Size-controlled synthesis of La and chitosan doped cobalt selenide nanostructures for catalytic and antibacterial activity with molecular docking analysis

Co-precipitation method was adopted to synthesize ternary heterostructure catalysts La/CS-CoSe NSs (lanthanum/chitosan‑cobalt selenide nanostructures) without the use of a surfactant. During synthesis, a fixed amount (3 wt%) of CS was doped with 2 and 4 wt% La to control the growth, recombination rate and stability of CoSe NSs. The doped samples served to enhance the surface area, porosity and active sites for catalytic degradation of rhodamine B dye and antibacterial potential against Staphylococcus aureus (S. aureus). Additionally, the synthesized catalysts were examined for morphological, structural and optical characteristics to assess the influence of dopants to CoSe. XRD spectra verified the hexagonal and cubic structure of CoSe, whereas the porosity of the undoped sample (CoSe) increased from 45 to 60 % upon incorporation of dopants (La and Cs). Among the samples analyzed during this study, 4 % La/CS-CoSe exhibited significant bactericidal behavior as well as the highest catalytic reduction of rhodamine B dye in a neutral environment. Molecular docking analysis was employed to elucidate the underlying mechanism behind the bactericidal activity exhibited by CS-CoSe and La/CS-CoSe NSs against DHFRS. aureus and DNA gyraseS. aureus.

QbD-Based Fabrication of Biomimetic Hydroxyapatite Embedded Gelatin Nanoparticles for Localized Drug Delivery against Deteriorated Arthritic Joint Architecture

Biomaterials such as nanohydroxyapatite and gelatin are widely explored to improve damaged joint architecture associated with rheumatoid arthritis (RA). Besides joint damage, RA is associated with inflammation of joints and cartilage, which potentiates the need for both bone nucleation and therapeutic intervention. For such purpose, a modified nanoprecipitation method is used herein to fabricate tofacitinib (Tofa)-loaded nanohydroxyapatite (nHA) embedded gelatin (GLT) nanoparticles (NPs) (Tofa-nHA-GLT NPs). The quality by design (QbD) approach is chosen to assess the key parameters that determine the efficiency of the NPs, and are further optimized via Box-Behnken design of experiment. The particle size, polydispersity, zeta potential, and encapsulation efficiency (EE) of the prepared NPs are found to be 269 nm, 0.18, -20.5 mV, and 90.7%, respectively. Furthermore, the NPs have improved stability, skin permeability, and a sustained drug release pattern at pH 6.5 (arthritic joint pH). Moreover, rhodamine-B loaded nHA-GLT NPs demonstrates considerably higher cellular uptake by the murine-derived macrophages than free rhodamine-B solution. In vitro, cell-based experiments confirm the good cell biocompatibility with insignificant toxicity. Thus, QbD-based approach has successfully led to the development of Tofa-nHA-GLT NPs with the potential to target inflamed arthritic joint.

Efficient Dye Degradation and Antimicrobial Behavior with Molecular Docking Performance of Silver and Polyvinylpyrrolidone-Doped Zn-Fe Layered Double Hydroxide

Zn-Fe layered double hydroxide (LDH) was synthesized through the low-temperature-based coprecipitation method. Various concentrations of Ag (1, 3, and 5 wt %) with a fixed amount (5 wt %) of polyvinylpyrrolidone (PVP) were doped into LDH nanocomposites. This research aims to improve the bactericidal properties and catalytic activities of doping-dependent nanocomposites. Adding Ag and PVP to LDH enhanced oxygen vacancies, which increased the amount of hydroxide adsorption sites and the number of active sites. The doped LDH was employed to degrade rhodamine-B dye in the presence of a reducing agent (NaBH4), and the obtained results showed maximum dye degradation in a basic medium compared to acidic and neutral. The bactericidal efficacy of doped Zn-Fe (5 wt %) showed a considerably greater inhibition zone of 3.65 mm against Gram-negative (G-ve) or Escherichia coli (E. coli). Furthermore, molecular docking was used to decipher the mystery behind the microbicidal action of Ag-doped PVP/Zn-Fe LDH and to propose an inhibition mechanism of β-ketoacyl-acyl carrier protein synthase IIE. coli (FabH) and deoxyribonucleic acid gyrase E. coli behind in vitro results.

Translocation of CdS nanoparticles in maize (Zea mays L.) plant and its effect on metabolic response

Cadmium sulfide nanomaterials are of great concern because of their potential toxicity and unavoidable releases due to multiple commercial applications of nanoparticles (NPs). Commercial NPs act as mediators of damage to plant cells and pose potential toxicity to plants and human health. In the current study, investigated the phytotoxicology, absorption, translocation, antioxidant enzyme activity, and metabolic profiles of maize (Zea mays L.) seedlings exposed to different hydroponic treatments for fifteen days. The different concentrations of CdS NPs (3, 15, 30, 50, and 100 mg/L), 0.3 mg/L Cd ions, and unexposed control were performed in treatments. The results indicated that CdS NPs could present phytotoxic effects on seed germination and root elongation. Compared to the control, the CdS NPs dramatically reduced the shoots and root biomass, as well as the shape of the roots. Transmission electron microscopy and energy-dispersive mapping confirmed that CdS NPs could penetrate the maize root epidermis and bioaccumulate in the shoots with high concentrations. According to metabolomics studies, exposure to CdS NPs and Cd ions would result in metabolic disruption. Based on the statistical analysis, 290 out of 336 metabolites (86.30%) were obviously inhibited. The findings of this study demonstrated possible risks of emerging potential toxic NPs, and the release of these NPs to environment is a serious concern for agricultural activities.

AVPCD: a plant-derived medicine database of antiviral phytochemicals for cancer, Covid-19, malaria and HIV

Serious illnesses caused by viruses are becoming the world's most critical public health issues and lead millions of deaths each year in the world. Thousands of studies confirmed that the plant-derived medicines could play positive therapeutic effects on the patients with viral diseases. Since thousands of antiviral phytochemicals have been identified as lifesaving drugs in medical research, a comprehensive database is highly desirable to integrate the medicinal plants with their different medicinal properties. Therefore, we provided a friendly antiviral phytochemical database AVPCD covering 2537 antiviral phytochemicals from 383 medicinal compounds and 319 different families with annotation of their scientific, family and common names, along with the parts used, disease information, active compounds, links of relevant articles for COVID-19, cancer, HIV and malaria. Furthermore, each compound in AVPCD was annotated with its 2D and 3D structure, molecular formula, molecular weight, isomeric SMILES, InChI, InChI Key and IUPAC name and 21 other properties. Each compound was annotated with more than 20 properties. Specifically, a scoring method was designed to measure the confidence of each phytochemical for the viral diseases. In addition, we constructed a user-friendly platform with several powerful modules for searching and browsing the details of all phytochemicals. We believe this database will facilitate global researchers, drug developers and health practitioners in obtaining useful information against viral diseases.

