle group, and 11 (91.67%) subjects in the Double-bundle group. The mean age of the subjects were 25.75±7.57 years old in the Allinside Single-bundle group, and 24.5±6.87 years old in the Double-bundle group. In terms of the side of the knee that suffered the most injuries in both groups were the right knees. The result of the patient-reported outcomes using IKDC and Tegner-Lysholm scores showed no statistically significant differences in both groups at 6- and 12-month follow-ups (p=0.864; p=0.293 and p=0.589; p=0.233, respectively). The results of clinical assessments at 6- and 12-month follow-ups also showed no statistically significant differences in both groups. Conclusion: Our study showed no significant differences in the patient-reported and the clinical outcomes between the All-inside Single-bundle and the Double-bundle ACL reconstruction techniques at 6- and 12-month follow-ups.

Malaysianol B, an oligostilbenoid derivative from Dryobalanops lanceolata.

A new oligostilbenoid tetramer, malaysianol B (1), was isolated from the acetone extract of the stem bark of Dryobalanops lanceolata along with seven oligostilbenoids tetramers; hopeaphenol (2), stenophyllol A (3), nepalensinol B (4), vaticanol B (5) and C (6), upunaphenol D (7), and flexuosol A (8). The structures of the isolated compounds were established on the basis of their spectroscopic data evidence. The antibacterial activity of the isolated compounds was evaluated using resazurin microtitre-plate assay.

Malaysianol A, a new trimer resveratrol oligomer from the stem bark of Dryobalanops aromatica.

A new resveratrol trimer, malaysianol A (1), five known resveratrol oligomers: laevifonol (2), ampelopsin E (3), α-viniferin (4), ε-viniferin (5), diptoindonesin A (6), and bergenin (7) have been isolated from the acetone extract of the stem bark of Dryobalanops aromatica by combination of vacuum and radial chromatography techniques. Their structures were established on the basis of their spectroscopic evidence and comparison with the published data. The cytotoxic activity of the compounds was tested against several cell lines in which compound 4 was found to inhibit strongly the growth of HL-60 cell line.

Congener specific analysis of polychlorinated terphenyls.

In order to identify and to quantify polychlorinated terphenyls (PCT) in environmental matrices, the chromatographic behavior of coplanar and non-coplanar congeners was evaluated. A mixture of 16 single PCT congeners was used for method development. Four of these compounds were synthesized for the first time by SUZUKI-coupling reaction. These were p-PCT (2,2'',6,6''-tetrachloro-, 2',3,3'',4,4'',5',-hexachloro-, 2',3,3'',5,5',5''-hexachloro-) and m-PCT (2,2'',3,3'',5,5''-hexachloro-). They were characterized by NMR ((1)H,(13)C) spectroscopy. By means of the new column chromatographic clean-up reported here, a good matrix removal and the separation of the coplanar PCT congeners from the non-coplanar ones was obtained. The recovery rates for all congeners were good for the PCT in different test matrices like fat, charcoal, and soil. The quality of the clean-up, the separation and the recovery rates were determined by GC/MS analysis. The method was applied for the first time to a real sample from a fire accident, where different PCT, obviously formed during the combustion process, were found. The conclusion is drawn that this method is suitable for the analysis of PCT in different environmental samples.

Ageing in the South-East Asian region.

PIP: The increasing trend in the aging population of countries in the South-East Asia Region (SEAR) transforms these countries from "mature societies" to "aging societies.¿ The elderly population in this region would be increasing from 18.1% in 1995 to 21.4% of the world elderly population in 2025. Since women have a longer life expectancy than men, the proportion of elderly women in the region would increase to 13.2% by 2025, while the proportion of elderly men would be 11.6%. In SEAR, 11.8 million people reportedly suffered from blindness in 1998; 50-80% of these cases are caused by cataract, which is most common in those aged 60 years and above. Although the aged is one of the most vulnerable population groups, little attention is given to geriatric care. Health services in many countries still focus largely on communicable diseases, maternal care, and child care, rather than on the enormous needs of the elderly population. Care of the elderly should be a priority of the primary health care system, focusing on the promotion of a healthy old-age lifestyle and prevention of behaviors that are hazardous to health.^ieng

Different effects on hemesynthesis in male and female rabbits treated with lead acetate.

The feasibility of an animal model was investigated to study the mechanisms underlying the difference in response to inorganic lead exposure between males and females, as shown in the different increase of zincprotoporphyrin (ZPP) in blood concentrations. Groups of rabbits of both sexes received s.c. injections of 0.25 (L) or 0.50 (H) mg lead acetate/kb b.w. or a control solution three times a week during 14 weeks. A steep increase of blood lead (PbB) was found in the first 4 weeks of exposure; in subsequent weeks PbB leveled off. In the L-group PbB increased to 775--1387 microgram/l rbc and in the H-group to 892--1522 microgram/l rbc. In female rabbits ZPP increased earlier than in males; the relative increase of ZPP was stronger in female rabbits, particularly in the H-group. No effect on Hb, Ht and body weight was observed. The response to lead in female and male rabbits is very similar to that observed in humans.

The effect of testosterone administration on lead induced zincprotoporphyrin in blood concentration in castrated male rabbits.

The influence of testosterone propionate on the concentration of zincprotoporphyrin in blood (ZPP) of castrated lead treated rabbits was investigated. The experimental design allowed comparison of the relative ZPP increase (RZI) in testosterone treated and non testosterone treated rabbits. Testosterone was administered by subcutaneous injection of 3 mg/kg body weight/day for 7 consecutive days directly prior to the lead exposure, which was performed by subcutaneous injection of 0.50 mg lead acetate/kg body weight, three times a week for 7 weeks. No effect was found on the hemoglobin concentration (Hb) and hematocrit (Ht) and on the increase of body weight during the experiment. But the increase of RZI in the non testosterone treated rabbits was significantly steeper and earlier than in the testosterone treated group. The possible consequences of the findings had been further commented on.