International Journal of Applied and Basic Medical Research最新文献

Background: Intracranial aneurysms pose significant challenges due to their potential to rupture, leading to subarachnoid hemorrhage (SAH) with severe neurological consequences. Endovascular treatment has emerged as a minimally invasive alternative to surgical clipping, offering distinct advantages in terms of morbidity and recovery. This study aims to compare the clinical profiles, treatment outcomes, and prognostic factors between microsurgical clipping and endovascular treatment in the management of intracranial aneurysms.

Materials and methods: This study analyzed 103 patients treated for intracranial aneurysms at a tertiary care institution in North India between January 2018 and December 2023. Of these, 53 underwent microsurgical clipping and 50 underwent endovascular treatment. Data on demographics, clinical presentations, aneurysm characteristics, and treatment details were meticulously collected. Immediate and long-term outcomes, including neurological status and complications, were assessed. Statistical analyses, including Chi-square tests and t-tests, were used to identify significant predictors of poor outcomes.

Results: The mean age was 52.43 years for the clipping group and 54.42 years for the endovascular treatment group, with no significant difference (P = 0.951). The most common clinical presentations were headache and altered sensorium, with similar frequencies in both groups. Anterior communicating artery aneurysms were the most common location in both cohorts. The mean duration of operation was significantly longer for clipping (120.5 ± 30.6 min) compared to endovascular treatment (68.53 ± 25.23 min, P < 0.001). Postoperative complications were higher in the clipping group, including vasospasm (22.6% vs. 38.0%, P = 0.090) and cerebral infarcts (22.6% vs. 20.0%, P = 0.741). Endovascular treatment patients had a shorter hospital stay (18.30 ± 9.40 days vs. 27.55 ± 22.43 days, P = 0.162).

Conclusion: Both endovascular treatment and microsurgical clipping are effective treatment modalities for intracranial aneurysms, each with distinct advantages. Endovascular treatment offers a less invasive approach with shorter hospital stays and potentially better long-term outcomes. Microsurgical clipping provides durable aneurysm occlusion and remains critical for complex aneurysms. The choice of treatment should be individualized based on aneurysm characteristics, patient condition, and available expertise.

Background: Pregabalin is being used as preemptive analgesic for better postoperative pain management. This present study was aimed at comparing effectiveness and safety of 75 mg and 150 mg of oral pregabalin given as premedication 1 h before the surgery.

Materials and methods: This was prospective, randomized, and double-blinded placebo controlled study in which 90 patients were enrolled and randomized into three groups of 30 patients each. Groups P75 (given 75 mg pregabalin), P150 (given 150 mg pregabalin) and C (given placebo drug). Postoperative pain and sedation assessment were done. Adverse effects such as somnolence, dizziness, nausea, and vomiting were noted.

Results: Pain was lowest in P150 group than P75 and control group at 2 h. The duration of analgesia was highest in the P150 group followed by the P75 group with the control group showing the shortest duration. A significant difference was observed in total tramadol consumption (P < 0.001) in three groups. Sedation scores were the highest in P150 followed by P75 and C (P < 0.001) during the 1^st h. Somnolence was the highest in P150 group which was statistically significant. Difference in other side effects such as dizziness, nausea, vomiting, headache, and dryness of mouth was not statistically significant.

Conclusion: Pregabalin is a safe drug and has good analgesic effect. Although the analgesic effectiveness of higher dose, i.e., 150 mg was better, adverse effect in terms of sedation was more. Hence, we suggest pregabalin 75 mg to be used preoperatively as it has demonstrated to have good analgesic effectiveness.

Background: Various materials are available to plug screw access hole (SAH) in a screw retained implant prosthesis. Bacterial contamination of this plugging material and its subsequent leakage can contribute to inflammation of peri-implant area.

Aim: The present study aimed to evaluate bacterial contamination of cotton (Co), polytetrafluoroethylene (PTFE), and cotton dipped in 1% chlorhexidine (Co1%CHX) as SAH plugging material.