A Challenging Diagnosis Of Rare Co-Existent Multiple Myeloma And Prostate Adenocarcinoma: A Systematic Review Of Case Reports

Objective

To review biochemical parameters, clinical characteristics, demographics, radiological and histopathological findings, treatment modalities and outcomes used to examine patients with coexisting multiple myeloma and prostate adencocarcinoma.

METHODS

The systematic review comprised search on PubMed, Google Scholar, Science Direct and the Directory of Open Access Journal databases for case reports published till June 1, 2022. The search was done in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using appropriate key words. Case reports included were those dealing exclusively with human subjects, were published in the English language and had free, full-text, public access. Quality assessment was done using Joanna Briggs Institute's Critical Appraisal Checklist for Case Reports. Data was extracted and the case reports were evaluated for demographic, diagnostic and treatment parameters.

RESULTS

Of the 515 studies initially identified, 5(0.97%) were analysed; all males with mean age 68.6±10.78 years. The most common symptom reported at presentation was low back pain 3(60%), Osteolytic lesions were seen in 4(80%) patients on imaging with elevated prostate surface antigen levels. Anaemia was found in 3(60%) patients and 2(40%) had thrombocytopenia.

Conclusion

Multiple myeloma and prostate adenocarcinoma can coexist although it is rare. Awareness regarding the possible coexistence of the two prominent cancer types may further help clinicians during their practice in considering multiple myeloma as a differential diagnosis when encountered with patients having osteolytic bony lesions along with elevated levels of prostate-specific antigen.

PROSPERO Registration Number

CRD42022334906.

Improving Postgraduate Anaesthesiology Training in a Low-Middle Income Country by Embracing the New Trends in Medical Education

Postgraduate medical training has increasingly adapted to competency-based medical education (CBME). In an endeavour to stay abreast with the new trends in medical education and adapt to CBME frameworks, an in-depth review and revision of the Anaesthesiology training curriculum were conducted. The authors worked on the task from December 2020 to December 2021. Learning outcomes were defined and corresponding competencies were identified and relevant teaching, learning and assessment strategies were aligned with each learning outcome. Additionally, lists were devised for topics to be covered through didactic lectures and simulation-based workshops. The revised curriculum is currently being implemented in a phased manner. Formative workplace-based assessment tools are being introduced to complement CBME. Moreover, daily clinical assessments, entrustable professional activity (EPA), simulation-based workshops and assessments have been introduced. Key Words: Anaesthesiology, Postgraduate training, Curriculum revision, Competency-based medical education, Low-middle income country, Simulation-based training.

Tissue characterization of benign cardiac tumors by cardiac magnetic resonance imaging, a review of core imaging protocol and benign cardiac tumors

Generally, cardiac masses are initially suspected on routine echocardiography. Cardiac magnetic resonance (CMR) imaging is further performed to differentiate tumors from pseudo-tumors and to characterize the cardiac masses based on their appearance on T1/T2-weighted images, detection of perfusion and demonstration of gadolinium-based contrast agent uptake on early and late gadolinium enhancement images. Further evaluation of cardiac masses by CMR is critical because unnecessary surgery can be avoided by better tissue characterization. Different cardiac tissues have different T1 and T2 relaxation times, principally owing to different internal biochemical environments surrounding the protons. In CMR, the signal intensity from a particular tissue depends on its T1 and T2 relaxation times and its proton density. CMR uses this principle to differentiate between various tissue types by weighting images based on their T1 or T2 relaxation times. Generally, tumor cells are larger, edematous, and have associated inflammatory reactions. Higher free water content of the neoplastic cells and other changes in tissue composition lead to prolonged T1/T2 relaxation times and thus an inherent contrast between tumors and normal tissue exists. Overall, these biochemical changes create an environment where different cardiac masses produce different signal intensity on their T1- weighted and T2- weighted images that help to discriminate between them. In this review article, we have provided a detailed description of the core CMR imaging protocol for evaluation of cardiac masses. We have also discussed the basic features of benign cardiac tumors as well as the role of CMR in evaluation and further tissue characterization of these tumors.

In-vitro synergistic microbicidal and catalytic evaluation of polyvinylpyrrolidone/chitosan doped tungsten trioxide nanoplates with evidential in-silico analysis

In this research, hydrothermally synthesized tungsten trioxide (WO₃) nanocomposites doped polyvinylpyrrolidone (PVP) and chitosan (CS) were studied. Various concentrations (3, 6, and 9 wt%) of PVP were doped into a fixed amount of binary system (CS-WO₃) nanocomposites. PVP/CS polymers showed attractive attention because of their different structure, functionality, and architecture control as dopant to WO₃. The PVP/CS encapsulates the WO₃ (ternary composite), which controls crystallite size (band gap reduction), rapidly overcomes the recombination electron-hole pairs issues, and generates the active sites, resulting in improved catalytic and antimicrobial activity. The synthesized nanocomposites revealed significant catalytic efficiency and methylene blue (MB) dye depletion of 99.9 % in the presence of reducing agent (NaBH₄) in neutral and acidic media. Antimicrobial effectiveness of produced nanostructures towards Escherichia coli (E. coli) pathogen at low and high concentrations were investigated by Vernier caliper in mm. Furthermore, to their microbicidal action, docking experiments of CS-doped WO₃ and PVP/CS-doped WO₃ nanostructures for DHFR and FabI of Escherichia coli suggested blockage of aforesaid enzymes as the plausible pathway.

