Search

Alzheimer’s disease (AD) is characterized by immune system dysregulation, impacting both central and peripheral immune responses. The study aimed to investigate the mechanism behind the neurotoxic effects of β-amyloid (Aβ) peptide in the rat brain including the study of neuroinflammation, neurodegeneration, and alterations in peripheral immune responses (PIR). The neuroinflammation brought on by Aβ1–42 and is unknown to influence PIR. Animal models were prepared, after 28 days, control, sham, and treated rats were anaesthetized and inflammatory markers of hippocampus and serum levels (reactive oxygen species, nitrite, tumor necrosis factor-α, and interleukin-1β), and some markers of PIR (splenic mononuclear cells or MNC, cytotoxicity and phagocytic index of the white blood cells leukocyte adhesion inhibition index or LAI), as well as polymorphonuclear cells of the spleen, were assessed. In addition to changes in peripheral immune responses, the present study found that AD rats had higher blood levels of inflammatory markers. Based on the study, the immune system irregularities observed in AD rats in the peripheral regions might be connected to neuroinflammation, which is facilitated by a compromised blood–brain barrier. Hence, it is viable to propose that the neuroinflammatory condition in rats with Aβ-induced AD could modify immune responses in the peripheral areas with significantly higher levels of inflammatory cytokines markers in the hippocampal tissue in Aβ-injected AD rats.

In the past two decades, oxidative stress (OS) has drawn a lot of interest due to the revelation that individuals with many persistent disorders including diabetes, polycystic ovarian syndrome (PCOS), cardiovascular, and other disorders often have aberrant oxidation statuses. OS has a close interplay with PCOS features such as insulin resistance, hyperandrogenism, and chronic inflammation; there is a belief that OS might contribute to the development of PCOS. PCOS is currently recognized as not only one of the most prevalent endocrine disorders but also a significant contributor to female infertility, affecting a considerable proportion of women globally. Therefore, the understanding of the relationship between OS and PCOS is crucial to the development of therapeutic and preventive strategies for PCOS. Moreover, the mechanistic study of intracellular reactive oxygen species/ reactive nitrogen species formation and its possible interaction with women’s reproductive health is required, which includes complex enzymatic and non-enzymatic antioxidant systems. Apart from that, our current review includes possible regulation of the pathogenesis of OS. A change in lifestyle, including physical activity, various supplements that boost antioxidant levels, particularly vitamins, and the usage of medicinal herbs, is thought to be the best way to combat this occurrence of OS and improve the pathophysiologic conditions associated with PCOS.

System of Rice Intensification (SRI) was evaluated for the variety Hardinath-1 under nutrient omission treatment (-N, -P, -K, -Zn, -B and +All) through field experiment conducted in randomized complete block design (RCBD) with six treatments and four replications during spring season of 2018 at agriculture field of Sailaja Acharya Memorial Polytechnic, Siswani Jahada, Morang. The highest grain (4.62 t/ha) and straw yields (7.75 t/ha) were obtained from the fully fertilized plot (i. e.+All treatments) which might be due to application of all of the major nutrients in sufficient amount (i. e. 150 : 45 : 45 : 20 : 5 N : P : K : Zn : B kg/ha) along with following SRI principles. Omitting the major nutrients showed significantly lesser growth and yield parameters of rice. The P omitted treatment showed significantly higher sterility percentage (23.74) as P had major role on grain filling and development. The nutrients omission treatment also produced significant effect on plant uptake of N, P, K, Zn and B. Significantly higher uptake of N (76.73 kg/ha), P (38.28 kg/ha), K (52.41 kg/ha), Zn (0.086 kg/ha) and B (0.022 kg/ha) was obtained from fully fertilized plot. Based on plant uptake of nutrient on omission plot, native N, P, K, Zn and B supplying capacity of the soil at research plot was found to be 23.51, 25.94, 37.59, 0.075 and 0.019 kg/ha, respectively. The recovery efficiency of applied N, P, K, Zn and B was found to be 35.48, 5.7, 32.93, 0.06 and 0.06%, respectively. Owing to native nutrient supplying capacity of the soil at the research site, N, P, K, Zn and B required to obtain the target yield of 5 t/ha was found 139.5 kg N/ha, 45.22 kg P/ha, 50.8 kg K/ha, 12.1 kg Zn/ha and 2.6 kg B/ha, respectively. [ABSTRACT FROM AUTHOR]

