Spinning disc photoreactor based visible-light-driven Ag/Ag2O/TiO2 heterojunction photocatalyst film toward the degradation of amoxicillin.

The presence of antibiotics in waste and drinking water is causing increasing concern around the world, thereby an advanced sustainable technology needs to be developed to eliminate the antibiotics from water resources. Hence, an efficient spinning disc photoreactor (SDPR) equipped with visible light-activated Ag/Ag2O/TiO2 heterostructure thin film photocatalyst was assessed for the degradation of amoxicillin (AMX) as a typical antibiotic. The surface morphology, optoelectronic and structural features of Ag/Ag2O/TiO2 heterojunction were characterized by TEM, BET, mott Schottky, FESEM, EDS, AFM, XRD, UV-Vis-DRS, and contact angle measurements. Results confirm that Ag and Ag2O have a significant effect on the photocharge carrier separation and transfer of the as-developed photocatalyst system. The operative variables including illumination time, rotational speed, solution flow rate, aeration rate, pH, and initial AMX concentration were optimized by CCD. The results displayed the maximum AMX photodegradation (97.91%) could be achieved at optimal conditions involving illumination time of 80 min, a rotational speed of 225 rpm, the solution flow rate of 0.6 L/min, aeration rate of 20 L/min, pH = 6, and initial AMX concentration of 20 mg/L. Interestingly, more than 79% COD and 64% TOC were removed under optimum conditions during 80 min illumination time, respectively. Active species tests confirmed the dominant role of ·OH and ·O2- in AMX degradation. finally, the XRD pattern confirmed that the reusability assessments of the heterojunction film could successfully retain its stability for six consecutive photocatalytic degradation runs. This work demonstrates the feasibility of utilizing visible-light-driven thin-film photocatalysts in spinning disc photoreactors in treating the tenacious antibiotic pollutants.

Emerging salt marshes as a source of Trichoderma arenarium sp. nov. and other fungal bioeffectors for biosaline agriculture.

AIMS: Sustainable agriculture requires effective and safe biofertilizers and biofungicides with low environmental impact. Natural ecosystems that closely resemble the conditions of biosaline agriculture may present a reservoir for fungal strains that can be used as novel bioeffectors. METHODS AND RESULTS: We isolated a library of fungi from the rhizosphere of three natural halotolerant plants grown in the emerging tidal salt marshes on the south-east coast of China. DNA barcoding of 116 isolates based on the rRNA ITS1 and 2 and other markers (tef1 or rpb2) revealed 38 fungal species, including plant pathogenic (41%), saprotrophic (24%) and mycoparasitic (28%) taxa. The mycoparasitic fungi were mainly species from the hypocrealean genus Trichoderma, including at least four novel phylotypes. Two of them, representing the taxa Trichoderma arenarium sp. nov. (described here) and T. asperelloides, showed antagonistic activity against five phytopathogenic fungi, and significant growth promotion on tomato seedlings under the conditions of saline agriculture. CONCLUSIONS: Trichoderma spp. of salt marshes play the role of natural biological control in young soil ecosystems with a putatively premature microbiome. SIGNIFICANCE AND IMPACT OF THE STUDY: The saline soil microbiome is a rich source of halotolerant bioeffectors that can be used in biosaline agriculture.

Evaluation of the immune response in BALB/c mice induced by a novel DNA vaccine expressing GRA14 against Toxoplasma gondii.

Toxoplasma gondii can cause severe and even fatal disease in human beings and animals. Effective vaccines may contribute to control toxoplasmosis. GRA14, a novel secreted dense granule protein of T. gondii, has been proposed as a vaccine candidate due to its intervacuolar transport and unique topology in the parasitophorous vacuole membrane. In this study, we constructed a DNA vaccine encoding GRA14 of T. gondii. BALB/c mice were immunized intramuscularly three times at 2 week intervals and challenged with T. gondii RH strain 5 weeks later. The immune responses were evaluated using lymphocyte proliferation assay, cytokine and antibody measurements. In addition, the survival times and parasite load of mice challenged with the virulent T. gondii RH strain were evaluated. The results showed that the mice immunized with pcGRA14 induced both enhanced specific humoral and Th1 cellular immune responses, and also mice immunized with the pcGRA14 showed an increased survival time and decreased parasite load compared with control groups (P<.05). The results indicated, for the first time, that the GRA14 is a potential DNA vaccine against toxoplasmosis.