FREQUENCY OF HYPOMAGNESAEMIA IN PATIENTSPRESENTING WITH ACUTE CORONARY SYNDROME

OBJECTIVES:To determine the frequency of hypomagnesaemia in patients presenting with Acute CoronarySyndrome.Methodology: It was Descriptive Cross Sectional study conducted in Department of Cardiology, MTI-HMC, Peshawarfrom 07 Mar, 2021 to 20 Sept 2021 after approval from Institutional ethical board.About185 patients were enrolled in the study. All patients presenting with Acute coronary syndrome to CCU and admitted were enrolled in study .After informed consent ,using aseptic3cc BD syringe5ml of blood was drawn and was sent in the vial for assessment ofmagnesium level. Hypomagnesaemia was labelled as per operational definition. All the data wasnoted and recorded into the attached proforma along with demographic details of the patient. RESULTS:. Maximun number of patients were in age group 51-70 years ie 77.83% (144)patients .About 22.16%(41)patients were recorded in 35-50 years age group. Mean and SDs for age was 62+7.11years and BMI was 27.2+1.56 kg/m2. Mean and SDs formagnesium level was 0.79+0.04 mmoles 44 (23.78%) patients had unstable angina, 124(67.02%) patients had NSTEMI, 17 (9.18%) patients had STEMI. 15 (8.10%) patients wererecorded with hypomagnesaemia. CONCLUSION:Our results show variations in the occurrence of hypomagnesaemia in acute coronary syndromeand that is the reason we recommend early assessment of serum magnesium concentration in acutecoronary syndrome so as to follow and implement proper magnesium supplementations well intime as hypomagnesaemia is preventable and therefore identifying it at early stage may be ofsignificant help to the patients.

Presence of selected organochlorine pesticides (OCPs) in sediments and biota of River Satluj, Pakistan: first report

Abstract In the developed countries, the use of OCPs (organochlorine pesticides) has been banned. However, in South Asia several of them are still in use. In Pakistan and India a constant addition of OCPs into the atmosphere has been indicated by various researchers. In this study levels of selected organochlorine pesticide residues were assessed in sediment and biota collected from four (4) water reservoirs (3 Barrages & 1 Siphon) on the River Satluj Pakistan, along 231 miles (372 km) of River stretch which was further divided into 12 sampling sites. It was aimed to find out the levels of organochlorine pesticide (OCPs) residues in sediments and from selected fish species (Labeo rohita, Wallagu attu, Cyprinus carpio) of the River Satluj Pakistan. The Organochlorine residues (seven pesticides) present in samples of sediments and biota were investigated through multi residue method, using Gas Chromatograph (GC-ECD).In the current study, the concentration of DDT, was investigated in Wallago attu (0.786-3.987 ppb), Labeo rohita (0.779-4.355 ppb) and Cyprinus carpio (1.234-5.654 ppb). DDE was also found in Cyprinus carpio (1.244-6.322 ppb), Wallag attu (0.877-4.221 ppb) and Labeo rohita (2.112-5.897 ppb). Aldrin was not observed in Labeo rohita and Wallago attu. Currently, lindane and DDE was found predominately high in the sediments of study area at SZ-4 (Panjnad Barrage) ranging (2.238-8.226 ppb) and (4.234-6.876 ppb), respectively. Heaptachlor was found only at SZ-4 (Panjnad Barrage) from the sediments with concentration ranging (0.032-234 ppb). In short all other residues investigated were found below the MCL (maximum concentration level) in all the compartments of the study area set by various agencies like WHO/FAO- Codex Alimenterious.

Synthesis and Characterization of Ni Nanoparticles via the Microemulsion Technique and Its Applications for Energy Storage Devices

Herein, a unique synthetic approach called microemulsion is used to create nickel nanoparticles (Ni-NPs). SEM, TEM, EDX, and XRD techniques were employed for the investigation of morphology and structures of the synthesized material. Electrons from electroactive components are transferred to external circuits by Ni-NPs' superior electrical conductivity and interconnected nanostructures, which also provide a large number of channels for ion diffusion and additional active sites. The experimental findings showed that as a positive electrode for supercapacitors (SC), Ni-NPs had an outstanding ability to store charge, with a dominant capacitive charge storage of 72.4% when measured at 10 mV/s. Furthermore, at 1 A/g, Ni-NP electrodes exhibit a maximum capacitance of 730 F/g. Further, the Ni-NP electrode retains 92.4% of its capacitance even for 5000 cycles, highlighting possible applications for it in the developing field of renewable energy. The current study provides a new method for producing high-rate next-generation electrodes for supercapacitors.

Factors influencing the use of postoperative bilevel positive airway pressure (BiPAP) in patients undergoing adult cardiac surgery: A retrospective cohort study

BAckground and Aims

Respiratory complications are one of the biggest challenges following cardiac surgery, which can lead to hypoxia and acute respiratory failure (ARF). The aim of this study to identify the factors led to BiPAP application for postoperative respiratory complications and its effectiveness as the main outcome measures after cardiac surgery.

Methods

It was a retrospective cohort study with consecutive sampling technique. A total of 335 postcardiac surgery patients medical record was reviewed who were underwent for surgery from November 1, 2018 to November 30, 2019. 265 patients were finalized for the recruitment, five patients were excluded before the final analysis. Data of 260 patients were analyzed for compiling of results.

Results

The mean age was 59 years. 196 (75.4%) patients were males and females were 64 (24.6%). Mean weight was 72 kg and mean body mass index (BMI) 26.67 kg/m²_. BiPAP application was in 38 (14.6%) patients and significantly high in with high BMI, (p < 0.05). There are significant associations of BiPAP application patients with COPD (p < 0.05). Patients with positive fluid balance, cardiac dysfunction, and required inotropic support were significantly associated with BiPAP need (p < 0.05), respectively.

Conclusion

BiPAP is effective to treat ARF and other respiratory complications after adult cardiac surgeries. High BMI, atelectasis, and pneumonia are also the independent factors causing ARF. BiPAP can be a successful tool for preventing the adverse effects of postoperative pulmonary complications after cardiac surgery.

Pneumothorax as a Complication of Bevacizumab-Containing Chemotherapy: A Systematic Review of Case Reports

Bevacizumab is a monoclonal anti-vascular endothelial growth factor (VEGF) antibody that binds to and makes all of the VEGF isoforms inactive, and thus prevents angiogenesis, development, and the spread of the tumor. The most reported side effects after administering bevacizumab include bleeding, high blood pressure, heart failure, proteinuria, thrombosis, and gastrointestinal perforation. Pneumothorax has rarely been reported as a complication of bevacizumab, but with an unclear mechanism. This article aims to explore the occurrence of pneumothorax as a side effect after using bevacizumab through a systematic review of current case reports published on the topic. A literature search was conducted using PubMed, Google Scholar, ScienceDirect, and Directory of Open Access through the utilization of appropriate keywords, and case reports were selected based on predefined inclusion and exclusion criteria. Our results encompass five case reports that were further evaluated for demographic, clinical, and treatment parameters. This systematic review concludes that pneumothorax can occur after bevacizumab-containing chemotherapy although this side effect is relatively rare. Awareness regarding this possible side effect can assist clinicians during their practice in considering pneumothorax as a possible differential diagnosis when encountering patients presenting with pulmonary symptoms after starting bevacizumab-containing chemotherapy; hence, timely diagnosis and treatment can save a life.