Wood plastic composite (WPC) development has been facilitated by the economical extrusion of WPC profiles for various applications. The physical and mechanical properties of WPC products can be optimized by regulating extrusion processing conditions and material formulations. Rectangular WPC profiles were produced with varied high-density polyethylene (HDPE), wood fiber (WF), and lubricant contents under different extrusion conditions in a twin-screw extruder extrusion line. Optimal tensile and flexural properties were obtained with 50 wt% WF at 7 and 3 wt% lubricant and maleated polyethylene (MAPE) contents. The apparent shear viscosity of the WPC melts decreased gradually with increased lubricant content. Hence, for practical applications, a combination of HDPE grade, WF, lubricant, and MAPE contents can provide the benefits of lower shear viscosity while maintaining the mechanical properties and surface smoothness of WPC profiles. [ABSTRACT FROM PUBLISHER]

Abstract: Single-phase α-Ga2O3 thin films in the nanocrystalline form were prepared by the sol–gel technique. The optimum annealing temperature was found to be 500°C. Below this temperature, a mixed phase of α-GaO(OH) and α-Ga2O3 was found and above this range a mixed phase of α-Ga2O3 and β-Ga2O3 was detected. A pure β-phase was observed at higher annealing temperatures. The crystallite size of α-Ga2O3 was found to be about 16nm. The optical band gap of α-Ga2O3, determined from transmittance measurements, was found to be 4.98eV which was higher than that of the β-phase prepared in identical condition. The semiconducting transition of this phase was allowed direct type like β-phase. [Copyright &y& Elsevier]

Rhodium with activated carbon as carbon base layer (Rh/AC) was exploited as an oxygen reduction reaction (ORR) catalyst to explore its applicability in microbial fuel cell (MFC). Four MFCs were fabricated using the Rh/AC catalyst, adopting varying Rh loadings of 0.5, 1.0 and 2.0 mg cm−2 and without Rh on carbon felt cathode in order to understand the optimum loading of this catalyst to enhance the performance of MFC. The participation of Rh/AC in ORR was confirmed by cyclic voltammetry and electron impedance spectroscopy analysis, which supported the enhanced charge transfer capacity of the cathode modified with the prepared catalysts. Volumetric power density of MFC was found to be improved by 2.6 times when Rh/AC was used as cathode catalyst (9.36 W m−3) at a loading of 2.0 mg cm−2 in comparison to the control MFC (3.65 W m−3) without Rh on the cathode. It was thus inferred that the increase in the Rh loading up to 2 mg cm−2 can improve the performance of MFC significantly. • Rh over activated carbon (AC) proved as excellent oxygen reduction reaction catalyst. • Highest power density was observed with Rh/AC loading of 2.0 mg cm−2. • The participation of Rh/AC in ORR was confirmed by cyclic voltammetry analysis. • Highest net energy recovery was also observed with Rh/AC loading of 2.0 mg cm−2. [ABSTRACT FROM AUTHOR]