Association of SRD5A2 gene mutations with risk of hypospadias in the Iranian population.

BACKGROUND: Hypospadias is one of the most common forms of congenital malformation of the male external genitalia worldwide. The ratio in the Iranian population is one in 250 live male births. The conversion of testosterone to dihydrotestosterone (DHT) in the presence of steroid 5α-reductase 2, which is encoded by SRD5A2 gene, plays an important role in the normal development of the male reproductive system. METHODS: We examined whether SRD5A2 gene mutations (V89L and A49T polymorphisms) are associated with the risk of hypospadias in the Iranian population. We performed exons sequencing for SRD5A2 gene in 109 hypospadias patients. RESULTS: We identified two new mutations in the subgroups of affected cases: including a substitution of the nucleotide T > A in the codon 73 [c.219T > A (p.Leu73_Ser74insHisPro)] and an insertion of an extra A nucleotide in the codon 77 [c.229insA* (p.Gly77*)]. Additionally, we performed PCR-RFLP for the two identified polymorphisms and revealed that V89L [OR = 5.8, 95% CI (3.8-8.8), p value < 0.001] and A49T [OR = 10.16, 95% CI (3.94-26.25), p value < 0.001] are significantly associated with hypospadias occurrence in patients. Our haplotype analysis further indicated that the Leu-Ala haplotype increases risk of hypospadias; conversely, the Val-Ala haplotype decreases the risk of hypospadias in the studied patients. CONCLUSIONS: This study demonstrates that polymorphisms in the SRD5A2 gene could be considered as a risk factor for hypospadias disease emergence.

Copper Catalysis in Living Systems and In†Situ Drug Synthesis.

The copper-catalyzed azide-alkyne cycloaddition (CuAAC) reaction has proven to be a pivotal advance in chemical ligation strategies with applications ranging from polymer fabrication to bioconjugation. However, application in vivo has been limited by the inherent toxicity of the copper catalyst. Herein, we report the application of heterogeneous copper catalysts in azide-alkyne cycloaddition processes in biological systems ranging from cells to zebrafish, with reactions spanning from fluorophore activation to the first reported in situ generation of a triazole-containing anticancer agent from two benign components, opening up many new avenues of exploration for CuAAC chemistry.

Toxoplasma gondii infection among sheep and goats in Iran: a systematic review and meta-analysis.

Toxoplasmosis, a cosmopolitan parasitic infection caused by Toxoplasma gondii, is frequently found in meat-producing animals and human beings. This review and meta-analysis study was performed to evaluate the overall prevalence of T. gondii infection among sheep and goats in Iran. Data were systematically collected from 1977 to 2012 in Iran on the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Irandoc, IranMedex, and Scientific Information Database (SID). Additionally, abstracts of national scientific congresses and dissertations were included. A total of 34 articles in field of sheep and 18 articles about goat toxoplasmosis, totalizing to the examination of 14,372 sheep and 3,120 goats, reporting prevalence of toxoplasmosis from different regions of Iran fulfilled our eligibility criteria. The overall prevalence rate of toxoplasmosis in Iran was estimated to be 31% (95% confidence interval (CI) = 0.259825 to 0.352382) in sheep and 27% (95% CI = 0.140097 to 0.424782) in goats, respectively. There was no significant difference in infection rate between males and females among sheep (odds ratio (OR) = 1.002, 95% CI = 0.59 to 1.696) and goats (OR = 1.027, 95% CI = 0.685 to 1.541). Analysis revealed that infection rate in sheep over than 1 year old was 2.4 times more than that in less than 1 year old (OR = 2.396, 95% CI = 1.050 to 5.467). This systematic review and meta-analysis study revealed that infection is widespread in Iran. Further studies are required to improve strategies for controlling infection among flocks and consequently in human population.

Plain abdominal radiography: a powerful tool to prognosticate outcome in patients with zinc phosphide poisoning.

