Use of K-Y Jelly on Throat Packs for Postoperative Sore Throat after Nasal Surgery: A Randomized Controlled Trial

Introduction  Postoperative sore throat (POST) is a fairly common side effect of general anesthesia. The K-Y jelly is a well-known lubricant used in many medical procedures. Objective  In this randomized study, we evaluated the use of throat packs soaked with K-Y jelly for POST outcomes in patients submitted to nasal surgery. Methods  The present double-blinded, randomized, controlled study included 140 ASA I-II patients undergoing nasal surgery under general anesthesia. Patients received either or K-Y jelly or water-soaked X-ray detectable throat packs fully inserted into the mouth to occlude the oropharynx. Results  Comparison between the studied groups regarding the severity of POST assessed by visual analog scale revealed significantly lower POST levels in the K-Y jelly group on recovery from anesthesia, and at 2, 4, and 6 hours postoperatively. Conclusions  The use of K-Y jelly-soaked throat packs was associated with less severe POST after nasal surgery.

Superior Hypogastric Plexus Block for Pain Management Post-Hysterectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

We aimed to evaluate the efficacy of superior hypogastric plexus (SHP) block in pain relief among women undergoing hysterectomy. Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021 for the available randomized clinical trials (RCTs). We included RCTs that compared SHP block (intervention group) to saline (control group) in hysterectomy. Our primary outcomes were pain scores at different time intervals using the Visual Analog Scale (VAS). Our secondary outcomes were postoperative opioid consumption within 24 hours and postoperative nausea and vomiting incidence. We extracted the available data from included studies and pooled them in a meta-analysis model using RevMan software. Four RCTs with a total number of 289 patients met our inclusion criteria. The VAS pain scores were significantly declined at post-anesthesia care unit (PACU), 2, 6, and 12 hours postoperatively among SHP block group (p < 0.05). However, no significant difference was reported in VAS pain score 1 day postoperatively between intervention and control groups. Moreover, SHP block significantly reduced the postoperative opioid consumption and incidence of nausea and vomiting (p = 0.03 & p = 0.003). In conclusion, superior hypogastric plexus block effectively reduces postoperative pain, opioid consumption, and incidence of nausea and vomiting post-hysterectomy.

CYP11A1‑derived vitamin D hydroxyderivatives as candidates for therapy of basal and squamous cell carcinomas

Hydroxyderivatives of vitamin D3, including classical 1,25(OH)2D3 and novel CYP11A1‑derived hydroxyderivatives, exert their biological activity by acting as agonists on the vitamin D receptor (VDR) and inverse agonists on retinoid‑related orphan receptors (ROR)α and γ. The anticancer activities of CYP11A1‑derived hydroxyderivatives were tested using cell biology, tumor biology and molecular biology methods in human A431 and SCC13 squamous (SCC)‑ and murine ASZ001 basal (BCC)‑cell carcinomas, in comparison with classical 1,25(OH)2D3. Vitamin D3‑hydroxyderivatives with or without a C1α(OH) inhibited cell proliferation in a dose‑dependent manner. While all the compounds tested had similar effects on spheroid formation by A431 and SCC13 cells, those with a C1α(OH) group were more potent in inhibiting colony and spheroid formation in the BCC line. Potent anti‑tumorigenic activity against the BCC line was exerted by 1,25(OH)2D3, 1,20(OH)2D3, 1,20,23(OH)3D3, 1,20,24(OH)3D3, 1,20,25(OH)3D3 and 1,20,26(OH)3D3, with smaller effects seen for 25(OH)D3, 20(OH)D3 and 20,23(OH)2D3. 1,25(OH)2D3, 1,20(OH)2D3 and 20(OH)D3 inhibited the expression of GLI1 and β‑catenin in ASZ001 cells. In A431 cells, these compounds also decreased the expression of GLI1 and stimulated involucrin expression. VDR, RORγ, RORα and CYP27B1 were detected in A431, SCC13 and ASZ001 lines, however, with different expression patterns. Immunohistochemistry performed on human skin with SCC and BCC showed nuclear expression of all three of these receptors, as well as megalin (transmembrane receptor for vitamin D‑binding protein), the level of which was dependent on the type of cancer and antigen tested in comparison with normal epidermis. Classical and CYP11A1‑derived vitamin D3‑derivatives exhibited anticancer‑activities on skin cancer cell lines and inhibited GLI1 and β‑catenin signaling in a manner that was dependent on the position of hydroxyl groups. The observed expression of VDR, RORγ, RORα and megalin in human SCC and BCC suggested that they might provide targets for endogenously produced or exogenously applied vitamin D hydroxyderivatives and provide excellent candidates for anti‑cancer therapy.