Studies the substitution effect of (Zr[sub 1-x]Nb[sub x]) NCl solid solution on crystal structure and superconductivity. Electronic band structure calculation; Results of powder x-ray diffraction; Magnetic measurement; Relation between the decrease in superconducting volume fraction and the increase of niobium content in the samples.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is recognized for inducing severe respiratory symptoms like cough, and shortness of breathing. Although symptom severity varies, some individuals remain asymptomatic. This virus has sparked a global pandemic, imposing a substantial rate of mortality or morbidity, with extended periods of illness reported. People with underlying medical issues and the elderly are more likely to experience adverse results. The virus's frequent mutations pose challenges for medical professionals, necessitating adaptable therapeutic and preventive strategies. Vitamin D, a versatile regulatory molecule, not only influences physiological processes such as serum calcium regulation but also exhibits immunomodulatory functions. Calcium ions play a crucial role as secondary signal transduction molecules, impacting diverse cellular functions and maintaining homeostasis through ion channel regulation. Parathormone, another key regulator of serum calcium, often acts antagonistically to vitamin D. This review delves into the interplay of vitamin D, calcium, and parathormone, exploring their possible influence on the progression of COVID-19. The intricate signaling involving these elements contributes to adverse prognosis, emphasizing the need for comprehensive understanding. Monitoring and controlling these physiological factors and associated pathways have shown the potential to alter disease outcomes, underscoring the importance of a holistic approach., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interests, (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Tropical and subtropical regions face millions of deaths from mosquito-borne illnesses yearly. Insecticides prevent transmission but pose health risks like dermatitis and allergies. The primary objective was to mitigate the recurring dependence on synthetic insecticides, thereby curbing the development of mosquito resistance. Leaves of Cymbopogon flexuosus (lemongrass) was collected from Mayurbhanj, India, processed, then extracted by steam distillation for essential oils & analyzed spectroscopically. Larvicidal assays were performed across varying concentrations, revealing the significant mortality induced by the Cymbopogon flexuosus extract against Anopheles stephensi larvae. 3D structure was modelled by using G protein-coupled receptors (GPCR) sequence and structural stability was also validated. After docking the binding free energy was determined from GPCR protein with β-citral complex. Molecular dynamics (MD) study was conducted on the docked pose that displayed an optimal interactome profile. The larvicidal assay at the 12th and 24th hour revealed the highest LC50 (lethal concentration) of 23.493 ppm and 19.664 ppm . β-Citral has a high binding affinity and an identifiable binding site, which suggests that it may play a larvicidal role in regulating the receptor's function by creating stable complexes with it. β-Citral from lemongrass oils has potential larvicidal activity and effective against GPCR family 1 of mosquito and highly effective repellents against mosquito-borne diseases., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Diabetes-related ulcers and slow-healing wounds pose a significant health risk to individuals due to their uncertain causes. Mortality rates for diabetes foot ulcers (DFUs) range from 10% after 16 months to 24% after five years. The use of bioactive phytochemicals can play a key role in healing wounds in a predictable time. Recent literature has demonstrated that various natural substances, including flavonoids, saponins, phenolic compounds, and polysaccharides, play key roles at different stages of the wound-healing process through diverse mechanisms. These studies have categorized the compounds according to their characteristics, bioactivities, and modes of action. In this study, we evaluated the role of natural compounds derived from plant sources that have been shown to play a crucial role in immunomodulation. Macrophages are closely involved in immunomodulation within the wound microenvironment and are key players in efferocytosis, inflammation resolution, and tissue regeneration, all of which contribute to successful wound healing. Phytochemicals and their derivatives have shown capabilities in immune regulation, including macrophage migration, nitric oxide synthase inhibition, lymphocyte and T-cell stimulation, cytokine activation, natural killer cell enhancement, and the regulation of NF-κβ, TNF-α, and apoptosis. In this review, we have studied the role of phytochemicals in immunomodulation for the resolution of diabetic wound inflammation.

