Purpose: This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy. Methods: A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups. Results: There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued. Conclusion Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.

Purpose: This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy. Methods: A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups. Results: There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued. Conclusion Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.

Purpose: This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy. Methods: A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups. Results: There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued. Conclusion Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.

Purpose: This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy. Methods: A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups. Results: There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued. Conclusion Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.

Purpose: This study aimed to evaluate the efficacy of oil massage as an adjunct therapy for neonatal jaundice during phototherapy. Methods: A total of 160 neonates with unconjugated hyperbilirubinemia were enrolled and randomly allocated into two study groups using a computer-generated random number table.Group 1 (Intervention Group) consisted of 84 patients who received both phototherapy and massage therapy, while Group 2 (Control Group) consisted of 76 patients who received only phototherapy. The intervention group underwent massage therapy three times daily for 20 minutes over two consecutive days. Transcutaneous bilirubin levels were measured every eight hours. Additionally, the total duration of phototherapy and the 24-hour stool and urine output frequency were recorded in both groups. Results: There were no significant differences in the demographic characteristics between the two groups. However, stool frequency and urine output were significantly higher in the intervention group. The average duration of phototherapy was 19.4±4.17 hours in the intervention group compared to 28.4±6.58 hours in the control group (p<0.001). The rate of Transcutaneous bilirubin reduction was significantly higher in the intervention group during the first 24 hours. A rebound increase in bilirubin levels was observed at 40 and 48 hours in both groups after phototherapy was discontinued. Conclusion Phototherapy combined with massage significantly reduced total bilirubin levels in newborns with neonatal hyperbilirubinemia, making it a valuable adjunct treatment for the rapid reduction of bilirubin in neonates.

PURPOSE: Outcomes of peripheral arterial injury (PAI) depend on various factors, such as warm ischemia time and concomitant injuries. Suboptimal prehospital care may lead to delayed presentation, and a lack of dedicated trauma system may lead to poorer outcome. Also, there are few reports of these outcomes. The study aims to review our experience of PAI management for more than a decade, and identify the predictors of limb loss in these patients. METHODS: This is a retrospective analysis of prospectively maintained database of trauma admissions at a level I trauma center from January 2008 to December 2019. Patients with acute upper limb arterial injuries or lower limb arterial injuries at or above the level of popliteal artery were included. Association of limb loss with ischemia time, mechanism of injury, and concomitant injuries was studied using multiple logistic regressions. Statistical analysis was performed using STATA version 15.0 (Stata Corp LLC, Texas). RESULTS: Out of 716 patients with PAI, the majority (91.9%) were young males. Blunt trauma was the most common mechanism of injury. Median ischemia time was 4 h (interquartile range 2-7 h). Brachial artery (28.5%) was the most common injured vessel followed by popliteal artery (17.5%) and femoral artery (17.3%). Limb salvage rate was 78%. Out of them, 158 (22.1%) patients needed amputation, and 53 (7.4%) had undergone primary amputation. The majority (88.6%) of patients who required primary or secondary amputations had blunt trauma. On multivariate analysis, blunt trauma, ischemia time more than 6 h and concomitant venous, skeletal, and soft tissue injuries were associated with higher odds of amputation. CONCLUSION Over all limb salvage rates was 77.9% in our series. Blunt mechanism of injury and associated skeletal and soft tissue injury, ischemia time more than 6 h portend a poor prognosis. Injury prevention, robust prehospital care, and rapid referral to specialized trauma center are few efficient measures, which can decrease the morbidity associated with vascular injury.
Humans ; Male ; Female ; Retrospective Studies ; Adult ; Middle Aged ; Vascular System Injuries/surgery* ; Limb Salvage/methods* ; Aged ; Amputation, Surgical ; Popliteal Artery/injuries*

PURPOSE: Non-operative management (NOM) has been validated for blunt liver and splenic injuries. Literature on continuous intra-abdominal pressure (IAP) monitoring as a part of NOM remains to be equivocal. The study aimed to find any correlation between clinical parameters and IAP, and their effect on the NOM of patients with blunt liver and splenic injury. METHOD: A prospective cross-sectional study conducted at a level I trauma center from October 2018 to January 2020 including 174 patients who underwent NOM following blunt liver and splenic injuries. Hemodynamically unstable patients or those on ventilators were excluded, as well as patients who suffered significant head, spinal cord, and/or bladder injuries. The study predominantly included males (83.9%) with a mean age of 32.5 years. IAP was monitored continuously and the relation of IAP with various parameters, interventions, and outcomes were measured. Data were summarized as frequency (percentage) or mean ± SD or median (Q₁, Q₃) as indicated. χ² or Fisher's exact test was used for categorical variables, while for continuous variables parametric (independent t-test) or nonparametric tests (Wilcoxon rank sum test) were used as appropriate. Clinical and laboratory correlates of IAP < 12 with p < 0.200 in the univariable logistic regression analysis were included in the multivariable analysis. A p < 0.05 was used to indicate statistical significance. RESULTS: Intra-abdominal hypertension (IAH) was seen in 19.0% of the study population. IAH was strongly associated with a high injury severity score (p < 0.001), and other physiological parameters like respiratory rate (p < 0.001), change in abdominal girth (AG) (p < 0.001), and serum creatinine (p < 0.001). IAH along with the number of solid organs involved, respiratory rate, change in AG, and serum creatinine was associated with the intervention, either operative or non-operative (p = 0.001, p = 0.002, p < 0.001, p < 0.001, p = 0.013, respectively). On multivariable analysis, IAP (p = 0.006) and the mean change of AG (p = 0.004) were significantly associated with the need for intervention. CONCLUSION As a part of NOM, IAP should be monitored as a continuous vital. However, the decision for any intervention, either operative or non-operative cannot be guided by IAP values alone.
Humans ; Male ; Adult ; Female ; Wounds, Nonpenetrating/physiopathology* ; Spleen/injuries* ; Prospective Studies ; Cross-Sectional Studies ; Liver/injuries* ; Middle Aged ; Monitoring, Physiologic/methods* ; Pressure ; Abdominal Injuries/physiopathology* ; Intra-Abdominal Hypertension ; Young Adult