AIM: To evaluate the clinical features of zinc phosphide poisoning and to investigate whether outcome could be prognosticated based on abdominal radiography on presentation. MATERIALS AND METHODS: All zinc phosphide-poisoned patients who were referred to Loghman-Hakim Hospital between March 2011 and September 2013 were retrospectively reviewed. Data regarding patients' demographic characteristics, characteristics of the poisoning, abdominal radiography results, and patients' outcome were recorded. RESULTS: In 102 patients, the most common presenting signs/symptoms were nausea and vomiting (60%). Four patients died and another seven had developed complications during their hospitalization (metabolic acidosis, liver abnormalities, or acute renal failure). Nineteen patients had radio-opaque abdominal radiographs, nine of whom had died or developed complications (p = 0.001). Plain abdominal radiography had a sensitivity and specificity of 81% and 89% in predicting the patients' death or further development of complications. The positive and negative predictive values were 47% and 97%, respectively. CONCLUSION: Plain abdominal radiography is a very good tool for prognostication in patients with zinc phosphide poisoning. Immediate abdominal radiography can help stratify patients into high- or low-risk groups and determine treatment strategies.

QuadraPure-supported palladium nanocatalysts for microwave-promoted Suzuki cross-coupling reaction under aerobic condition.

Cross-linked resin-captured palladium (XL-QPPd) was readily prepared by simple physical adsorption onto the high loading QuadraPure macroporous resin and a subsequent reduction process. To enhance the mechanical stability, entrapped palladium nanocatalysts were cross-linked with succinyl chloride. Both transmission electron microscopy images and X-ray diffraction analysis revealed that the palladium nanoparticles were well dispersed with diameters ranging in 4-10 nm. The catalyst performed good catalytic activity in microwave-promoted Suzuki cross-coupling reactions in water under aerobic condition with mild condition by using various aryl halides and phenylboronic acid. In addition, the catalyst showed an excellent recyclability without significant loss of catalytic activity.

Simulation study of a simultaneous beta-gamma-ray detection using a 3-layer phoswich detector and Monte Carlo methods.

Combination of two or three dissimilar scintillator materials as a radiation detector has found major role in environmental radiation monitoring. In this paper, a three-layer Phoswich detector including BC-400, YAG, and CsI was designed to efficiently discriminate gamma-ray in the beta events up to 3.2 MeV using a simple rise-time discrimination method. MCNPX Monte Carlo code was used to obtain interaction probability of beta and gamma-rays as well as optimum thicknesses of the layers in the designing process. The optical transport of the system was simulated by GEANT4. In this regard, the pulses from simultaneous beta-gamma emitter sources were detected and discriminated based on pulse's rise-time so that the minimum number of gamma-ray contaminating events was observed in the beta spectrum. The results showed that using the proposed configuration and the method, output pulses with a rise-time shorter than 9 ns have been successfully detected as a beta particle while those with rising time longer than 15 ns have been identified as gamma-ray events. Overall results revealed that using the proposed system, an individual spectrum of beta particles or gamma-rays can be recorded from a simultaneous beta-gamma emitter source that minimizes contribution of the other radiation.

A highly sensitive fluorescent viscosity sensor.

Variation at the 3' position of fluorescein via Suzuki-Miyaura cross-coupling with aryl and heteroaryl moieties gave a family of anthofluoresceins whose spectroscopic properties were studied. The 1-methylindole derivative gave the highest quantum yield and was observed to behave as a molecular rotor, displaying marked variations in fluorescent intensities with viscosity and offering possible application in cellular sensing and fluorescent polarisation assays.

Enhancing the bond of a resin-based sealer to root dentine.

AIM: To evaluate whether application of a total-etch/separate adhesive layer can enhance the bond of a UDMA-based sealer to dentine. METHODOLOGY: The root canals of 20 decoronated maxillary premolar teeth with two canals were prepared to size 35-45, 0.04 taper using rotary NiTi instruments. The canals of each tooth were treated with application of either a total-etch/separate adhesive or the manufacturer-recommended primer, before root filling with sealer plus matching master cone using warm vertical compaction. After setting, roots were sectioned perpendicular to the long axis to obtain 1-mm-thick slices, and the root filling was subjected to the push-out test using a plunger closely matched to canal diameter. The roots of another 15 single-rooted premolars were sectioned in a bucco-lingual direction, and the cut surfaces were ground flat for microshear bond strength testing. One-half of the specimens were coated with a separate total-etch/adhesive layer, and then, a cylinder of sealer cement 1 mm diameter × 1.5 mm high was bonded to the prepared surface of all specimens. Microshear bond strength was measured in a universal testing machine after 48 h. Data were analysed using anova and paired t-tests, with significance set at P < 0.05. RESULTS: Use of a separate total-etch/adhesive markedly increased both microshear bond strength and push-out strengths compared with standard primer (P < 0.001). CONCLUSION: Application of a separate adhesive layer significantly increases bond strength of UDMA-based sealers to root dentine.