Caring for carers: A virtual psychosocial supervision intervention to improve the quality and sustainability of mental health and psychosocial support in humanitarian contexts

Introduction

Mental health and psychosocial support (MHPSS) staff in humanitarian settings have limited access to clinical supervision and are at high risk of experiencing burnout. We previously piloted an online, peer-supervision program for MHPSS professionals working with displaced Rohingya (Bangladesh) and Syrian (Turkey and Northwest Syria) communities. Pilot evaluations demonstrated that online, peer-supervision is feasible, low-cost, and acceptable to MHPSS practitioners in humanitarian settings.

Objectives

This project will determine the impact of online supervision on i) the wellbeing and burnout levels of local MHPSS practitioners, and ii) practitioner technical skills to improve beneficiary perceived service satisfaction, acceptability, and appropriateness.

Methods

MHPSS practitioners in two contexts (Bangladesh and Turkey/Northwest Syria) will participate in 90-minute group-based online supervision, fortnightly for six months. Sessions will be run on zoom and will be co-facilitated by MHPSS practitioners and in-country research assistants. A quasi-experimental multiple-baseline design will enable a quantitative comparison of practitioner and beneficiary outcomes between control periods (12-months) and the intervention. Outcomes to be assessed include the Kessler-6, Harvard Trauma Questionnaire and Copenhagen Burnout Inventory and Client Satisfaction Questionnaire-8.

Results

A total of 80 MHPSS practitioners will complete 24 monthly online assessments from May 2022. Concurrently, 1920 people receiving MHPSS services will be randomly selected for post-session interviews (24 per practitioner).

Conclusions

This study will determine the impact of an online, peer-supervision program for MHPSS practitioners in humanitarian settings. Results from the baseline assessments, pilot evaluation, and theory of change model will be presented.

Disclosure

No significant relationships.

Serum Anion Gap is Associated with Risk of All-Cause Mortality in Critically Ill Patients with Acute Myocardial Infarction

Purpose

Anion gap (AG) is a valuable and easily obtained clinical tool for differentially diagnosis of acid-base disorders. Current understanding of the prognostic impact of AG on mortality after acute myocardial infarction (AMI) is limited. We aimed to investigate whether AG is a predictor of short-term and long-term all-cause mortality after AMI.

Patients and Methods

We examined 1806 patients diagnosed with AMI in intensive care unit from the Medical Information Mart for Intensive Care III (MIMIC-III) database. We analyzed the association of AG with 30-day, 180-day and 1-year all-cause mortality on a continuous scale and in categories, using multivariable Cox regression. We utilized restricted cubic splines to evaluate the linearity between hazard ratio (HR) and AG concentrations.

Results

AG was associated with a higher risk of 30-day, 180-day and 1-year all-cause mortality, with adjusted HRs of 1.083 (95% CI 1.051 to 1.117), 1.077 (95% CI 1.049 to 1.105), and 1.074 (95% CI 1.047 to 1.101), respectively. The results were consistent in subgroup analyses. The association between AG and all-cause mortality was linear for 180-day and 1-year mortality, and near linear for 30-day mortality, as higher concentrations were associated with high all-cause mortality. When stratified according to quartiles, AG was associated with 30-day mortality (HR[95% CI]: second quartile, 2.243[1.273, 3.955]; third quartile, 3.026[1.763, 5.194]; top quartile, 4.402[2.573, 7.531]), 180-day mortality (HR[95% CI]: second quartile, 1.719[1.118, 2.645]; third quartile, 2.362[1.575, 3.542]; top quartile, 3.116[2.077, 4.676]), and 1-year mortality (HR[95% CI]: second quartile, 1.700[1.143, 2.528]; third quartile, 2.239[1.536, 3.264]; top quartile, 2.876[1.969, 4.201]) using bottom quartile as reference.

Conclusion

We firstly demonstrated that higher AG was significantly associated with increased 30-day, 180-day and 1-year all-cause mortality in AMI patients. AG as an easily obtained marker is of strong and reliable predictive value for AMI mortality during follow-up.

Cardiac Surgery and Blood-Saving Techniques: An Update

Cardiac surgery is typically attributed with a significant risk of intraoperative blood loss and allogeneic blood transfusions. Intraoperative blood loss, allogenic blood transfusions, high dose anticoagulation requirement, and interactions with cardiopulmonary bypass (CPB) have all been linked to cardiac surgeries. To reduce unnecessary transfusions and their negative effects, it is recommended to follow evidence-based multidisciplinary strategies, which are collectively termed patient blood management (PBM). This review highlights the most recent blood conservation strategies in adult cardiac surgery, which can be employed pre-operatively, intra-operatively, and postoperatively, to enhance red cell mass and attenuate the utilization of packed red blood cells (PRBCs) and other blood products.

Tongue Leptin Decreases Oro-Sensory Perception of Dietary Fatty Acids

Leptin, an anorectic hormone, regulates food intake, energy expenditure and body weight. We assessed the implication of tongue leptin in the modulation of oro-sensory detection of dietary fatty acids in mice. The RT-PCR analysis showed that mRNA encoding leptin and leptin receptor (Ob-Rb) was expressed in mice taste bud cells (TBC). Confocal microscopic studies showed that the lipid sensor CD36 was co-expressed with leptin in mice TBC. Silencing of leptin or Ob-Rb mRNA in tongue papillae upregulated preference for a long-chain fatty acid (LCFA), i.e., linoleic acid (LA), in a two-bottle paradigm in mice. Furthermore, tongue leptin application decreased the preference for the LCFA. These results suggest that tongue leptin exerts an inhibitory action on fatty acid preference. In isolated mice TBC, leptin decreased LCFA-induced increases in free intracellular calcium concentrations, [Ca²⁺]i. Leptin and LCFA induced the phosphorylation of ERK1/2 and STAT-3 and there were no additive or opposite effects of the two agents on the degree of phosphorylation. However, leptin, but not the LCFA, induced phosphoinositide-3-kinase (PI-3-K)-dependent Akt phosphorylation in TBC. Furthermore, leptin induced hyperpolarization, whereas LCFA induced depolarization in TBC. Our study demonstrates that tongue leptin exerts an inhibitory action on oro-sensory detection of a dietary fatty acid by interfering with Ca²⁺ signaling and membrane potential in mice TBC.

