Introduction In recent years, cold snare polypectomy (CSP) has increasingly been used over hot snare polypectomy (HSP) for the removal of colorectal polyps (4 – 10 mm in size). However, the optimal technique (CSP vs. HSP), in terms of complete polyp resection and complications, is uncertain. Our aim was to compare incomplete resection rate (IRR) of polyps and complications using CSP vs. HSP. Methods Randomized controlled studies (RCTs) comparing CSP and HSP for removal of 4 – 10 mm colorectal polyps were considered. Studies were included in the analysis if they obtained biopsy specimens from the resection margin to confirm the absence of residual tissue and reported complications. IRR and complication rate were the outcome measures. Pooled rates were reported as Odds Ratios (OR) or risk difference with 95 % Confidence Interval (CI). Results In total, three RCTs were included in the final analysis. A total of 1051 patients with 1485 polyps were randomized to either HSP group (n = 741 polyps) or CSP group (n = 744 polyps). The overall IRR did not differ between the two groups (HSP vs. CSP: 2.4 % vs. 4.7 %; OR 0.51, 95 %CI 0.13 – 1.99, P = 0.33, I 2 = 73 %). The HSP group had a lower rate of overall complications compared to the CSP group (3.7 % vs. 6.6 %; OR 0.53, 95 % CI 0.3 – 0.94, P = 0.03, I 2 = 0 %). Polyp retrieval rates were not different between the two groups (99 % vs. 98.1 %). Conclusion Our results suggest that HSP and CSP techniques can be effectively used for the complete removal of 4 – 10 mm colorectal polyps; however, HSP has a lower incidence of overall complications.

Background Post-esophagectomy anastomotic strictures are difficult to treat. The impact of adding local steroid injection to endoscopic dilation for the treatment of post-esophagectomy anastomotic strictures is unclear. We conducted a systematic review and meta-analysis to assess the efficacy of performing steroid injection in addition to dilation. Methods A search was conducted in MEDLINE, Cochrane Library, EMBASE, and Web of Science from inception to January 2019. Randomized controlled trials (RCTs) comparing the efficacy of endoscopic dilation plus either local steroid injection (steroid group) or saline injection (placebo group) were included in the analysis. Results Three RCTs were eligible for the final analysis: 72 patients (mean age 61.3 years, 74 % male) in the steroid group and 72 patients (mean age 59.6 years, 71 % male) in the placebo group. The mean number of dilations required to resolve the stricture was significantly lower in the steroid group compared with the placebo group, with a mean weighted difference of –1.62 (95 % confidence interval [CI] –2.73 to –0.50; P = 0.004). After 6 months of follow-up, there was a trend toward more patients in the steroid group remaining dysphagia free compared with the placebo group, with a pooled odds ratio of 2.36 (95 %CI 0.94 to 5.91; P = 0.07, I2  = 24 %). Conclusion This meta-analysis showed that the addition of local steroid injection at the time of dilation for benign anastomotic strictures led to a significant decrease in the number of procedures required to resolve the stricture and may well reduce dysphagia symptoms during follow-up.

Herein, we report synthesis of novel organotin(IV) carboxylates i.e; [(C6H5)3Sn(C10H14NO3)] B1 and [(C4H9)3Sn(C10H14NO3)] B2 by reacting triphenyltin hydroxide and bis(tributyltin) oxide with as‐prepared ligand 3‐cyclohexylcarbamoyl‐acrylic acid A under inert atmosphere. The as‐synthesized complexes were characterized by elemental analysis (CHNS), fourier transform infrared spectroscopy (FTIR), nuclear magnetic resonance spectroscopy(1H‐NMR, 13C‐NMR) and mass spectrometry (EI‐MS). The structures of both as‐prepared tin complexes B1 and B2 were determined by single crystal X‐ray crystallography. Thermogravimetric analysis has shown single step decomposition of both these complexes. The as‐prepared complexes were used as single source precursor for the deposition of tin oxide thin films at 350 °C and 400 °C by aerosol assisted chemical deposition (AACVD) on bare and at 400 °C on carbon nanodots pre‐coated glass substrate. The as‐deposited thin films were characterized by powdered X‐rays diffraction (pXRD), field emission scanning electron microscope (FE‐SEM) and energy dispersive X‐rays spectroscopy (EDX). Furthermore, antimicrobial, anti‐oxidant and cytotoxicity studies of both complexes showed moderate to good biological activities. Thus, as‐prepared novel complexes have potential applications in materials as‐well as in medicinal chemistry.

To study the effect of direct acidification either by using organic acids or natural source of these acids on the properties and quality of Mozzarella cheese, Lactic and acetic acids as organic acids and lemon, orange and pomegranate juice were used in direct acidification during Mozzarella cheese making and compared with that made by bio-acidification by starter bacteria as control treatment. Resultant cheese from all treatments and control were chemically, rheologically and microbiologically analyzed. Samples in three replicates were analyzed and the main of values was recorded. Results showed that, Mozzarella cheese made by direct acidification with lemon juice gained the best chemical, Rheological properties and high yield. Also, all treatments except which acidified with orange juice had good properties when compared with control Mozzarella cheese. Moreover, Mozzarella cheese made by pomegranate extract has good chemical and rheological properties but it wasn't appreciated to the judges. It was recommended from the previous results that the use of direct acidification in the Manufacture of mozzarella cheese to improve the rheological properties, reduced the processing time and increase the cheese yield. Finally, natural acidulants like lemon or some organic acids (acetic, lactic acid) can applied on the acidification and making of Mozzarella cheese with good and appreciated quality.

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Background:: Current guidelines recommend the use of vancomycin for the initial treatment of Clostridioides difficile Infection (CDI). Cadazolid, an experimental drug, has been utilized and compared in several studies with varying results. Methods:: A systematic literature search was performed using electronic databases [Medline, Google Scholar and Cochrane] for eligible studies. Randomized Controlled Trials (RCTs) comparing cadazolid with vancomycin for CDI treatment were included. Demographic variables and outcomes (CDI resolution, CDI recurrence, and adverse events) were collected. The primary outcome was clinical cure rate defined as the resolution of CDI at the end of a 10-day course. Results:: Two studies with three RCTs met the inclusion criteria with a total of 1283 patients with CDI who received either cadazolid 250 mg twice daily (624 patients) or vancomycin 125 mg four times daily (659 patients). Clinical cure rate at the end of the treatment was not statistically significant (pooled OR= 0.82; 95% CI = 0.61 to 1.11; p=0.20; I2= 0%). Sustained clinical response at clinical follow-up was also not significantly different (pooled OR = 1.14; 95% CI = 0.91 to 1.43; p=0.27; I2 = 0 %). Cadazolid had a lower recurrence rate than vancomycin (pooled OR = 0.71; 95% CI = 0.52 to 0.98; p=0.04; I2 = 13 %). Conclusion:: Cadazolid is non-inferior to vancomycin and offers a promising alternative for the treatment of CDI. More studies including RCTs and longitudinal studies with large and diverse patient population are needed to further confirm this. Furthermore, cadazolid should also be compared with fidaxomicin in a head-to-head trial to evaluate their efficacy for CDI.

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