Reactive oxygen species (ROS) production in hepatic ischemia-reperfusion injury (IRI) is a complex process where multiple cellular and molecular pathways are involved. Few of those molecular pathways are under the direct influence of SIRT3 and its downstream mediators. SIRT3 plays a major role in the mechanism of IRI, and its activation has been shown to attenuate the deleterious effect of ROS during IRI via SOD2-, CYP-D-, and HIF-1α-mediated pathways. The objective of this review is to analyze the current knowledge on SIRT3 and its downstream mediators: SOD2, CYP-D, and HIF-1α, and their role in IRI. For the references of this review article, we have searched the bibliographic databases of PubMed, Web of Science databases, MEDLINE, and EMBASE with the headings “SIRT3,” “SOD2,” “CYP-D,” “HIF-1α,” and “liver IRI.” Priority was given to recent experimental articles that provide information on ROS modulation by these proteins. All the recent advancement demonstrates that activation of SIRT3 can suppress ROS production during IRI through various pathways and few of those are via SOD2, CYP-D, and HIF-1α. This effect can improve the quality of the remnant liver following resection as well as a transplanted liver. More research is warranted to disclose its role in IRI attenuation via this pathway.
Background: Cardiovascular diseases are the number one cause of death globally. Cardiovascular diseases have emerged as a major health burden in developing countries. Myocardial infarction (MI) is defined by the demonstration of myocardial cell necrosis due to significant and sustained ischaemia. Author attempted to study the risk factors and clinical profile of patients with MI admitted in Cardiology Department of tertiary care center, Chitwan, Nepal.Methods: This descriptive retrospective study was conducted in College of Medical Sciences Teaching Hospital (CMS-TH), Chitwan, Nepal, from January 2016 to November 2017. Demographic features, cardiovascular risk factors, clinical presentation, Electrocardiogram (ECG) findings, regions of infarction and rhythm disturbances were studied and documented.Results: A total of 132 patients diagnosed with MI were studied. Most of the patients (90.15%) had ST-elevation MI (STEMI). The patients were predominantly male (87%). The majority of patients lied in the age group of 61-70 yrs (29.54%). The most common presenting symptom was chest pain (86.36%) followed by shortness of breath (42.42%) and vomiting (12.87%). Tobacco smoking/chewing (62.87%) was the major risk factor followed by hypertension (43.18%) and diabetes (34.09%). Majority of infarction occurred on anterior wall (52.94%). Most of the patients (90.90%) had normal sinus rhythm on ECG. On arrival to emergency department eight (6.06%) patients had cardiogenic shock and only one had congestive cardiac failure.Conclusions: STEMI was most common type of MI presenting to CMS-TH. Most of the patients were male and the most common risk factor contributing to MI was cigarette smoking. Most of the patients arrived more than 24 hours after onset of symptom.
Hepatocellular carcinoma (HCC) is among the most common and fatal cancers. It is a multistage and multifactorial carcinoma, in which a number of factors serve roles in its initiation and progression. Small nucleolar RNAs (snoRNAs), considered to serve a role in various cancers, have recently been identified to have significant contributions to HCC tumorigenesis. Recent studies suggest that snoRNAs have a critical role in the pathogenesis of HCC. Moreover, detailed studies have demonstrated that various snoRNAs are involved in a range of biological processes associated with HCC, including initiation, proliferation, tumor growth, the cell cycle, apoptosis and metastasis. In the present review, an overview of recent studies to date has been provided, focusing on the association of snoRNAs with HCC. Based on the findings, further studies focusing on the association of snoRNAs with HCC are required to verify the diagnostic and therapeutic capacities of snoRNAs in HCC.
Background: Neutrophil lymphocyte Ratio (NLR) and Platelet lymphocyte Ratio (PLR) are an indicator of the status of inflammation. The objective of this study was to evaluate the relationship between recipient pre-operative Neutrophil lymphocyte Ratio (NLR) and Platelet lymphocyte Ratio (PLR) with delayed graft function in the kidney transplant patient. Methods: The preoperative full blood count, data regarding patient demographics and postoperative graft function was retrospectively evaluated from the database of our institution. All statistical calculations were carried out using SPSS 20.0 version (SPSS Inc., Chicago, IL, USA). A p-value<0.05 was considered statistically significant. Results: 289 patients were included in this study. DGF occurred in 33 cases. Elevated preoperative NLR had a sensitivity of 75.75% and specificity of 76.56% whereas elevated preoperative PLR had a sensitivity of 72.72% and specificity of 58.20% for predicting DGF. The area under the ROC curve was found to be 0.762 and 0.655 for NLR and PLR, respectively. Multivariate analysis showed NLR>3.5 and PLR>120 independently responsible for DGF. Conclusion: Recipient preoperative NLR and PLR can predict the occurrence of DGF following DBD renal transplantation. In addition, NLR is better than PLR in predicting DGF. DGF prolongs the total ICU and in-hospital stay.