Lemongrass ( Cymbopogon flexuosus ) essential oil (LGEO) contains α-citral, β-citral and other phytochemicals extracted using various methods. This research extracted essential oils using steam distillation (SD) and microwave-assisted hydro distillation (MAHD) to maximize quantity and purity. LGEO was tested for antibacterial properties. LGEO was extracted using SD and compared to MAHD output based on oil production and chemical composition. We performed GCMS to characterize LGEO. Fourier transform infrared spectroscopy (FTIR) used for quantum chemical analysis. Spectroscopic analysis showed that SD extracted secondary metabolites (ethyl-linalool, isogeranial, β-citral, α-citral, geranyl acetate, and caryophyllene) yielded 9.7 %, 11.5 %, 35.4 %, 13.4 %, 6.4 %, and 6.4 %, respectively, while MAHD yielded 10.2 %, 13.4 %, 43.2 %, 17.3 %, 6.9 %, and 7.3 %. MAHD extracted α and β citral content was better than SD extraction technique. FTIR spectroscopy and quantum chemistry analysis showed extracted oil chemical composition, electronic structure of α and β citral isomers. In the disc-diffusion experiment, both extracts were effective against Gram-positive and Gram-negative bacteria and harmful fungi. LGEO from SD and MAHD extraction (30 mg/mL) demonstrated disc diffusion assay antibacterial efficacy against microorganisms. The two extracts effectively inhibited microorganisms with MIC values of 3.75 and 7.5 μg/mL. It can be concluded that, LGEO have greater antimicrobial activity in MAHD extraction., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Matrix Metalloproteinases (MMPs), which are endopeptidase reliant on zinc, are low in embryonic tissues but increases in response to a variety of physiological stimulus and pathological stresses. Neuro-glial cells, endothelial cells, fibroblasts, and leucocytes secrete MMPs, which cleave extracellular matrix proteins in a time-dependent manner. MMPs affect synaptic plasticity and the development of short-term memory by controlling the size, shape, and excitatory synapses' function through the lateral diffusion of receptors. In addition, MMPs influence the Extracellular Matrix proteins in the Peri-Neuronal Net at the Neuro-glial interface, which aids in the establishment of long-term memory. Through modulating neuronal, and glial cells migration, differentiation, Neurogenesis, and survival, MMPs impact brain development in mammals. In adult brains, MMPs play a beneficial role in physiological plasticity, which includes learning, memory consolidation, social interaction, and complex behaviors, by proteolytically altering a wide variety of factors, including growth factors, cytokines, receptors, DNA repair enzymes, and matrix proteins. Additionally, stress, depression, addiction, hepatic encephalopathy, and stroke may all have negative effects on MMPs. In addition to their role in glioblastoma development, MMPs influence neurological diseases such as epilepsy, schizophrenia, autism spectrum disorder, brain damage, pain, neurodegeneration, and Alzheimer's and Parkinson's. To help shed light on the potential of MMPs as a therapeutic target for neurodegenerative diseases, this review summarizes their regulation, mode of action, and participation in brain physiological plasticity and pathological damage. Finally, by employing different MMP-based nanotools and inhibitors, MMPs may also be utilized to map the anatomical and functional connectome of the brain, analyze its secretome, and treat neurodegenerative illnesses., Competing Interests: Declaration of competing interest The authors declare no conflicting interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: The widespread presence of bisphenol-A (BPA) in consumer goods like water bottles and eyeglass frames raises serious concerns about the chemical's ability to accumulate in human tissues. Molecular filtration and activated carbon adsorption are two of the many BPA treatment technologies that have emerged in response to these issues; both are essential in the removal or degradation of BPA from water sources and industrial effluents., Content: To secure the long-term health and environmental advantages of BPA treatment approaches, sustainable development is essential. Both the efficient elimination or destruction of BPA and the reduction of the treatment operations' impact on the environment are important components of a sustainable approach. Different search engines like Pub-Med, MEDLINE, Google Scholar and Scopus are used for these systematic reviews and analyzed accordingly. This can be accomplished by making treatment facilities more energy efficient and using environmentally friendly materials. Greener ways to deal with BPA pollution are on the horizon, thanks to innovative techniques like bioremediation and improved oxidation processes. Reducing dependence on conventional, resource-intensive procedures can be achieved by investigating the use of bio-based materials and natural adsorbents in treatment processes., Summary and Outlook: This review article tackling the health and environmental concerns raised by BPA calls for an integrated strategy that incorporates sustainable development principles and technology progress. We can reduce the negative impacts of BPA contamination, improve environmental stewardship in the long run, and ensure human health by combining cutting-edge treatment technologies with sustainable behaviours., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

In this issue of Structure, Walker et al. 1 determined the NMR structure of a recently discovered defensin, Pp19, from the venom of an assassin bug. This peptide adopts an α-defensin-like structure, which had not been observed in insects before. Unlike mammalian α-defensins, which are generally antimicrobial, Pp19 has insecticidal activity., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Infections due to pathogenic fungi are endemic in particular area with increased morbidity and mortality. More than a thousand people are infected per year and the way of treatment is of high demand having a significant impact on the population health. Medical practitioners confront various troublesome analytic and therapeutical challenges in the administration of immunosuppressed sufferer at high danger of expanding fungal infections. An upgraded antimycosal treatment is fundamental for a fruitful result while treating intrusive mycoses. A collection of antimycosal drugs keeps on developing with their specific antifungal targets including cell membrane, mitochondria, cell wall, and deoxyribonucleic acid (DNA)/ribonucleic acid (RNA) or protein biosynthesis. Some fundamental classes of ordinarily directed medications are the polyenes, amphotericin B, syringomycin, allylamines, honokiol, azoles, flucytosine, echinocandins etc. However, few immunotherapy processes and vaccinations are being developed to mark this need, although one presently can't seem to arrive at the conclusion. In this review article, there has been a trial to give details upgradation about the current immune therapeutic techniques and vaccination strategies against prevention or treatment of mycosis as well as the difficulties related with their turn of events. There has been also a visualization in the mentioned review paper about the various assorted drugs and their specific target analysis along with therapeutic interventions., Competing Interests: The authors declare that there are no conflicts of interest., (© 2024 The Authors.)

