Transient neurologic syndrome after spinal anesthesia with epidural steroid treatment

Background: Transient neurologic syndrome (TNS) is a rare complication of spinal and epidural anesthesia. It is defined as paradoxic postoperative back pain radiating to the lower extremities with no neurologic deficits. Because it is a self-limited disease, the treatment is usually symptomatic and consists of NSAIDs and injections of a neuromuscular-blocking drug at the trigger points. The syndrome may be resistant to this treatment regimen and may last for several months, resulting in a long convalescence.Case summary: A 63-year-old Turkish woman (height, 165 cm; weight, 71 kg) underwent hemorrhoidectomy in the jackknife position using spinal anesthesia. No adverse events occurred during puncture or surgery or in the immediate postoperative recovery period. Recovery from the sensory and motor block was normal. Twenty-four hours after surgery, lower limb and plantar pain developed with no sensory or motor deficit. Neurologic examination revealed normal motor and sensory function. Electroneuromyography showed partial denervation potential of muscles innervated by the left sciatic nerve. The symptoms were suggestive of TNS. Combination oral NSAID treatment with amitriptyline (25 mg/d) and gabapentin (1200 mg/d) was initiated. Because the pain still persisted 6 weeks after surgery, epidural steroid injection with triamcinolone acetate (80 mg) with isotonic saline was administered, resulting in definite pain relief (visual analog scale score = 0).Conclusions: Epidural steroid treatment was effective in this patient with TNS resistant to treatment with NSAIDs, amitriptyline, and gabapentin. Future studies are needed to evaluate this treatment.     

Odiosoft-Rhino versus rhinomanometry in healthy subjects

CONCLUSION: Odiosoft-Rhino (OR) is a non-invasive test that is completed in an extremely short period of time. It is easy to perform and little patient cooperation is needed. OR is safe and could be used in the rhinological setting if further improved. OBJECTIVE: To evaluate nasal obstruction objectively with a new technique, OR, and to compare the results with a widely accepted method, rhinomanometry, in normal subjects. SUBJECTS AND METHODS: OR and anterior RMM were performed in 79 subjects without any rhinologic symptoms and signs. Visual analogue scales (VAS) of nasal obstruction, nasal airway resistance and nasal expiratory and inspiratory sounds were analysed. RESULTS: VAS of nasal obstruction was found to be correlated with OR findings of expiration at 2000-4000 Hz frequency interval on both sides (r = 0.564, p < 0.01 for the left side, r = 0.533, p < 0.01 for the right side). Correlations were found (p < 0.05) between left 2000-4000 Hz in expiration OR and left expiration RMM, left 4000-6000 Hz in expiration OR and left expiration RMM, right 2000-4000 Hz in expiration OR and right expiration RMM, and right 4000-6000 Hz in expiration OR and right expiration RMM. No correlation was seen between VAS, anterior RMM and OR at inspiration in any interval.     

Lack of Chlamydophila pneumoniae and predominance of Alloiococcus otitidis in middle ear fluids of children with otitis media with effusion

Objective

To investigate the presence of Chlamydophila pneumoniae and other bacterial pathogens in middle ear effusion samples obtained from children with otitis media with effusion (OME).

Materials and methods

Twenty-eight children (mean age 7.03; standard deviation 2.18) with OME unresponsive to medical therapy were included in the study. All of the children underwent ventilation tube insertion under general anesthesia. Eighteen patients were bilaterally affected whereas 10 children had unilateral disease. The middle ear fluids (46 samples in total) were collected during ventilation tube insertion, and were evaluated subsequently for the presence of C. pneumoniae and other bacterial pathogens using polymerase chain reaction (PCR).

Results

Although all samples were negative for C. pneumoniae, bacterial DNA was detected in 21 of 46 samples. Overall 40% of the patients (4/10) with unilateral involvement, and 61% of the patients (11/18) with bilateral involvement were positive for bacterial DNA. In 6 patients with bilateral OME bilateral samples were positive, whereas 5 patients with bilateral OME showed only unilateral positivity. According to the results of DNA sequencing analysis, all of the positive samples harbored only one bacterial species. In 12 of 46 samples Alloiococcus otitidis DNA (26%), in 7 Haemophilus influenzae DNA (15%), in one Streptoccoccus pneumoniae DNA (2%) and in one Moraxella catarrhalis DNA (2%) were present.