Effect of various ratios of carbohydrate-protein supplementation on resistance exercise-induced muscle damage.

AIM: Previous studies have indicated that exercise-induced muscle damage might be attenuated by coingestion of protein and carbohydrate supplement. The purpose of this study was to compare the effect of three various ratios of carbohydrate-protein (CHO+PRO) supplements on resistance exercise-induced muscle damage indices. METHODS: Twenty-eight untrained male students voluntarily participated in this study and were randomly assigned to one of the four groups: 1) CHO+PRO 2:1 ratio, N.=7; 2) CHO+PRO 3:1 ratio, N.=8; 3) CHO+PRO 4:1 ratio, N.=7; 4) placebo group, N.=6. They performed a single bout of resistance exercise (whole body: 3 set×8-10 reps with 70-75% 1RM), with eccentric concentration. Every group consumed prepared CHO/PRO beverages (9% concentration, 10 mL/kg/bw-1 at different ratios) or the same amount of placebo beverage before and in 15 min intervals during exercise. Blood samples were taken before the exercise bout and also at 1 and 24 h post-exercise. In addition, muscle soreness scores were recorded before and 1, 24, and 48 h postexercise. Repeated measures ANOVA (between-within design) and Bonferroni post hoc test were used to analyze dependent measures (α=0.05). RESULTS: Serum creatine kinase (CK) and myoglobin (Mb) increased in all groups compared with pre-exercise but the significant difference among groups was observed in 24 h postexercise, in a way that both CK and Mb levels were higher in placebo group. Muscle soreness increased for all groups from pre to postexercise, but there was not any significant difference among groups at any time point. CONCLUSION: Findings of this study showed that CHO+PRO decreased serum CK and Mb at 24 h post exercise, but did not affect muscle soreness at any time points after exercise. Moreover, there were no significant differences between various ratios of CHO-PRO supplementation.

WO3/Ag/ZnO S-scheme heterostructure thin film spinning disc photoreactor for intensified photodegradation of cephalexin antibiotic.

The presence of antibiotics in wastes and drinking water has led to serious environmental and health concerns, further necessitating the development of an advanced sustainable strategy to eliminate antibiotics from aquatic media. In this context, the present research reports the successful fabrication of a spinning disc photoreactor (SDPR) supported ZnO/Ag/WO3 S-scheme visible-light-driven thin-film photocatalyst to study the degradation of cephalexin (CPX) as a target pollutant under blue light irradiation. The optical, electrochemical and physicochemical characterization of the as-prepared thin-film samples were carried out by XRD, top-view FE-SEM, EDS-mapping, UV-Vis-DRS, contact angle, EIS, transient photocurrent, mott Schottky and AFM techniques. The rod shape morphology of the samples with moderate surface roughness, desirable hydrophobicity, low bandgap and remarkable band structure alignment confirmed the applicability of as-prepared thin-film with an average photon flux of 1.94 × 10-4-8.61 × 10-5 E's m-2 s-1. The use of a rotating catalytic disc impressively declined the photon propagation distance, decremented the probability of light absorption by the solution, and intensified the mass transfer rate. The maximum throughputs of 98.8% efficiencies for CPX degradation were achieved at a rotational speed of 180 rpm, the solution flow rate of 1.0 L min-1, the light intensity of 11 mW cm-2, and initial CPX concentration of 40 mg L-1, illumination time of 80 min, and pH of 6. Damkohler number (Da) value was found to be 1.23 × 10-2 at the optimum conditions, indicating the negligibility of the external mass transfer resistance in the SDPR. The photocatalytic mechanism was elucidated for finding the most operative radical species, suggesting the crucial role of ·O2- in photodegradation of CPX and a drastic improvement of the charge separation by S-scheme heterostructure and facilitation by Ag mediator. Findings indicated that the developed reusable and robust SDPR benefited from an s-scheme photocatalyst can be a promising technology for degradation of the organic compounds.

Optimal dose of pre-incision/post-incision gabapentin for pain relief following lumbar laminectomy: a randomized study.