Type 2 diabetes mellitus is a long-lasting endocrine disorder characterized by persistent hyperglycaemia, which is often triggered by an entire or relative inadequacy of insulin production or insulin resistance. As a result of resistance to insulin (IR) and an overall lack of insulin in the body, type 2 diabetes mellitus (T2DM) is a metabolic illness that is characterized by hyperglycaemia. Notably, the occurrence of vascular complications of diabetes and the advancement of IR in T2DM are accompanied by dysbiosis of the gut microbiota. Due to the difficulties in managing the disease and the dangers of multiple accompanying complications, diabetes is a chronic, progressive immune-mediated condition that plays a significant clinical and health burden on patients. The frequency and incidence of diabetes among young people have been rising worldwide. The relationship between the gut microbiota composition and the physio-pathological characteristics of T2DM proposes a novel way to monitor the condition and enhance the effectiveness of therapies. Our knowledge of the microbiota of the gut and how it affects health and illness has changed over the last 20 years. Species of the genus Eubacterium, which make up a significant portion of the core animal gut microbiome, are some of the recently discovered 'generation' of possibly helpful bacteria. In this article, we have focused on pathogenesis and therapeutic approaches towards T2DM, with a special reference to gut bacteria from ancient times to the present day., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

In a retrospective view, this review examines the impact of mucormycosis on health workers and researchers during the COVID era. The diagnostic and treatment challenges arising from unestablished underlying pathology and limited case studies add strain to healthcare systems. Mucormycosis, caused by environmental molds, poses a significant threat to COVID-19 patients, particularly those with comorbidities and compromised immune systems. Due to a variety of infectious Mucorales causes and regionally related risk factors, the disease's incidence is rising globally. Data on mucormycosis remains scarce in many countries, highlighting the urgent need for more extensive research on its epidemiology and prevalence. This review explores the associations between COVID-19 disease and mucormycosis pathology, shedding light on potential future diagnostic techniques based on the fungal agent's biochemical components. Medications used in ICUs and for life support in ventilated patients have been reported, revealing the challenge of managing this dual onslaught. To develop more effective treatment strategies, it is crucial to identify novel pharmacological targets through "pragmatic" multicenter trials and registries. In the absence of positive mycology culture data, early clinical detection, prompt treatment, and tissue biopsy are essential to confirm the specific morphologic features of the fungal agent. This review delves into the history, pathogens, and pathogenesis of mucormycosis, its opportunistic nature in COVID or immunocompromised individuals, and the latest advancements in therapeutics. Additionally, it offers a forward-looking perspective on potential pharmacological targets for future drug development., (© 2024 The Author(s).)

Lemongrass contains a variety of substances that are known to have antioxidant and disease-preventing properties, including essential oils, compounds, minerals, and vitamins. Lemongrass ( Cymbopogon Spp. ) essential oil (LGEO) has been demonstrated to ameliorate diabetes and accelerate wound healing. A member of the Poaceae family, Lemongrass, a fragrant plant, is cultivated for the extraction of essential oils including myrcene and a mixture of geranial and neral isomers of citral monoterpenes. Active constituents in lemongrass essential oil are myrcene, followed by limonene and citral along with geraniol, citronellol, geranyl acetate, neral, and nerol, which are beneficial to human health. A large part of lemongrass' expansion is driven by the plant's huge industrial potential in the food, cosmetics, and medicinal sectors. A great deal of experimental and modeling study was conducted on the extraction of essential oils. Using Google Scholar and PubMed databases, a systematic review of the literature covering the period from 1996 to 2022 was conducted, in accordance with the PRISMA declaration. There were articles on chemistry, biosynthesis, extraction techniques and worldwide demand of lemongrass oil. We compared the effectiveness of several methods of extracting lemongrass essential oil, including solvent extraction, supercritical CO2 extraction, steam distillation, hydrodistillation (HD), and microwave aided hydrodistillation (MAHD). Moreover, essential oils found in lemongrass and its bioactivities have a significant impact on human health. This manuscript demonstrates the different extraction techniques of lemongrass essential oil and its physiological benefits on diabetic wound healing, tissue repair and regeneration, as well as its immense contribution in ameliorating arthritis and joint pain.Key teaching pointsThe international market demand prediction and the pharmacological benefits of the Lemongrass essential oil have been thoroughly reported here.This article points out that different extraction techniques yield different percentages of citral and other secondary metabolites from lemon grass, for example, microwave assisted hydrodistillation and supercritical carbon dioxide extraction process yields more citral.This article highlights the concept and application of lemongrass oil in aromatherapy, joint-pain, and arthritis.Moreover, this manuscript includes a discussion about the effect of lemongrass oil on diabetic wound healing and tissue regeneration - that paves the way for further research.