Conclusions

Our findings support that C. pneumoniae does not seem to have a role in OME in children whereas A. otitidis was found to be more frequent than the other common pathogens. Further studies are required to elucidate the exact pathogenetic role of these microorganisms in OME.     

Caesarean scar endometriosis

Introduction  Caesarean section incidence is rising and caesarean scar endometriosis could be encountered more in the day to day clinical practice. Materials and methods  We present three cases of caesarean scar endometriosis which were managed in our unit with excision biopsy. Conclusions  Complete excision is both diagnostic and therapeutic. FNAC could be a tool to exclude malignancy and allows a quick diagnosis.     

Percutaneous aspiration versus open drainage of liver abscess in children

Liver abscess, though a very grave problem, is rarely seen in infancy and childhood. Affected children are usually immunocompromised and are of poor socioeconomic status. Although liver abscess due to wandering ascarids is rare outside, it is common complication among children of Kashmir. Usual site of abscess is the right lobe of the liver and USG and CT of the abdomen are the main tools of diagnosis. The study was conducted over a period of 10 years from January 1991 to December 2000 and total of 129 cases were studied in the age group of 0–14 years. Diagnosis was made by a detailed clinical examination together with USG and CT of the abdomen. Out of 129 cases, 49 were treated with antibiotics alone, 55 cases were taken for open drainage, and 27 cases were taken for percutaneous aspiration under USG guidance. Percutaneous aspiration failed in five patients who were later taken for open drainage. Open method was found still to be the best modality of management, although percutaneous aspiration is safe and effective but needs lot of expertise.     

Theoretical investigation of the optoelectronic response of highly correlated Cu3P photocatalyst

Photocatalytic materials attract immense scientific interest due to their possible applications in energy harvesting. These applications are strongly dependent on the material''s band gap and efficient visible light absorption, which ultimately relies on the underlying electronic structure of the material. In this work, we have theoretically studied the electronic and optical response of a Cu₃P semiconductor. We have used Density Functional Theory (DFT), and the Many-Body Perturbation Theory (MBPT) based Bethe–Salpeter Equation (BSE). Cu₃P has intriguing band gap nature, as DFT predicts a semi-metallic state which was corrected by employing the Hubbard potentials. Only astronomically large values of Hubbard potentials reproduced the semiconducting state of Cu₃P. The optical response of the material is computed within a Random Phase Approximation (RPA) and using the BSE on top of DFT+U wavefunctions and on the ground state computed with the PBE0 functional. The BSE captures the excitonic physics, and the optical absorption obtained from it was red-shifted compared to the RPA, which shows the significance of electron–hole interactions in Cu₃P. The comparison of the BSE with experiments suggests that BSE@PBE0 reproduces the optical absorption much more closely to the experimental data.

The optical absorption from BSE@PBE0 is in better agreement with the experiment than BSE@DFT+U. The electron–hole interaction and strong correlation between electrons play a vital role in the optoelectronic response of Cu₃P.     

Hepatitis B among University Population: Prevalence,Associated Risk Factors,Knowledge Assessment,and Treatment Management

