MATERIALS AND METHODS: Quantification of the total phenolic (TPC) and flavonoid contents (TFC) in PSPE were done via colourimetric methods; and the determination of the concentrations of four specific phytochemicals (gallic acid, caffeic acid, rutin, and quercetin) were done via High- Performance Liquid Chromatography (HPLC).
RESULTS: Colourimetric determination of PSPE showed TPC and TFC values of 84.53±9.40 mg GAE/g and 11.96±4.51 mg QE/g, respectively. Additional analysis of the phytochemicals using HPLC revealed that there were 6.45±3.36 g/kg, 5.91±1.07 g/kg, 0.39±0.84 g/kg, and 0.19±0.47 g/kg of caffeic acid, gallic acid, rutin, and quercetin, respectively.
CONCLUSION: The findings show that PSPE contains substantial amounts of caffeic acid, gallic acid, rutin, and quercetin, which may indicate its potential as antibacterial, anti-inflammatory, anti-lipid, and antiviral medicines.
METHODS: This systematic review was conducted by performing searches for relevant publications on two databases (PubMed and Scopus). The publication period was limited from January 2011 to December 2021. Cochrane collaboration tools were used for the risk of bias assessment of each trial.
RESULT: Six out of 8 randomised controlled trials (n:776) demonstrated a significant improvement in lipid profile (p <0.05), 5 out of 7 trials (n:701) showed a significant reduction in glycaemic indices (p <0.05), 1 out of 5 trials (n:551) demonstrated significant improvements in blood pressure (p <0.05), and 2 out of 7 trials (n:705) showed a significant reduction in anthropometric measurements (p <0.05).
CONCLUSION: Nigella Sativa has proved to have a significant positive effect on lipid profile and glycaemic index. The results showed in the parameters of blood pressure and anthropometric indices are less convincing, as results were inconsistent across studies. Nigella Sativa can therefore be recommended as an adjunct therapy for metabolic syndrome.
MATERIALS AND METHODS: Analysis of metformin and sildenafil (SIL) from rat plasma was done by high performance liquid chromatography. Optimum chromatographic separation and quantification of MET, SIL and Cetirizine was achieved on Phenomenex EVO C18 column with triethyl amine (0.3%): Methanol: Acetonitrile (70:05:25 v/v) as mobile phase maintaining flow rate of 1 ml/min, the detector was tuned at 224 nm. The extraction of MET and sildenafil from rat plasma was achieved by solid-phase extraction using Strata-X cartridges. The method was validated as per the ICH guidelines. For docking studies, the crystal structure of organic cation transporter 1 (OCT1) protein and multidrug and toxin extrusion (MATE) protein (5XJJ) were downloaded from the PubChem database. The docking study was performed by PyRx virtual screening software, and the results were analyzed by BIOVIA Discovery Studio.
RESULTS: The validation of HPLC method was done, intraday and interday precision study of HPLC method demonstrated %RSD values less than 5%, the extraction recovery for MET and SIL were near to 80 % for low, medium and high QC samples. The plasma stability of MET and SIL showed % RSD values <10% for low, medium, and high QC samples. A sensitivity study for MET and SIL in rat plasma suggested a lower limit of quantification values of 8 and 10 ng/mL, respectively. The pharmacokinetic parameters were recorded, Cmax of experimental and control rats was 611.2 and 913.2 ng/mL; t1/2 1.66 and 1.98, AUC (0-t) 1637.5 and 2727.24, AUC (0-∞) 1832.38 and 2995.24 for MET. The results suggested that the Cmax of MET in experimental rats (MET + SIL) was 33.07% lower than the control (MET only) and also the t1/2 was 0.32 h shorter. Docking analysis suggested a higher binding affinity of sildenafil with MATE protein (5XJJ) compared to OCT1, suggesting possible involvement of MATE family proteins for pharmacokinetic alterations of MET.
CONCLUSIONS: The HPLC and solid-phase extraction method were developed and applied successfully for the pharmacokinetics of MET and SIL. Intake of SIL altered the pharmacokinetics of MET in rats. Molecular docking studies suggested the involvement of MATE family proteins for alterations of MET pharmacokinetics.
MATERIAL AND METHODS: This is a randomised, double-blinded control trial which randomised samples to moderate NMB (train-of-four count [TOF] of 1 or 2) or deep NMB (post-tetanic count [PTC] of 1 or 2). Surgery began with IAP 8 mmHg but was allowed to increase the pressure if the surgical condition was unfavourable. The surgical condition was rated on a 4-point scale. Post-operative abdominal pain and shoulder tip pain was assessed using a numerical rating scale for pain, with 0 defined as no pain and 10 severe pain at recovery area (time 0), 30 minutes, and 24 hours post-operation.