Background: Inguinal hernia is one of the most common surgical conditions in children. Herniotomy is the surgery performed for a pediatric hernia and hydrocele. This study was done to know the demography and outcome of pediatric herniotomy at our center. Materials and methods: A prospective study on patients who underwent herniotomy from 10th May 2016 to 9th May 2017 was conducted at the Department of Surgery, Western Regional Hospital. Results: During this study 112 patients underwent herniotomy out of which 98 were boys while 14 were girls. 59(52.67%) patients had unilateral hernia, 40(35.71%) had unilateral hydrocele and 13(11.6%) had bilateral condition among which 8 had hernia and 5 had hydrocele. 69(61.6%) patients presented with a right-sided, 30(26.7%) with left-sided, and 13(11.6%) with bilateral conditions. 13 patients (11.6%) presented at the emergency with irreducible hernia. Two among the patient who underwent emergency herniotomy developed postoperative wound infection and one among the elective surgery had recurrence. Conclusion: Pediatric inguinal hernias and hydroceles are often difficult to diagnose clinically. Herniotomy is often performed by junior consultants who have no specific training in pediatric surgery. Timely planning of surgery is required to minimize preoperative complications.
Background: Burn injury is one of the major causes of morbidity and mortality in our country. Study of epidemiological characteristics of burn injury helps in planning of the prevention and upgradation of its treatment facility. Material and Methods: This is a hospital based retrospective epidemiological study of the burn patients admitted in our center from September 2018 to April 2019. Results: In total 52 patients were included in this study. There was a slight preponderance of female patients over male patients. Mean age of the patients was 34.77± 29.16 years. Eighty percentage of burn injury occurred inside house. Majority of burn cases were scald burn followed by flame burn. Percentage total body surface area involved in burn had a mean of 14.183 ± 8.224. Lower extremity was the most commonly involved area. Total duration of hospital stay was 18.21 ± 13.656 days. Out of total patients only four patients needed admission in Intensive Care Unit (ICU). Regarding outcome, 88.5% patients survived while 9.6% patients died and 1.9% patient went on discharge on request. Conclusion: Burn injury is a preventable condition with high rate of morbidity and mortality. Burn patients have prolonged hospital stay as recovery is slow. Awareness programs for prevention of burn injury are needed to decrease the incidence of the burn injury.
Background:Inguinal herniorrhaphy is a common general surgical operation. The repair of recurrent hernia is difficult surgery due to obscured and distorted anatomy and risk of further recurrence. The aim of this study is to determine the outcome in terms of operative time, hospital stay, return to work, complications and recurrence of open pre-peritoneal repair for recurrent inguinal hernias after Lichtenstein tension-free hernioplasty. Materials And Method: It is a prospective observational study conducted at Western Regional Hospital, Pokhara from 2013 to 2016 . A total of eight patients including referred from other centers were included. Pre-peritoneal repair was performed on recurrent hernias after Lichtenstein tensionfree hernioplasty. Age, sex, operating time, hospital stay, time to return work, postoperative complications and recurrence of patients were noted. Statistical analysis was done using SPSS-21. Patients were called for follow up in 2 weeks, 3 months and 12 months time. Results: Out of eight patients, seven were male, one was female with mean age of 59.5 years. Recurrence was common on direct inguinal hernia (six patients) who had previous Lichtenstein hernioplasty. Mean operative time was 43.13 minutes (35 to 50 minutes), mean hospital stay was 2.5 days (2 to 4 days) and mean time to return to work was 8.12 days (7 to 10 days). There was hematoma formation in one patient. Conclusion: Pre-peritoneal mesh repair is easy, safe, with less operative time, short hospital stay, low recurrence and complication rate for recurrent inguinal hernia after Lichtenstein hernioplasty.
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