Background: Very few studies have been reported on hepatitis B in the State of Azad Jammu and Kashmir, Pakistan, and none of them are specific to the prevalence and causes of hepatitis B spread among educational institutes. This study aimed to estimate the prevalence of hepatitis B infection and its associated risk factors among the University of AJ and K population. Methods: An observational, cross-sectional, and analytical study was conducted with 7015 students and employees. Hepatitis B was detected by rapid immunochromatographic tests (ICTs), enzyme-linked immunosorbent assay (ELISA), and real-time quantitative PCR. A questionnaire and interview method was used to assess the disease knowledge and associated risk factors with hepatitis B through Chi-square, Fisher’s exact test, and paired t-test. Results: Of the participants, 150 (2.13%) were found positive for the hepatitis B surface antigen (57.3% male and 42.7% female). Only 0.3% participants were found fully vaccinated against the hepatitis B virus. Among ethnic groups, the Syed tribe was found more prevalent for hepatitis B infection (40.6%), while use of contaminated mourning blades (95% CI: p = 0.0001) was found as an overlooked risk factor. Hepatitis preventive awareness sessions were found to be very significant (p = 0.0001). Conclusions: The study showed that an overlooked risk factor is playing a key role in the spread of HBV in a tribe living worldwide, which must be addressed globally to eradicate hepatitis B. In Pakistan, a country-wide annual HBV vaccination program should be launched to control hepatitis B.     

Metabolic and pharmacological profiling of Penicillium claviforme by a combination of experimental and bioinformatic approaches

BackgroundPenicillium produces a wide range of structurally diverse metabolites with significant pharmacological impacts in medicine and agriculture. For the first time, a complete metabolome of Penicillium claviforme (P. claviforme) (FBP-DNA-1205) was studied alongside pharmacological research in this study.MethodsThe metabolic profile of P. claviforme fermented on Potato Dextrose Broth (PDB) was investigated in this work. The complete metabolomics studies of fungus were performed using GC-MS and LC-MS-QTOF techniques. An in vitro model was utilised to study the cytotoxic and antioxidant activities, while an in vivo model was employed to investigate the antinociceptive and acute toxicity activities. Molecular Operating Environment (MOE) software was used for molecular docking analysis.ResultsGC-MS study showed the presence of alkanes, fatty acids, esters, azo and alcoholic compounds. Maculosin, obtain, phalluside, quinoline, 4,4’-diaminostilbene, funaltrexamine, amobarbital, and fraxetin were among the secondary metabolites identified using the LC-MS-QTOF technique. The n-hexane fraction of P. claviforme displayed significant cytotoxic activity in vitro, with an LD50 value of 92.22 µgml⁻¹. The antinociceptive effects in vivo were dose-dependent significantly (p < .001). Interestingly, during the 72 h of investigation, no acute toxicity was demonstrated. In addition, a docking study of tentatively identified metabolites against the inflammatory enzyme (COX-2) supported the antinociceptive effect in an in silico model.ConclusionMetabolic profile of P. claviforme shows the presence of biologically relevant compounds in ethyl acetate extract. In addition, P. claviforme exhibits substantial antioxidant and cytotoxic activities in an in vitro model as well as antinociceptive activity in an in vivo model. The antinociceptive action is also supported by a molecular docking study. This research has opened up new possibilities in the disciplines of mycology, agriculture, and pharmaceutics.

Key messages

• The first time explored complete metabolome through GC-MS and LC-MS-QTOF.
• Both in vivo & in vitro pharmacological investigation of P. claviforme.
• In silico molecular docking of LC-MS-QTOF metabolites.

     

Rheological properties of moderately concentrated solutions of polystyrene-block-polybutadiene-block-polystyrene in different selective solvents and at different temperatures

The shear viscosity of a moderately concentrated solution of the triblock copolymer polystyrene-block-polybutadiene-block-polystyrene is studied in a common solvent (1,4-dioxane) and in so-called selective solvents (mixtures of 1,4-dioxane with different alcohols). In the latter, which dissolve only the styrene blocks and precipitate the butadiene blocks, the block copolymer molecules aggregate and form micelles with the precipitated blocks as the core and the dissolved blocks as the cilia. The micelle solutions exhibit non-Newtonian behaviour over certain concentration ranges. The viscosity of the micellar solutions in the dilute regime is found to be lower than that of their unimer solutions (i. e., the viscosity measured in 1,4-dioxane) at the same concentration, whereas at higher concentrations the situation is opposite. The viscosity of micellar solutions is first increasing and then decreasing with temperature for all selective solvents used. These variations with concentration and temperature are explained in terms of micelle structure, intermicellar entanglement, swelling of the inner core and coiling of the micelle cilia.