RESULTS: Seventy patients completed the study. The rate of increasing IAP between the 2 groups ( P = 0.172) is not significant, but deep NMB requires less pressure - mean highest IAP of 10.31 (± 1.39) mmHg, moderate NMB 11.54 (± 1.69) mmHg. The mean surgical space condition score was significantly better in the deep NMB group at 2.4 (± 0.7) compared to moderate NMB at 3.2 (± 0.66), P < 0.005. There was a significantly lower post-operative abdominal pain score in deep NMB but no significant difference in shoulder tip pain score between the 2 groups.
CONCLUSIONS: Deep NMB enables the usage of lower IAP in laparoscopic surgery without interfering with surgical space condition, and it reduces the post-operative abdominal pain score in 24 hours compared to moderate NMB.
METHODS: Databases of MEDLINE, EMBASE, and CENTRAL were searched from their inception date until October 2023. Randomized Clinical Trials (RCT) comparing methylene blue and placebo in adults with septic shock were included.
RESULTS: Our systematic review included 5 studies (n = 257) for data analysis. As compared to the placebo, our pooled analysis showed that methylene blue significantly increased mean arterial pressure (MD: 1.34 mmHg, 95% CI 0.15 to 2.53, p = 0.03, level of evidence: very low). Patients who were given methylene blue were associated with statistically lower mortality rate (OR = 0.49, 95% CI 0.27 to 0.88, p = 0.02, level of evidence: low), reduced serum lactate levels (MD: -0.76 mmoL.L-1, 95% CI -1.22 to -0.31, p = 0.0009, level of evidence: low), reduced length of hospital stay (MD: -1.94 days, 95% CI -3.79 to -0.08, p = 0.04, level of evidence: low), and increased PaO2/FiO2 (MD: 34.78, 95% CI 8.94 to 60.61, p = 0.008, level of evidence: low).
CONCLUSIONS: This meta-analysis demonstrated that methylene blue administration was associated with an increased in mean arterial pressure and PaO2/FiO2 ratio, along with a reduction in mortality rates, serum lactate levels, and length of hospital stay. However, substantial degree of heterogeneity and inadequate number of studies with low level of evidence warrant future adequately powered RCTs to affirm our results.
METHODS: A total of 479 patients with primary pterygium who were admitted to our hospital from March 2019 to March 2023 were randomly divided into three groups: the normal group (Group A: 89 patients), the control group (Group B: 195 patients), and the modified group (Group C: 195 patients). Each group received different intervention measures. Group A did not undergo surgical treatment and were required to follow up as outpatients. Group B received LSC transplantation combined with interrupted suturing plus BCL, whereas Group C received modified LSC transplantation combined with BCL. The degree of corneal irritation symptoms, wound healing and graft status under slit lamp, incidence and recurrence rate of complications, tear film rupture time, tear secretion test, intraocular pressure, ocular surface inflammation response(IL-1β, PGE2, TNF-α, VEGF), and visual quality were compared and analyzed at various time points after surgery.
RESULTS: Compared with those in the Group B, patients in the Group C experienced faster normalization of corneal epithelium recovery, fewer corneal irritation symptoms, and better wound healing. The break-up time (BUT) of the tear film at 1 week to 1 year postoperatively was significantly greater in the Group C than Group B, with values approaching those of Group A by 3 months (P 0.05). The ELISA results indicated that the expression levels of the ocular surface inflammatory factors IL-1β, TNF-α, PEG2, and VEGF in the Group C were lower than those in Group B from 1 week to 1 year post surgery. Under both natural light and low-light conditions (spatial frequency/6 cd), Group C had better best-corrected visual acuity and contrast sensitivity than Group B at 1 week to 1 year postoperatively. Additionally, Group C had lower corneal higher-order aberrations (including astigmatism, spherical aberrations, and total higher-order aberrations) and superior vision-related quality of life scores at 1 year postoperatively than Group B, with statistically significant differences (P
METHODS: This double blinded randomized controlled trial was conducted in University Malaya Medical Centre between October 2019 and March 2022. Patients undergoing emergency laparotomy requiring incisions less than 35 cm were included. Statistical analysis was performed using χ2 test for categorical variables, independent T-test or Mann-Whitney U were used for parametric or non-parametric data respectively besides logistic regression. P values of
DESIGN: Multicenter prospective before-and-after comparison design study.