Nuclear envelope (NE) disassembly during mitosis is critical to ensure faithful segregation of the genetic material. NE disassembly is a phosphorylation-dependent process wherein mitotic kinases hyper-phosphorylate lamina and nucleoporins to initiate nuclear envelope breakdown (NEBD). In this study, we uncover an unexpected role of the PP2A phosphatase B55 SUR-6 in NEBD during the first embryonic division of Caenorhabditis elegans embryo. B55 SUR-6 depletion delays NE permeabilization and stabilizes lamina and nucleoporins. As a result, the merging of parental genomes and chromosome segregation is impaired. NEBD defect upon B55 SUR - 6 depletion is not due to delayed mitotic onset or mislocalization of mitotic kinases. Importantly, we demonstrate that microtubule-dependent mechanical forces synergize with B55 SUR - 6 for efficient NEBD. Finally, our data suggest that the lamin LMN-1 is likely a bona fide target of PP2A-B55 SUR - 6 . These findings establish a model highlighting biochemical crosstalk between kinases, PP2A-B55 SUR - 6 phosphatase, and microtubule-generated mechanical forces in timely NE dissolution., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

This study focuses on the probable use of municipal organic solid waste charcoal (MOSWC) as an adsorbent for Methyl orange (MO) adsorption. The prepared MOSWC is characterized by FE-SEM and FT-IR. Batch adsorption experiments were conducted with the influencing of different operational conditions namely time of contact (1-180 min), adsorbate concentration (60-140 mg/L), adsorbent dose (1-5 g/L), pH (3-11), and temperature (25-60 °C). The high coefficient value ( R 2  = 0.96) of the process optimization model suggests that this model was significant, where pH and adsorbent dose expressively stimulus adsorption efficiency including 40.11 mg/g at pH (3), MO concentration (100 mg/L), and MOSWC dose (1 g/L). Furthermore, the machine learning approaches (ANN and BB-RSM) revealed a good association between the tested and projected values. The highest monolayer adsorption capacity of MO was 90.909 mg/g. Pseudo-second-order was the well-suited kinetics, where Langmuir isotherm could explain better for equilibrium adsorption data. Thermodynamic study shows MO adsorption is favourable, exothermic, and spontaneous. Finally, this study indicates that MOSWC could be a potential candidate for the adsorption of MO from wastewater., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