Materials and methods: Forty implant sites were included in the study. After prosthetic restorations, cotton was used as the primary SAH plugging material in all implant sites. Next month, implant sites were randomly divided into subgroups Co1%CHX and PTFE and given respective plugging material after retrieving the cotton pellet, which was subjected for microbial assay the same day. On the next visit, respective plugging material was retrieved and sent for microbial analysis. SAH was re-plugged with the respective plugging material. Peri-implant sulcular fluid (PISF) was collected from respective sites and stored at - 80°C. After 3 months of the last visit, patients were recalled for the collection of PISF, stored suitably. All the PISF samples were analyzed for interleukin-6 (IL-6) levels via sandwich enzyme-linked immunosorbent assay.

Results and conclusion: Bacterial contamination of cotton was highest and statistically significant when compared with both PTFE and Co1%CHX for both aerobic and anaerobic bacteria. Co1%CHX with fewer positive samples and lower bacterial counts was found to be a better plugging material than PTFE. However, the leakage from SAH for both PTFE and Co1%CHX was insufficient to cause any significant increase in IL-6 levels in PISF of patients after 3 months.

Solitary fibrous tumors (SFTs) are a rare spindle cell neoplasm arising from mesenchymal cells. It was first described in the pleura. There are numerous reports that document their extrapleural locations. SFT involving the cervix is extremely rare and only a handful of cases have been reported in Indian and western literature. Previously, it was thought that SFT tumor cells differentiated from mesothelial cells into fibroblasts. With the advent of immunohistochemistry, it is revealed that tumor cells in SFT lack mesothelial characteristics but express CD34 and Bcl-2, suggesting that the tumor originates from mesenchymal tissue. Preoperative definitive diagnosis of SFT cervix is difficult.

Background: Chronic heart failure (CHF), characterized by ventricular remodeling and myocardial fibrosis, remains a major therapeutic challenge. This study investigated the cardioprotective effects of quercetin, an Astragalus-derived bioactive compound, focusing on its modulation of the Akt/Bcl-2 pathway.

Methods: This study established both H9C2 cardiomyocyte hypoxia/reoxygenation (H/R) injury models and aortic constriction-induced heart failure (HF) rat models to investigate the cardioprotective effects of quercetin. Cell viability and mitochondrial function were assessed using CCK-8 assay and Mitotracker staining, while apoptosis, reactive oxygen species (ROS) levels, and myocardial fibrosis were measured. Real-time-quantitative polymerase chain reaction and Western blot analyses were performed to examine the expression of key molecules in the Akt/Bcl-2 pathway, elucidating the molecular mechanisms by which quercetin improves ventricular remodeling and myocardial fibrosis through regulation of this signaling pathway.

Results: In H/R-injured H9C2 cells, quercetin significantly enhanced cardiomyocyte survival, inhibited apoptosis, maintained mitochondrial function, and reduced ROS in H/R-injured H9C2 cells. Molecular analysis demonstrated that quercetin regulated the Akt pathway by upregulating Bcl-2 and downregulating P53, thereby reducing apoptosis. In aortic constriction-induced HF rats, quercetin improved cardiac function, attenuated fibrosis, and inhibited ventricular remodeling through activation of the Akt/Bcl-2 signaling pathway.

Conclusion: Quercetin mitigates ventricular remodeling and myocardial fibrosis through Akt/Bcl-2 pathway activation, offering a promising therapeutic strategy for CHF.

Background: Hypertrophic cardiomyopathy (HCM), associated with left ventricular hypertrophy, can lead to significant morbidity. Given the hereditary association, identifying population-specific genetic markers and gender disparities could enable better screening and management strategies.

Aim: The study aimed to observe the genetic patterns of HCM and investigate its gender associations among the Indian population.

Methodology: A prospective analysis was performed based on the medical records of patients with HCM. Genetic testing was conducted among those with a family history of HCM or sudden cardiac death. Genetic testing results, echocardiography, and clinical outcomes were documented. The prevalence of HCM types and genetic abnormalities were estimated in the study population and were compared between the two genders.