Effect of laser biostimulation and a low-calorie diet vs. a low-calorie diet alone on insulin resistance, inflammatory biomarkers, and depression among obese postmenopausal women: a randomized controlled trial

OBJECTIVE

Postmenopausal women are significantly predisposed to a multitude of disorders. Laser biostimulation (LB) and a healthy diet have been linked to multiple health benefits. This study aimed to investigate the effect of a combined LB and balanced low-calorie diet (LCD) vs. an LCD alone on insulin resistance (IR), inflammatory biomarkers, and depression score in obese postmenopausal women.

PATIENTS AND METHODS

In the present study, a total of 66 postmenopausal women, with a mean age of 66.61 ± 4.80 years and a body mass index (BMI) of 35.93 ± 2.67 kg/m2, were randomized into two equal groups. The experimental group received LB and LCD (including 50-60% carbohydrates, 15-20% protein, 20-35% fat, and 25 g of fiber/day plus a restriction of 500-1000 kcal/d), while the control group followed the same diet program only for 12 weeks. Before and after the intervention, IR [measured by the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR index)], inflammatory biomarkers [C-reactive protein (CRP), white blood cells (WBCs), lymphocytes, and erythrocyte sedimentation rate (ESR)], and depression level [as assessed by the Hamilton Depression Rating Scale (HAMD-17)] were all measured.

RESULTS

Using an intention-to-treat analysis for 60 women who completed the study, the body weight average reduction was -13.14% for the experimental group (p<0.001) vs. -6.36% for the control group (p<0.001). BMI, IR, inflammatory markers, and depression levels were also similarly changed.

CONCLUSIONS

In postmenopausal obese women, adding LB to a suitable dietary program provides the most significant benefit in terms of lowering IR, metabolic inflammation, and depression.

Effect of aerobic exercise with diet on sex hormones and selected coagulation biomarkers in obese postmenopausal women: a randomized clinical trial

OBJECTIVE

The current study determined the effect of aerobic training and diet program versus diet only on sex hormones and selected coagulation biomarkers in obese postmenopausal women. Further, the correlation between the measured variables after the intervention was identified.

PATIENTS AND METHODS

Eligible 40 women were distributed into two equal groups: the experimental group that received aerobic training three times per week for 12 weeks along with a balanced diet, and the control group that received a balanced diet only. Changes in weight, body mass index, sex hormones, and coagulation biomarkers were assessed pre-and post-intervention. The correlation between evaluated variables was assessed.

RESULTS

Both groups demonstrated a significant difference in sex hormones (i.e., a substantial decrease in estradiol, total testosterone, free testosterone, and a substantial increase in sex hormone-binding globulin) and coagulation biomarkers (a considerable reduction in plasminogen activator inhibitor-1 activity, fibrinogen, and a significant increase in tissue plasminogen activator, prothrombin time, and cephalin-kaolin coagulation time). This discrepancy was highly significant in the experimental group (p < 0.01) relative to the control group (p < 0.05), and there was a strong link between sex hormones and coagulation biomarkers (p ≤ 0.05). Conversely, no correlation between variables was noticed in the control group (p > 0.05).

CONCLUSIONS

Aerobic exercise along with a balanced diet modulates sex hormones level, improves homeostasis balance in postmenopausal women, and reduces the potential risk of cardiovascular disease.