SETTING: Twenty-one PICUs.
PATIENTS: Patients fulfilled the Pediatric Acute Lung Injury Consensus Conference 2015 definition of PARDS and were on invasive mechanical ventilation.
INTERVENTIONS: The LPMV protocol included a limit on peak inspiratory pressure (PIP), delta/driving pressure (DP), tidal volume, positive end-expiratory pressure (PEEP) to F io2 combinations of the low PEEP acute respiratory distress syndrome network table, permissive hypercarbia, and conservative oxygen targets.
MEASUREMENTS AND MAIN RESULTS: There were 285 of 693 (41·1%) and 408 of 693 (58·9%) patients treated with and without the LPMV protocol, respectively. Median age and oxygenation index was 1.5 years (0.4-5.3 yr) and 10.9 years (7.0-18.6 yr), respectively. There was no difference in 60-day mortality between LPMV and non-LPMV protocol groups (65/285 [22.8%] vs. 115/406 [28.3%]; p = 0.104). However, total adherence score did improve in the LPMV compared to non-LPMV group (57.1 [40.0-66.7] vs. 47.6 [31.0-58.3]; p < 0·001). After adjusting for confounders, adherence to LPMV strategies (adjusted hazard ratio, 0.98; 95% CI, 0.97-0.99; p = 0.004) but not the LPMV protocol itself was associated with a reduced risk of 60-day mortality. Adherence to PIP, DP, and PEEP/F io2 combinations were associated with reduced mortality.
CONCLUSIONS: Adherence to LPMV elements over the first week of PARDS was associated with reduced mortality. Future work is needed to improve implementation of LPMV in order to improve adherence.
METHODS: This was a cross-sectional observational study on patients with Type II diabetes mellitus from October 2020 to May 2021. Data collected include systolic/diastolic blood pressure, visual acuity, glycated hemoglobin, and central macular thickness. Diabetic retinopathy severity was categorized using the Early Treatment Diabetic Retinopathy Study classification. Photoplethysmography signals were acquired using pulse-oximeter modules (OEM-60; Dolphin Medical, Inc) measured for 90 seconds at 275 Hz sampling rate and 16-bit resolution, which records photoplethysmography fitness index, vascular risk prediction index, and vascular age.
RESULTS: One hundred and forty-one patients were equally distributed into six DR categories. Mean age was 58.8 ± 9.9 years, with female-to-male ratio of 1.27. There were significant differences in mean systolic (125.5 ± 10.0 mmHg, P = 0.007) and diastolic blood pressure (80.0 ± 8.8 mmHg), mean glycated hemoglobin (7.6 ± 1.9%, P = 0.005), median log unit of minimal angle of resolution (0.3, interquartile range: 0.2-0.5, P < 0.001), and central macular thickness ( P = 0.003) across DR severity. Significant differences were also seen in photoplethysmography fitness index ( P = 0.001), vascular risk prediction index ( P < 0.001), and vascular age ( P = 0.001), with poorer values in severe compared with mild/moderate DR. After adjusting for age, blood pressure, and glycated hemoglobin, photoplethysmography fitness reduces by 3.3% (regression coefficient, b = -3.27, P < 0.001), vascular age increases by 2.5 years ( b = 2.54, P = 0.002), and vascular risk prediction index increases by 3.1 ( b = 3.08, P < 0.001) with every DR worsening.
CONCLUSION: More severe DR stages were associated with poorer photoplethysmography vascular markers.
METHODS: In this randomized, double-blind, placebo-controlled trial, 80 patients were allocated to receive either oral ALA plus B vitamins, i.e., Bionerv® (n =40) (intervention group) or placebo (n = 40) for 12 weeks. QoL, Body Mass Index (BMI), and Blood Pressure (BP) were assessed at baseline, 6 weeks, and 12 weeks. QoL was measured using the Revised Diabetes Quality of Life Questionnaire (Rv-DQoL), where higher scores indicate poorer QoL. Metabolic parameters (glycated haemoglobin (HbA1c), fasting blood sugar (FBS), fasting lipid profile (FLP) were assessed at baseline and 12 weeks.