Results: The study included 103 patients with a mean age of 56.3 ± 13.9 years. Genetic analysis was conducted in 48/103 individuals based on the hereditary linkage. Only 50% of the 48 individuals had known genes associated with HCM. About 48% had apical or midapical HCM, and 31.1% had reverse curvature HCM. About 38% of apical and 60% of neutral or reverse curvature were associated with genetic abnormalities. The more commonly associated genes were MYBPC3 and MYH7. The current study also identified genetic variants in several emerging genes in Indian HCM patients.

Conclusion: Our study findings indicate that the prevalence of different types of HCM is different in the Indian population. With only 50% of the hereditary HCM linked to known genes, the study calls for further screening of genes associated with HCM in the Indian population.

Background: Aflatoxin B1 (AFB1) is a mycotoxin generated by the fungi Aspergillus flavus and Aspergillus parasiticus, known for its potential to cause liver cancer and has been associated with several adverse health effects. It commonly contaminates cereals, peanuts, corn, and other crops, posing serious risks to both poultry and human health. One promising natural compound that has gained attention for its potential health benefits is resveratrol. The current research aims to explore the possible effect of resveratrol on AFB1-induced kidney damage in rats.

Materials and methods: Forty adult male albino rats were evenly assigned into four groups: a control group, a group treated with resveratrol at a dosage of 10 mg/kg/day orally for 10 days, a group treated with AFB1 at a dosage of 1.5 mg/kg/day orally for 10 days and a group treated with both resveratrol and AFB1. After 10 days of treatment, renal tissues were processed for biochemical, gene expression, histopathological, and immunohistochemical investigations.

Results: Administering resveratrol led to a reduction in serum creatinine, blood urea nitrogen, renal malondialdehyde concentrations, interleukin 6 gene expression, and the immunoreactivity of the proapoptotic protein (Bax). It also restored reduced glutathione levels, increased sirtuin 1 gene expression, and the immunoreactivity of the antiapoptotic protein (Bcl2). Furthermore, resveratrol improved the alterations in the histopathology in AFB1-treated group.

Conclusions: Coadministration of resveratrol in AFB1 toxicity exhibited a significant ability to improve renal function through antioxidant, anti-inflammatory, and antiapoptotic mechanisms in experimentally induced renal damage by AFB1.

Aim: This study aims to design and develop novel lidocaine analogs specific for the Na_v1.7 channel using in silico approaches.

Background: Neuropathic pain (NP) is defined as chronic pain originating from abnormalities found within the nervous system. Voltage-gated sodium channels play a significant role in enhancing neuronal excitability, thus gained significance as a crucial target for developing drugs to treat NP. It consists of 9 different isoforms, with Na_v1.7 predominantly found in the dorsal root ganglion, playing a crucial role in the pathophysiology of NP. The selective inhibitors targeting the Na_v1.7 channel hold greater potential for treating NP while minimizing interference with the physiological functions of other sodium channel isoforms.

Methods: Atom and field-based three-dimensional (3D) quantitative structure-activity relationship (QSAR) was created using lidocaine analogs to identify the structural features required for the Na_v1.7 inhibitory activities. Further, the molecular interaction of the scaffold with the Na_v1.7 channel VSD4 was studied by docking the molecules with it followed by absorption, distribution, metabolism, and excretion (ADME) analysis.

Results: The 3D QSAR studies revealed that the presence of hydrophobic groups and steric parameters heightened the specificity for Na_v1.7 channel. Docking analysis revealed that 4 compounds, i.e., A15, A14, A6, and A5, exhibited the highest binding affinity in comparison to reference drug lidocaine. Furthermore, ADME predictions indicated that the compounds exhibited favorable characteristics in terms of oral bioavailability and solubility.

Conclusion: This research offers valuable structural insights to improve the specific inhibition of the Na_v1.7 channel, facilitating the design and development of novel, Na_v1.7 channel-specific inhibitors.