BACKGROUND: Gabapentin has been introduced as an effective agent for post-operative pain control. This study aimed to test the effects of pre- and post-incision administration of different doses of gabapentin on post-operative morphine requirement and pain following lumbar laminectomy. METHODS: In this randomized clinical trial, 175 patients were allocated into seven groups of 25 patients each to receive placebo or gabapentin 600, 900 or 1200 mg pre- or post-incision. Total patient-controlled intravenous morphine consumption during the first 24 post-operative hours, and the time to the first demand for morphine were recorded. Pain score at rest (visual analogue scale) was recorded every 30 min in the first 4 h and then every 2 h until 24 h post-operatively. Side-effects were observed. RESULTS: In the first 12 h, morphine consumption was less, pain scores were lower and the time to the first demand for analgesia was longer in groups receiving gabapentin 900 or 1200 mg either pre- or post-incision, compared with placebo and gabapentin 600 mg (P<0.001). There was no difference between gabapentin 900 and 1200 mg. Pain score, morphine consumption and time to the first demand for analgesia in equal pre- or post-incision doses of gabapentin were not significantly different. No differences in the side-effects were observed between groups. CONCLUSION: Gabapentin 900 or 1200 mg, administered either pre- or post-incision, was found to be effective in pain management following lumbar laminectomy. Similar doses of gabapentin provide the same post-operative analgesia whether administered pre- or post-incision.

Monitoring udder health status using somatic cell counts in Holstein dairy herds located in north-east of Iran and effectiveness of 10-point mastitis control program.

BACKGROUND: The somatic cell count (SCC) of individual cow samples is a useful proxy for monitoring udder health status. AIMS: The present study aimed to provide updated information about udder health in Iranian Holstein dairy cattle, and to quantify the effectiveness of the mastitis control program. METHODS: A total of 17,990 monthly test-day records from 1,663 Holstein dairy cattle in 10 "regular" herds and 2,389 test-day records from 386 Holstein dairy cattle in 2 herds that were assigned to the 10-point mastitis control program ("controlled" herds) were included. Each test-day record comprised the date of recording, daily milk production (kg), fat and protein (%), days in milk, parity, and SCC. RESULTS: Median (Q1-Q3) SCC × 103 for "regular" and "controlled" herds were 136 (52-391) and 64 (24-204) cells/ml, respectively. Also, the percentage of records containing SCC >200,000 cells/ml (elevated SCC) for these groups were 40.3% and 25.5%, respectively. Mixed effects logistic analysis revealed that milk records from cows in the first lactation, early lactation, and with >40 kg daily milk yield had lower odds of elevated SCC. The odds of elevated SCC were lower in summer and autumn than in winter. CONCLUSION: Host and environmental characteristics influence SCC. This should be considered for the interpretation of SCC results. Mastitis control programs can support dairy producers to reach a standard level of udder health.

Renoprotective effects of prazosin on ischemia-reperfusion injury in rats.

BACKGROUND: Renal ischemia-reperfusion (IR) injury is one of the main leading causes of acute kidney injury associated with inflammation, oxidative stress and cell apoptosis. We studied the effects of prazosin, as a specific blocker of α1-AR, on renal IR injury. METHODS: Rats were divided into normal control; untreated IR and prazosin-treated IR (1 mg/kg body weight). Prazosin was administered by intraperitoneal injection 30 min prior to IR induction. The level of urea/creatinine and oxidative factors were detected by colorimetric methods. Apoptosis-associated factors, inflammatory, and signaling proteins were analyzed in renal tissue. The abnormalities of renal histopathology were detected by immunohistochemistry. RESULTS: Administration of prazosin to IR rats ameliorated serum urea and creatinine and IR-induced histopathological damages. Lipid peroxidation was significantly improved after treatment by prazosin in IR injury rats, however, antioxidant status was not affected. Rats subjected to IR injury activated Bax protein and NF-κB mediated inflammatory response. Moreover, treatment with prazosin inhibited renal NF-κB activation, resulting in a significant decline in pro-inflammatory cytokine of IL-6. CONCLUSION: These findings suggest that prazosin could be a good candidate to attenuate renal IR injury due to its ability to modulate renal function, apoptosis and inflammation.

Gene cloning, expression and serological evaluation of the 12-kDa antigen-B subunit from Echinococcus granulosus.