As a rare and exceptional injury with significant syndesmotic disruption, the outcome of Logsplitter injury remains poor and unfavorable. In this study, we retrospectively investigated the relationship between the intraoperative reduction quality and the prognosis such as the posttraumatic osteoarthritis to help surgeons achieve better functional outcomes for this high-energy transsyndesmotic ankle fracture dislocation. From January 2015 to February 2019, 31 patients (average 37.6 ± 9.4 years with 19 male and 12 female) diagnosed with the Logsplitter injury were treated by ORIF procedure and enrolled in our study. Particularly, nine vital radiographic parameters including medial clear space, talocrural angle, superior clear space, tibiofibular clear space, tibiofibular overlap, talar tilt, coin sign, tibial medial malleolus angle, and fibular lateral malleolus angle were measured from a postoperative film (AP and mortise view). Next, we compared the clinical outcome by using range of ankle motion, AOFAS scores, Burwell-Charnley score system, and Kellergen-Lawrence criteria from the patients who obtained the intraoperative anatomical reduction with those who failed. Our results showed that AOFAS score with all the patients was 79.33 ± 5.82 at the final follow-up. 14 (45.1%) of 31 patients were observed with radiographic posttraumatic arthritis of the ankle joint with an average Kellgren-Lawrence score of 1.75 ± 1.6 at final follow-up. Most importantly, our results proved that there were significant differences between the patients eligible for anatomical reduction quality with those who failed with regard to OA rate (33.3% vs. 85.7%, P = 0.003) and AOFAS scores (75.33 ± 6.53 vs. 66.89 ± 4.28, P = 0.037) at the final follow-up. Furthermore, the functional outcome after the operation showed an increased range of motion of the ankle joint of the patients obtained anatomical reduction compared with those who failed ( P < 0.05). In this study, the significant discrepancy with regard to the functional outcomes was observed between the acceptable and unacceptable radiographic parameters, indicating that the quality of intraoperative reduction is scientifically significant and thus can be utilized as the major factor to predict the clinical outcomes for Logsplitter injuries. Moreover, this reduction algorithm arising from our study can also be applied to other ankle fractures and dislocation involving syndesmotic complex., Competing Interests: The authors have declared that there is no conflict of interests., (Copyright © 2020 Kangquan Shou et al.)

Background: Currently, there is inadequate evidence on which to base clinical management of neurotoxic snakebite envenoming, especially in the choice of initial antivenom dosage. This randomised controlled trial compared the effectiveness and safety of high versus low initial antivenom dosage in victims of neurotoxic envenoming., Methodology/ Principal Findings: This was a balanced, randomised, double-blind trial that was conducted in three health care centers located in the Terai plains of Nepal. Participants received either low (two vials) or high (10 vials) initial dosage of Indian polyvalent antivenom. The primary composite outcome consisted of death, the need for assisted ventilation and worsening/recurrence of neurotoxicity. Hourly evaluations followed antivenom treatment. Between April 2011 and October 2012, 157 snakebite victims were enrolled, of which 154 were analysed (76 in the low and 78 in the high initial dose group). Sixty-seven (43·5%) participants met the primary outcome definition. The proportions were similar in the low (37 or 48.7%) vs. high (30 or 38.5%) initial dose group (difference = 10·2%, 95%CI [-6·7 to 27·1], p = 0·264). The mean number of vials used was similar between treatment groups. Overall, patients bitten by kraits did worse than those bitten by cobras. The occurrence of treatment-related adverse events did not differ among treatment groups. A total of 19 serious adverse events occurred, including seven attributed to antivenom., Conclusions: This first robust trial investigating antivenom dosage for neurotoxic snakebite envenoming shows that the antivenom currently used in Nepal performs poorly. Although the high initial dose regimen is not more effective than the low initial dose, it offers the practical advantage of being a single dose, while not incurring higher consumption or enhanced risk of adverse reaction. The development of new and more effective antivenoms that better target the species responsible for bites in the region will help improve future patients' outcomes., Trial Registration: The study was registered on clinicaltrials.gov (NCT01284855) (GJ 5/1).

Introduction: Road traffic accident is alarming in Nepal. The objective of this research is to find out the characteristics of RTA in central part of Nepal., Methods: A prospective descriptive study was taken from 1 August 2014 to 31 July 2015. Data were collected from postmortem department and nine hospitals in Kathmandu Valley. Inventory sheets with targeted variables for secondary sources were created., Results: A total of 3461 morbidity cases from hospitals and 265 mortality cases from postmortem department were included in this study. The ratio of male victim to female was 2.3:1. Around 75% of victims were between 15-49 years old. Pedestrians were the most vulnerable (33%) followed by riders of motorized 2-3 wheelers. Two wheeler motorized vehicles were most frequently (67.2%)involved in RTAs. More RTA occurred on daytime, Saturdays, July and November. Around half of the victims did not arrive in hospitals in one hour. The most common injury type was soft tissue injury (37.6%), followed by open wound (20.9%), fracture (18%) and traumatic brain injuries (12.7%)., Conclusions: According to the characteristic of RTA found in this study, following preventive measures are recommended Helmet was necessary for two wheeled backseat riders. Road safety education towards age group of 15-49 was compulsory. Precaution should neither be omitted regarding road safety on weekends, holidays, nor in rainy and festival season. Future studies could be focused on estimation of burden of disease caused by RTA and its determinants in Nepal.