Range of factors in the reduction of hyperhydricity associated with in vitro shoots of Salvia santolinifolia Bioss

Hyperhydricity is a serious physiological disorder and affects In vitro propagation of many plants and as well of Salvia santolinifolia. The donor material to initiate the in vitro culture was the callus taken from the in vitro shoots produced on Murashig and Skoogs (MS) medium at 4.0 mg/l BA. This callus formed numerous hyperhydric shoots on culturing upon the medium of the same composition. The aim was to systematically evaluate the effect of cytokinins (Benzyladnine (BA) and N6-(-2-isopentenyl) adenine (2iP), culture vessels magnitude, medium solidification, source of nitrogen and calcium chloride for the alleviation of hyperhydricity. In the tissue cultures of S. santolinifolia BA and 2iP induced severe hyperhydricity, when other factors i.e. culture vessels magnitude and a suitable concentration of agar, ammonium nitrate (NH4NO3), potassium nitrate (KNO3) & calcium chloride (CaCl2.2H2O) were not optimized. After 30 days' culture, we observed 83.82% hyperhydric shoots at increased level (1.5 mg/l 2iP) and 81.59% at decreased levels (1.0 mg/l 2iP). On the other hand, hyperhydricity percentage at decreased (0.4%) and at increased (0.8%) levels of agar were 72.37% and 39.08%, respectively. MS medium modification with NH4NO3 (412 mg/l), KNO3 (475 mg/l) and CaCl2.2H2O (880 mg/l) was found the best medium to reduced hyperhydricity (23.6%).

Predictors and 3-year outcomes of compromised left circumflex coronary artery after left main crossover stenting

BACKGROUND

There are few predictors of decreased fractional flow reserve (FFR) in the left circumflex coronary artery (LCx) after left main (LM) crossover stenting.

OBJECTIVES

We aimed to determine the predictors for low FFR at LCx and possible treatment strategies for compromised LCx, together with their long-term outcomes.

METHODS

Altogether, 563 patients who met the inclusion criteria were admitted to our hospital from February 2015 to November 2020 with significant distal LM bifurcation lesions. They underwent single-stent crossover percutaneous coronary intervention (PCI) under intravascular ultrasound (IVUS) guidance with further LCx intervention based on the measured FFR.

RESULTS

The patients showed significant angiographic LCx ostial affection post-LM stenting, but only 116 (20.6%) patients had FFR < 0.8. The three-year composite major adverse cardiac events (MACE) rates were comparable between the high and low FFR groups (16.8% vs. 15.5; p = 0.744). In a multivariate analysis, low FFR at the LCx was associated with post-stenting minimal luminal area (MLA) of LCx (odds ratio [OR]: 0.032, p < .001), post-stenting LCx plaque burden (OR: 1.166, p < .001), poststenting LM MLA (OR: 0.821, p = .038), and prestenting LCx MLA (OR: 0.371, p = .044). In the low FFR group, those with compromised LCx managed with drug-eluting balloon had the lowest three-year MACE rate (8.1%), as compared to either those undergoing kissing balloon inflation (KBI) (17.5%) or stenting (20.5%) (p = 0.299).

CONCLUSION

Unnecessary LCx interventions can be avoided with FFR-guided LCx intervention. Poststenting MLA and plaque burden of the LCx, and main vessel stent length are poststenting predictors of low FFR.

Diagnosing a rare case of lymphocytic infiltration of the pituitary gland without the invasive procedure of pituitary biopsy

Background. Lymphocytic infiltration of the pituitary is an unusual inflammatory disorder of the pituitary and indicated to be autoimmune in origin. Presentations depend on the site of involvement and degree of destruction of the cellular population of the pituitary and may range from an asymptomatic state to pan-hypopituitarism with or without mass effects. In the present study, we represent a rare case of lymphocytic infiltration of the pituitary gland who was diagnosed with such condition and the subsequent management. Case presentation. A 22-year-old male who was admitted with symptoms of increased thirst and excessive fatigue. Following a thorough physical, clinical, laboratory, biochemistry, and imaging examinations a timely diagnosis of lymphocytic infiltration of the pituitary was made without using the invasive procedure of pituitary biopsy. In light of the diagnosis prompt management with the mainstay of glucocorticoid was started along with replenishing the other deficient hormones. In this study we describe a rare case of lymphocytic infiltration of the pituitary discussing in terms of epidemiology, sign and symptoms, laboratory evaluation, imaging studies, histopathology, management, and the usual outcome. Conclusion. Lymphocytic infiltration of the pituitary gland can be diagnosed with the clinical presentation along with lab evaluation and imaging but without pituitary biopsy, which could help in an early and accurate diagnosis which is the basis for better management of the rare condition.

Mean Temperature Loss During General Anesthesia for Laparoscopic Cholecystectomy: Comparison of Males and Females

Introduction

Mild hypothermia is common after general anesthesia. It is associated with discomfort and shivering. Greater fall of temperature is associated with more devastating complications. Data regarding the effect of gender on perioperative hypothermia is scanty.

Objectives of the study

To determine and compare mean core temperature loss in males and females undergoing laparoscopic cholecystectomy under general anesthesia.

Setting and design

Descriptive cross-sectional study in a tertiary care teaching hospital.

Subjects and methods

Ninety-seven elective laparoscopy patients were included through non-probability consecutive sampling. Intraoperatively, there was standardization of monitoring equipment, drapes, operation room temperature (21-22 °C), humidity (50%), irrigation fluid temperature (37 °C), peritoneal CO₂ temperature (21-22 °C), anesthetic fresh gas flow rates at induction and maintenance. Temperature recording equipment (nasopharyngeal probe) and temperature recording interval (10 minutes) were also standardized from induction till the end of surgery. Final temperature was recorded at the end of surgery before emergence.

Results

Mean temperature loss was 0.73 ⁰C ± 0.47⁰C. Mean loss was significant in males compared to females with a mean difference of 0.28°C ± 0.93⁰C; P-value= 0.003.

Conclusion

Mean temperature decreases significantly in laparoscopic cholecystectomy patients under general anesthesia. We recommend that more care is needed to prevent hypothermia in male patients because of their higher susceptibility to hypothermia.