Ganoderma lucidum, a medicinal mushroom renowned for its production of a diverse array of compounds, accounts for the pharmacological effects including anti-inflammatory, antioxidant, immunomodulatory, and anticancer characteristics. Thus, it is recognized as a valuable species of interest in the pharmaceutical and nutraceutical industries due to its important medicinal properties. Recent advances in omics technologies such as genomes, transcriptomics, proteomics, and metabolomics have considerably increased our understanding of the bioactives in G. lucidum. This review explores the application of molecular breeding techniques to enhance both the yield and quality of G. lucidum across the food, pharmaceutical, and industrial sectors. The article discusses the current state of research on the use of contemporary omics technologies which studies and highlights future research directions that may increase the production of bioactive compounds for their therapeutic potential. Additionally, predictive methods with computational studies have recently emerged as effective tools for investigating bioactive constituents in G. lucidum, providing an organized and cost-effective strategy for understanding their bioactivity, interactions, and possible therapeutic uses. Omics and machine learning techniques can be applied to identify the candidates for pharmaceutical applications and to enhance the production of bioactive compounds in G. lucidum. The quantification and production of the bioactive compounds can be streamlined by the integrating computational study of bioactive compounds with non-destructive predictive machine learning models of the same. Synergistically, these techniques have the potential to be a promising approach for the future prediction of the bioactive constituents, without compromising the integrity of the fungal organism.

Purpose: Postoperative nausea and vomiting (PONV) is a prevalent and distressing complication, especially in laparoscopic surgeries. This review compares the efficacy and safety of palonosetron and ondansetron in preventing PONV after laparoscopic surgery. Methods: A systematic review was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library to identify comparative studies that reported the efficacy (nausea and vomiting) at three postoperative time points T1 (0–2 hours), T2 (2–6 hours), T3 (6–24 hours) and safety (incidence of adverse effects). Meta-analysis of relative risk was performed using a random effect model and subgroup analysis based on factors such as antiemetic dose and timing of administration, type of surgery, and anesthetic agents. Results: Twenty-one randomized controlled trials were published between 2011 and 2022, involving 2,043 participants. Nineteen trials were included in the meta-analysis (efficacy, 17;safety, 11). The pooled risk ratio revealed that patients receiving palonosetron demonstrated significantly less likelihood of developing nausea and vomiting at various postoperative time points. Subgroup analysis indicated significantly less PONV when palonosetron was administered before intubation and in combination with isoflurane anesthesia. Headache, dizziness, constipation, and drowsiness were the most commonly reported. The safety profiles of palonosetron and ondansetron were comparable. Conclusion Palonosetron exhibits superior efficacy within the first 24 hours postoperatively and requires less rescue antiemetic intervention compared to ondansetron in laparoscopic surgery patients. Both demonstrate nearly comparable safety profiles. Future trials focusing on cardiac safety (QT interval) and cost consideration are needed.

Purpose: Postoperative nausea and vomiting (PONV) is a prevalent and distressing complication, especially in laparoscopic surgeries. This review compares the efficacy and safety of palonosetron and ondansetron in preventing PONV after laparoscopic surgery. Methods: A systematic review was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library to identify comparative studies that reported the efficacy (nausea and vomiting) at three postoperative time points T1 (0–2 hours), T2 (2–6 hours), T3 (6–24 hours) and safety (incidence of adverse effects). Meta-analysis of relative risk was performed using a random effect model and subgroup analysis based on factors such as antiemetic dose and timing of administration, type of surgery, and anesthetic agents. Results: Twenty-one randomized controlled trials were published between 2011 and 2022, involving 2,043 participants. Nineteen trials were included in the meta-analysis (efficacy, 17;safety, 11). The pooled risk ratio revealed that patients receiving palonosetron demonstrated significantly less likelihood of developing nausea and vomiting at various postoperative time points. Subgroup analysis indicated significantly less PONV when palonosetron was administered before intubation and in combination with isoflurane anesthesia. Headache, dizziness, constipation, and drowsiness were the most commonly reported. The safety profiles of palonosetron and ondansetron were comparable. Conclusion Palonosetron exhibits superior efficacy within the first 24 hours postoperatively and requires less rescue antiemetic intervention compared to ondansetron in laparoscopic surgery patients. Both demonstrate nearly comparable safety profiles. Future trials focusing on cardiac safety (QT interval) and cost consideration are needed.