A 12-kDa subunit of antigen B from Echinococcus granulosus has recently been cloned, expressed and used in diagnostic ELISA to test human sera for evidence of cystic echinococcosis. The performance of the ELISA based on the recombinant antigen (rAgB) was compared with that of similar assays based on native antigen B (nAgB) or hydatid-cyst fluid. For the preparation of the rAgB, total RNA was extracted from Ec. granulosus protoscoleces so that antigen-B complementary DNA could be synthesised, amplified by PCR, and then cloned into the pQE30 expression vector. The recombinant plasmid was transformed in Escherichia coli and induced using isopropyl-beta-D-thiogalactopyrano-side. Bacterial samples were collected, lysed and then analysed by SDS-PAGE and western blotting. The recombinant protein was purified by affinity chromatography. Although the performance of the ELISA based on cyst fluid appeared identical to that of the assay based on the recombinant antigen (with a sensitivity, specificity, positive predictive value and negative predictive value of 96.0%, 97.0%, 97.2% and 95.5%, respectively), the corresponding results for the ELISA based on nAgB (98.6%, 100%, 100% and 98.5%) were slightly better. Despite this difference (which was not statistically significant), the comparative ease with which large quantities of the recombinant antigen could be produced make the antigen a potentially useful tool in the diagnosis of cystic echinococcosis.

Case report: Xanthogranulomatous pyelonephritis masquerading as cystic renal cell carcinoma.

Background: Xanthogranulomatous pyelonephritis (XGP) is a rare chronic bacterial inflammation of the renal parenchyma and is often a diagnostic dilemma.Case Presentation: We present a challenging case of a patient with XGP. Initially thought to have had renal cell cancer she was treated accordingly with a partial nephrectomy. However, on the final pathology, she was found to have XGP and required further antibiotic therapy and referral to the infectious disease service.Discussion: Management of XGP and diagnostic pitfalls are discussed.Conclusion: XGP is a diagnostic and therapeutic dilemma. Partial Nephrectomy may be appropriate in management of XGP in select cases.

Hemodynamic Changes and Early Recovery of Liver Graft Function after Liver Transplantation.

BACKGROUND: Patients with liver cirrhosis experience a hyperdynamic circulation. OBJECTIVE: To investigate the association between early hemodynamic changes and graft function after liver transplant. METHODS: Those patients who underwent liver transplantation in 2016 were enrolled in the study. Liver function indices measured in postoperative days (POD) 1, 3, 5, 7, 9, and 11 along with hemodynamic indices including pulse rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and central venous pressure (CVP) measured q6h in the first 3 days after transplantation were recorded. RESULTS: 57 deceased-donor liver recipients with a mean±SD age of 41.4±11.8 years including 33 (58%) males were enrolled in the study. The mean±SD aspartate and alanine aminotransferases, alkaline phosphatase, and lactate dehydrogenase were significantly decreased from 1879±670.5, 369.2±40.5, 174.9±18.8, and 1907.6±323.1 U/L in POD 1 to 37.2±10.7, 243.4±37.3, 207.5±19.5, and 382.4±59.8 U/L in POD 3, respectively (p=0.028, <0.001, 0.002, and 0.001, respectively). During this period, the pulse rate of the patients was significantly (p<0.001) decreased by a median (IQR) of 28.7 (8.5-39.7) beats/min; it was significantly correlated with a decrease in serum hepatic enzymes activities during this period. SBP, DBP, and CVP were significantly increased (p<0.001 for all) during this period. Liver graft function improved significantly earlier in those patients with a mean pulse rate of 87 beats/min compared with others (p=0.03). CONCLUSIONS: There may be an association between changes of hemodynamic indices, especially reduction of pulse rate, and improved graft function early after liver transplantation.

A novel technique for the removal of fractured instruments in the apical third of curved root canals.

AIM: To report on a conservative approach for removal of a fractured file in the severely curved apical portion of the distobuccal canal of a mandibular molar. SUMMARY: With the assistance of stainless steel hand files and a chloroform-dipped gutta-percha cone, a fractured rotary NiTi instrument was successfully removed. The use of this technique may assist in removal of loose instrument fragments that are not easily accessible to other removal techniques. KEY LEARNING POINTS: Instrument fractures do not always lead to an unfavourable prognosis and their removal from the apical third of curved canals should not be routinely attempted. The case highlights that it is possible to conservatively remove loosely bound objects from the hard-to-reach areas of the root canal system.