Effect of garlic supplementation on zootechnical performance and hepato-renal functions in nitrate-treated rabbits

The effect of garlic supplementation on zootechnical performance and hepato-renal functions of rabbits exposed to experimental nitrate poisoning was evaluated. Adult male 6-8 week-old albino rabbits (n= 24) were randomly divided into four groups (A - D) and subjected to nitrate intoxication through the oral administration of sodium nitrate solution at 2 ml/kg bodyweight per day for 40 days. Group A was a control that received no treatment except sodium nitrate. Rabbits in groups B and C were treated with 1% methylene blue solution (2 mg/kg bodyweight per day) and aqueous garlic extract (500 mg/kg bodyweight per day) through intraperitoneal and oral routes, respectively. Rabbits in group D were treated with both 1% methylene blue solution (2 mg/kg bodyweight per day, intraperitoneally) and aqueous garlic extract (500 mg/kg bodyweight per day, orally). On completion of the treatment period, the groups were compared in growth performance, biochemical profile and histopathological changes of hepato-renal tissues. Although the total feed consumption of the groups remained comparable, Group C showed relatively better weight gain and feed conversion ratio (FCR). Likewise, garlic extract significantly increased the serum bilirubin concentration and reduced the level of other biochemical attributes in comparison with control animals. The hepatic and renal tissues of Groups C and D remained normal, whereas those of the control group exhibited distinct histopathological alterations. It was concluded that garlic supplementation ameliorated the deleterious effects of nitrate intoxication on production performance and hepato-renal functions of rabbits.

Drug resistance and susceptibility testing of Gram negative bacterial isolates from healthy cattle with different β - Lactam resistance Phenotypes from Shandong province China

The objective of this study was to evaluate the effectiveness of common antibiotics against different microorganisms in apparently healthy cattle in Shandong province and its suburb. A total of 220 nasal swab samples were collected and cultured for bacteriological evaluation. All the bacteria isolates after preliminary identification were subjected to antibiogram studies following disc diffusion method. It was found in the study that E. coli is the most commonly associated isolate (21%), followed by Klebsiella spp. (18%), Pseudomonas aeruginosa (13%), Salmonella spp. (15%), Shigella spp (12%), and Proteus spp (11%). While the antibiogram studies reveled that highest number of bacterial isolates showed resistance to Ampicillin (95%), followed by Augmentin (91%), Cefuroxime (85%) and Tetracycline (95%) of (Escherichia coli and Klebsiella spp). In the case of pseudomonas spp. and Salmonella the highest resistance was showed by Ampicillin (90%) followed by Amoxicillin + Clavulanic Acid (80%), Cefixime (90%), and Erythromycin (80%). In Shigella spp and Salmonella spp highest resistance was showed by Amoxicillin, Ceftazidime, Augmentin (60%), and Amoxicillin + Clavulanic Acid (50%). It is concluded that in vitro antibiogram studies of bacterial isolates revealed higher resistance for Ampicillin, Augmentin, Cefuroxime, Cefixime, Tetracycline, Erythromycin, and Amoxicillin + Clavulanic Acid. The high multiple Antibiotics resistance indexes (MARI) observed in all the isolates in this study ranging from 0.6 to 0.9. MARI value of >0.2 is suggests multiple antibiotic resistant bacteria and indicate presence of highly resistant bacteria.

Ameliorative effects of morel mushroom (Morchella esculenta) against Cadmium-induced reproductive toxicity in adult male rats

Cadmium (Cd) is one of the major toxicants, which affects human health through occupational and environmental exposure. In the current study, we evaluated the protective effects of morel mushrooms against Cd-induced reproductive damages in rats. For this purpose, 30 male rats were divided into 6 groups (n=5/group), the first group served as the control group, second group was treated with an intraperitoneal (i.p) injection of 1 mg/kg/day of Cd. Third and fourth groups were co-treated with 1 mg/kg/day of Cd (i.p) and 10 and 20 mg/kg/day of morel mushroom extract (orally) respectively. The final 2 groups received oral gavage of 10 and 20 mg/kg/day of morel mushroom extract alone. After treatment for 17 days, the animals were euthanized, and testes and epididymis were dissected out. One testis and epididymis of each animal were processed for histology, while the other testis and epididymis were used for daily sperm production (DSP) and comet assay. Our results showed that Cd and morel mushrooms have no effect on animal weight, but Cd significantly decreases the DSP count and damages the heritable DNA which is reversed in co-treatment groups. Similarly, the histopathological results of testes and epididymis show that morel mushrooms control the damage to these tissues. Whereas the morel mushroom extract alone could enhance the production of testosterone. These results conclude that morel mushrooms not only control the damage done by Cd, but it could also be used as a protection mechanism for heritable DNA damage.

Frequency of Blood Transfusion in Elective Coronary Artery Bypass Grafting and Its Correlation With Acute Kidney Injury at a Tertiary Care Hospital in a Lower Middle-Income Country

Background

Blood transfusion remains a significant management aspect in various cardiac surgical procedures including coronary artery bypass grafting (CABG). These patients have a reportedly high incidence of transfusion of blood products. It varies considerably amongst different institutions; most variability being seen in the transfusion trigger. This case series enumerate the frequency of administration of blood products in patients during elective CABG and its association with acute kidney injury (AKI) and ascertain whether blood transfusion is justifiable at a tertiary care hospital.

Materials and methods

Using non-probability consecutive sampling, 172 patients were enrolled in the study. Patient’s preoperative hemoglobin and creatinine, intraoperative hemoglobin, transfusion trigger, number of transfusions (whole blood and packed RBCs-PRBCs), postoperative hemoglobin and creatinine in the ICU and number of transfusions in the first 24 hours were recorded.

Results

Out of the 172 patients, 96 (55.81%) patients received blood transfusion and 73 (42.69%) patients suffered from AKI. 45 (61.64%) patients with AKI received transfusion whereas 28 (38.36%) patients had no transfusion. Of these 96 patients, 45 (46.8%) received transfusion intra-operatively, 24 (25%) patients received both intra-operatively and post-operatively while 27 (28.2%) patients were transfused postoperatively. Majority of the patients, 46 (88.3%), received unjustifiable transfusion (Hb >8 g/dl) during the first 24 hours post-operatively.

Conclusion

There is marked divergence in the peri-operative use of blood products that remain on a loco-regional as well as international basis. A standardized and a multidisciplinary strategy as well as robust institutional regulation would significantly reduce inappropriate patient exposure to blood products.

