METHODS: A prospective, randomized, single-blinded control trial was performed on eligible diabetic patients with full-thickness cavity wounds. Patients' demographics, size and site of wounds, and baseline routine blood investigations were recorded. The wounds were dressed every other day with Kelulut honey for the intervention group or gel for the control group. The wound size reduction and granulation tissue formation percentage were calculated every 6 days for 1 month.
RESULTS: Seventy-one patients were randomized. After 30 days of follow-up, 62 participants were available for analysis: 30 from the control group and 32 from the treatment group. The control group had increased granulation tissue at baseline and more wounds on the lower limb and posterior trunk. Both groups showed an increasing mean and median percentage of wound epithelialization and granulation tissue over time, with significantly higher values at every timepoint in the honey group (p
MATERIALS AND METHODS: Six electronic databases (Medline, Embase, PsycInfo, CINHAL, CENTRAL, International Pharmaceutical Abstracts) reference lists of retrieved articles and relevant websites were searched for randomized controlled trials published in the English language involving adults with chronic pain. Studies were included if one of the intervention arms had received pharmacist-led medication review independently or as part of a multidisciplinary intervention. Risk of bias was assessed for all the included studies.
RESULTS: The search strategy yielded 583 unique articles including 5 randomized controlled trials. Compared with control, meta-analysis showed that participants in the intervention group had: a 0.8-point reduction in pain intensity on a 0 to 10 numerical rating scale at 3 months [95% confidence interval (CI), -1.28 to -0.36] and a 0.7-point reduction (95% CI, -1.19 to -0.20) at 6 months; a 4.84 point (95% CI, -7.38 to -2.29) and -3.82 point (95% CI, -6.49 to -1.14) improvement in physical functioning on a 0- to 68-point function subscale of Western Ontario and McMaster Universities Osteoarthritis Index at 3 and 6 months, respectively; and a significant improvement in patient satisfaction equivalent to a "small to moderate effect."
DISCUSSION: Pharmacist-led medication review reduces pain intensity and improves physical functioning and patient satisfaction. However, the clinical significance of these findings remain uncertain due to small effect size and nature of reported data within clinical trials that limits recommendation of wider clinical role of pharmacist in chronic pain management.
METHODS: The polyphenolic compounds in SCFE were identified with Reverse phase-high performance liquid chromatography (RP-HPLC). Meanwhile, murine 3T3-L1 preadipocytes, measuring leptin levels, reactive oxygen species (ROS), and lipid and triglyceride (TG) contents were utilized during anti-adipogenic activity assessments. Concurrently, the effects of SCFE on adipogenic transcription factors were established with quantitative real-time-polymerase chain reaction (qRT-PCR).
RESULTS: The RP-HPLC results indicated three polyphenolic compounds in SCFE, including one flavonoid (naringin) and two phenolic acids (syringic and p-coumaric). Although SCFE treatments (250-1000 μg/mL) did not result in cell toxicity, they significantly reduced dose-dependent lipid accumulation, ROS production, and TG and leptin levels relative to control-differentiated adipocytes. Moreover, SCFE suppressed sterol regulatory element binding protein-1 (SREBP-1), peroxisome proliferator-activated receptor-gamma (PPAR-γ), and CCAAT/enhancer-binding protein-alpha (C/EBP-α) gene expressions during preadipocyte differentiation into adipocytes.
CONCLUSION: The findings revealed the anti-adipogenic properties of SCFE, indicating its potential as a natural obesity management remedy. Nevertheless, more studies are necessary to elucidate the reactions resulting in SCFE anti-adipogenic effects and the active constituents responsible for the property.
CASE REPORT: Here we report an unusual case of surgical subcutaneous emphysema after multiple attempts of purging to remove an ingested fishbone. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Fishbone foreign body is a common presentation to the ED. A thorough history and examination for the migratory foreign body is essential, as the complications are consequential.
RESULTS: Shell gland (Uterus) and liver tissue samples were collected from hens during the active growth phase of calcification (15-20 h post-ovulation) for RT-PCR analysis. In the oviduct (shell gland and magnum) and liver of laying hens, the relative expression of functional eggshell and hepatic selenoproteins genes was investigated. Results of qPCR confirmed the higher (p