RESULTS: In the intervention group, the mean Rv-DQoL score decreased significantly in withingroup analysis from 29.50 ± 5.25 at baseline to 24.37 ± 3.43 at week 12 [F(2,156)=55.16; p-value <0.001]. However, between-group differences were not significant (p-value =0.151). Blood pressure also declined significantly within the intervention group (p-value <0.05), but no significant differences were observed between the placebo and intervention groups (p-value >0.05). Metabolic parameters (HbA1c, FBS, FLP, BMI) showed no significant changes between intervention and control groups (p-value >0.05).
DISCUSSION: Twelve-week treatment with ALA plus B vitamins resulted in improvements in QoL and BP among DSPN patients. However, these changes did not reach statistical significance compared with placebo, and no alterations in metabolic parameters were observed. The short duration and small sample size may have limited the detectability of effects.
CONCLUSION: Twelve weeks of treatment with ALA and B vitamins resulted in an improvement in QoL and BP among DSPN patients. However, these changes did not reach statistical significance compared with placebo, and no alterations in metabolic parameters were observed.
OBJECTIVES: To determine the effect of continuous distending pressure in the form of CPAP on the need for IPPV and associated morbidity in spontaneously breathing preterm infants with respiratory distress.
SEARCH METHODS: We used the standard strategy of Cochrane Neonatal to search CENTRAL (2020, Issue 6); Ovid MEDLINE and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Daily and Versions; and CINAHL on 30 June 2020. We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials.
SELECTION CRITERIA: All randomised or quasi-randomised trials of preterm infants with respiratory distress were eligible. Interventions were CPAP by mask, nasal prong, nasopharyngeal tube or endotracheal tube, compared with spontaneous breathing with supplemental oxygen as necessary.
DATA COLLECTION AND ANALYSIS: We used standard methods of Cochrane and its Neonatal Review Group, including independent assessment of risk of bias and extraction of data by two review authors. We used the GRADE approach to assess the certainty of evidence. Subgroup analyses were planned on the basis of birth weight (greater than or less than 1000 g or 1500 g), gestational age (groups divided at about 28 weeks and 32 weeks), timing of application (early versus late in the course of respiratory distress), pressure applied (high versus low) and trial setting (tertiary compared with non-tertiary hospitals; high income compared with low income) MAIN RESULTS: We included five studies involving 322 infants; two studies used face mask CPAP, two studies used nasal CPAP and one study used endotracheal CPAP and continuing negative pressure for a small number of less ill babies. For this update, we included one new trial. CPAP was associated with lower risk of treatment failure (death or use of assisted ventilation) (typical risk ratio (RR) 0.64, 95% confidence interval (CI) 0.50 to 0.82; typical risk difference (RD) -0.19, 95% CI -0.28 to -0.09; number needed to treat for an additional beneficial outcome (NNTB) 6, 95% CI 4 to 11; I2 = 50%; 5 studies, 322 infants; very low-certainty evidence), lower use of ventilatory assistance (typical RR 0.72, 95% CI 0.54 to 0.96; typical RD -0.13, 95% CI -0.25 to -0.02; NNTB 8, 95% CI 4 to 50; I2 = 55%; very low-certainty evidence) and lower overall mortality (typical RR 0.53, 95% CI 0.34 to 0.83; typical RD -0.11, 95% CI -0.18 to -0.04; NNTB 9, 95% CI 2 to 13; I2 = 0%; 5 studies, 322 infants; moderate-certainty evidence). CPAP was associated with increased risk of pneumothorax (typical RR 2.48, 95% CI 1.16 to 5.30; typical RD 0.09, 95% CI 0.02 to 0.16; number needed to treat for an additional harmful outcome (NNTH) 11, 95% CI 7 to 50; I2 = 0%; 4 studies, 274 infants; low-certainty evidence). There was no evidence of a difference in bronchopulmonary dysplasia, defined as oxygen dependency at 28 days (RR 1.04, 95% CI 0.35 to 3.13; I2 = 0%; 2 studies, 209 infants; very low-certainty evidence). The trials did not report use of surfactant, intraventricular haemorrhage, retinopathy of prematurity, necrotising enterocolitis and neurodevelopment outcomes in childhood.
AUTHORS' CONCLUSIONS: In preterm infants with respiratory distress, the application of CPAP is associated with reduced respiratory failure, use of mechanical ventilation and mortality and an increased rate of pneumothorax compared to spontaneous breathing with supplemental oxygen as necessary. Three out of five of these trials were conducted in the 1970s. Therefore, the applicability of these results to current practice is unclear. Further studies in resource-poor settings should be considered and research to determine the most appropriate pressure level needs to be considered.