Distribution of commensal rodents in some shops of three districts in Malakand region, Pakistan

Using wire mesh live traps distribution pattern of the Rattus rattus and Mus musculus in different shops of three districts of Malakand region, Pakistan were recorded from September 2014 to October 2015. Over all 103 rodents (Rattus rattus 86 and Mus musculus 17) were caught during in 0.04 trap success (2448 trap nights). Regression of daily captures on cumulative captures revealed an estimate of 103 rodents from all the sampled structures with an average of 3.55 rodents per shop. R. rattus; 83.4% of captures were numerically dominant in almost all types of shops sampled, and were significantly different than Mus musculus; 16.5% of captures. Both species were found together in some shops while they were mostly trapped from the separate shops. Male rodents outnumbered the females.

Novel coronavirus 2019 (COVID-19) pandemic outbreak: A comprehensive review of the current literature

Coronavirus disease 2019 (COVID-19) is a pandemic caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The spread of the virus was rapid and currently COVID-19 cases are present worldwide in 213 countries, area or territories. Researchers worldwide are working and sharing their contribution regarding epidemiology, prevention, treatment, clinical and diagnostic patterns of the COVID-19. Current review is another contribution to the current knowledge, presenting the data in organized and systematic format about the current pandemic of COVID-19. The epidemiological information presented in the paper is subject to change as new cases are diagnosed and status of active cases is updated on daily basis.

Cutaneous leishmaniasis-Awareness, knowledge and practices among general population in rural and urban areas in Malakand region, Pakistan

Malakand region is an endemic area for cutaneous leishmaniasis (CL). However, there are limited number of studies of this disease in Pakistan. Therefore, a study was conducted to understand the level of awareness attitude and practice among the residents of Makaland towards CL and the disease vectors. This study adopted a cross-sectional approach with a total of 400 respondents (n=93 rural and n= 307 urban). Overall, the population in Malakand region (61.2%) were well-informed in the role of sand fly in transmitting diseases, but most lack knowledge on the vector's behavior and almost a quarter (24.5%) were unable to provide knowledge on proper control measures. Alarmingly, the practice and attitudes of the general population was not satisfactory as close to half (49.8%) of the population did adopt any control method. This study calls for increase in awareness through health education campaign to reduce the risk of cutaneous leishmaniasis outbreaks in the future.

Synthesis of TiO2 modified self-assembled honeycomb ZnO/SnO2 nanocomposites for exceptional photocatalytic degradation of 2,4-dichlorophenol and bisphenol A

In this study, we have successfully synthesized honeycomb-like self-assembled structure of TiO₂ modified ZnO/SnO₂ nanostructure via co-precipitation method with exceptional high degradation activities for 2,4-dichlorophenol (2,4-DCP) and bisphenol A (BPA) pollutants. The as-prepared samples were calcined in tube furnace at high elevated temperature (700, 800 and 900 °C) for 1 h. Among the TiO₂ modified samples, ZST10-700 showed higher charge separation as demonstrated from surface photovoltage spectroscopy, photoluminance and electrochemical curve. Surface morphology, crystallinity, optical property and different functional groups in the samples were determined with SEM, EDX, XRD, UV-Vis DRS and FTIR, respectively. Interestingly, 72% and 58% photocatalytic degradation efficiencies were achieved with optimized ZST10-700 for 2,4-DCP and BPA, respectively. In comparison, the pure ZS-700 only showed 36% and 29% photocatalytic degradation efficiencies, respectively. The improved photocatalytic degradation efficiencies of the optimized ZST10-700 are mainly due to improved charge separation and prolonged charge lifetime. It was further verified that by increasing calcination temperature, the photocatalytic activity decreased, and this is attributed to the formation of photo-inactive phases like Zn₂SnO₄ and ZnTiO₃. We believe that this work will provide an effective strategy to construct ternary heterojunction for the elimination of pollutants.

Potentially toxic elements' occurrence and risk assessment through water and soil of Chitral urban environment, Pakistan: a case study

This study investigated the concentrations of potentially toxic elements (PTE) including copper (Cu), chromium (Cr), cobalt (Co), cadmium (Cd), nickel (Ni), iron (Fe), zinc (Zn), lead (Pb), molybdenum (Mo) and manganese (Mn) in water and soil of the Chitral city, Pakistan. For this purpose, water (n = 66) and soil (n = 48) samples were collected from various locations of the Chitral city and analyzed for the PTE concentrations. Determined PTE concentrations were evaluated for the human and ecological potential risk. Results revealed that hazard quotient through water consumption was less than the threshold limit (1). However, for soil, the Fe mean hazard index (HI > 1) value for children only surpassed the threshold limits. The mean cancer risk index values via soil exposure were higher (RI > 1 × 10^-4) through consumption of Co, Ni and Cd for children and only Co for adults. Contamination factor (CF) values for Mo, Cd and Fe were found very high, considerable and moderate for 79%, 8% and 77% of sampling sites, respectively. Geoaccumulation index (I_geo) showed that soils were moderately-heavily polluted due to Mo. Potential ecological risk index (PERI) values exhibited considerable risk with an average risk index value in the range 190 < RI < 380. Higher values of CF, I_geo and PERI revealed the presence of pollution and pose risk to ecological environment.

Novel coronavirus 2019 (COVID-19) pandemic outbreak: A comprehensive review of the current literature

Coronavirus disease 2019 (COVID-19) is a pandemic caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The spread of the virus was rapid and currently COVID-19 cases are present worldwide in 213 countries, area or territories. Researchers worldwide are working and sharing their contribution regarding epidemiology, prevention, treatment, clinical and diagnostic patterns of the COVID-19. Current review is another contribution to the current knowledge, presenting the data in organized and systematic format about the current pandemic of COVID-19. The epidemiological information presented in the paper is subject to change as new cases are diagnosed and status of active cases is updated on daily basis.

In vivo phytotoxicity, uptake, and translocation of PbS nanoparticles in maize (Zea mays L.) plants

PbS nanomaterials are of great concern because of their potential toxicity and unavoidable releases of multiple commercial applications of nanoparticles (NPs). Commercial NPs act as mediators of damage to plant cells and pose potential toxicity to plants and human health. The mechanisms involved in the toxicity, uptake, and biotranslocation of PbS NPs in plants are poorly understood. We synthesize 15 ± 6 nm PbS nanoparticles (NPs) and report the phytotoxicology, uptake, and translocation of PbS NPs in maize (Zea mays L.) plants under various hydroponic treatments (5 mg/L, 10 mg/L, 20 mg/L, 30 mg/L, 40 mg/L, 50 mg/L of PbS NPs, 1.5 mg/L Pb²⁺ ion and controls) for 15 days. The findings indicate that PbS NPs has phytotoxic effects on seeds germination and similar effects in root elongation. The PbS NPs significantly inhibites the biomass of shoots and roots, as well as root morphology compared with the controls. The PbS NPs can penetrate the epidermis of maize roots and bioaccumulate in shoots at higher concentrations than controls treated with Pb²⁺ ions. The observations are consistent with indices of biotranslocation factor and confirmed by STEM-EDS mapping. The results illustrate PbS NPs can enter the cell wall and exist in intercellular space and cytoplasm of the cortical cell of maize seedlings by apoplastic and symplastic pathways. This study highlights the importance of the uptake, phytotoxicity, and biotranslocation of PbS NPs in maize crops and demonstrates the possible transfer into human food as an outcome of the fate of PbS NPs in plants.

Predictors of suboptimal coronary blood flow after primary angioplasty and its implications on short-term outcomes in patients with acute anterior STEMI

BACKGROUND

Suboptimal coronary blood flow after primary percutaneous coronary intervention (PCI) is a complex multifactorial phenomenon. Although extensively studied, defined modifiable risk factors and efficient management strategy are lacking. This study aims to determine the potential causes of suboptimal flow and associated impact on 30-day outcomes in patients presenting with anterior ST-elevation myocardial infarction (STEMI).

METHODS

We evaluated a total of 1104 consecutive patients admitted to our hospital from January 2016 to December 2018 with the diagnosis of anterior wall STEMI who had primary PCI.

RESULTS

Overall, 245 patients (22.2%) had final post-PCI TIMI flow ≤2 in the LAD (suboptimal flow group) and 859 (77.8%) had final TIMI-3 flow (optimal flow group). The independent predictors of suboptimal flow were thrombus burden grade (Odds ratio (OR) 1.848; p < 0.001), age (OR 1.039 per 1-year increase; p < 0.001), low systolic blood pressure (OR 1.017 per 1 mmHg decrease; p < 0.001), total stent length (OR 1.021 per 1 mm increase; p < 0.001), and baseline TIMI flow ≤1 (OR 1.674; p = 0.018). The 30-day rates of major adverse cardiovascular events (MACE) and cardiac mortality were significantly higher in patients with TIMI flow ≤2 compared to those with TIMI-3 flow (MACE: adjusted risk ratio [RR] 2.021; P = 0.025, cardiac mortality: adjusted RR 2.931; P = 0.031).

CONCLUSION

Failure to achieve normal TIMI-3 flow was associated with patient-related (age) and other potentially modifiable risk factors (thrombus burden, admission systolic blood pressure, total stent length, and baseline TIMI flow). The absence of final TIMI-3 flow carried worse short-term clinical outcomes.

Synthesis of NiF2 and NiF2·4H2O Nanoparticles by Microemulsion and Their Self-Assembly

Superstructures or self-assembled nanoparticles open the development of new materials with improved and/or novel properties. Here, we present nickel fluoride (NiF₂) self-assemblies by successive preparatory methods. Originally, the self-assemblies were obtained by exploiting the water-in-oil microemulsion technique as a result of auto-organization of hydrated NiF₂ (NiF₂·4H₂O) nanoparticles. The nanostructuration of NiF₂·4H₂O nanoparticles was confirmed by X-ray diffraction (XRD) and transmission electron microscopy (TEM) data. The size and shape of NiF₂·4H₂O nanoparticles and their subsequent self-assemblies varied slightly as a function of water-to-surfactant and water-to-oil ratios. Scanning electron microscopy (SEM) and TEM characterizations revealed that the nanoparticles are organized into a succession of self-assemblies: from individual nanoparticles assembled into layers to truncated bipyramids, which further auto-organized themselves into almond-shaped superstructures. Anhydrous NiF₂ was achieved by heating NiF₂·4H₂O self-assemblies under the dynamic flow of molecular fluorine (F₂) at a moderate temperature (350 °C). Preservation of self-assemblies during the transformation from NiF₂·4H₂O to NiF₂ is successfully achieved. The obtained materials have a specific surface area (SSA) of about 30 m²/g, more than 60% of that of bulk NiF₂. The lithium-ion (Li⁺) storage capacities and the mechanism of the nanostructured samples were tested and compared with the bulk material by galvanostatic cycling and X-ray absorption spectroscopy (XAS). The nanostructured samples show higher capacities (∼650 mAh/g) than the theoretical (554 mAh/g) first discharge capacity due to the concomitant redox conversion mechanism of NiF₂ and solid-electrolyte interphase (SEI) formation. The nanostructuration by self-assembly appears to positively influence the lithium diffusion in comparison to the bulk material. Finally, the magnetic properties of nanostructured NiF₂·xH₂O (x = 0 or 4) have been measured and appear to be very similar to those of the corresponding bulk materials, without any visible size reduction effect. The hydrated samples NiF₂·4H₂O show an antiferromagnetic ordering at T_N = 3.8 K, whereas the dehydrated ones (NiF₂) present a canted antiferromagnetic ordering at T_N = 74 K.

Postoperative Cognitive Dysfunction following General Anaesthesia in Patients Undergoing Elective Non-cardiac Surgery

OBJECTIVE

To determine frequency of early postoperative cognitive dysfunction (POCD) in patients aged 40 to 60 years, following general anaesthesia in patients undergoing elective, non-cardiac surgery.

STUDY DESIGN

Descriptive study.

PLACE AND DURATION OF STUDY

Department of Anaesthesiology, The Aga Khan University Hospital (AKUH), Karachi, from December 2015 to May 2016.

METHODOLOGY

After obtaining approval from Ethical Review Committee of AKUH and informed consent, ASA I and II patients, aged between 40 to 60 years of either gender, undergoing general anaesthesia for elective non-cardiac surgical procedures, were recruited. Patients were assessed preoperatively by using mini-mental state examination (MMSE); and patients having a score equal to or greater than 23 (maximum 30) were included in the study. All patients were reassessed at 24 hours postoperatively by MMSE. Both the MMSE evaluations were performed by primary investigator on predesigned data collection form.

RESULTS

A total of 150 patients were enrolled in the study. Preoperative MMSE score ranged from 24 to 30 while postoperative MMSE score (at 24 hours) was between 25 and 30. Thus, no patient developed POCD following general anaesthesia for elective, non-cardiac surgery in this study.

CONCLUSION

Early POCD was not found in the presently studied population of middle aged patients having elective non-cardiac surgery under general anaesthesia. Key Words: Postoperative cognitive dysfunction (POCD), General anaesthesia, Non-cardiac surgery, Mini- mental state examination.