Antioxidant activities of butylatedhydroxyanisole (BHA) and orange peel powder extract in ghee stored at different storage temperatures (T1:6 ± 2 °C; T2: 32 ± 2 °C; T3:60 ± 2 °C) were evaluated during storage period of 21 days. Peroxide value (PV), thiobarbituric acid (TBA), radical scavenging activity (RSA) and free fatty acids (FFA) of ghee samples were analyzed during the study. PV, TBA and FFA of ghee samples increased significantly while radical scavenging activity (RSA) of ghee samples decreased significantly at accelerated temperature (T3) as compared to the temperatures at T1 and T2. Effect of storage temperature on development of peroxides and TBA of ghee samples was significantly higher than the effect of treatment and storage period while treatment had more significant effect on the change in FFA and RSA as compared to storage temperature and storage period. Ghee incorporated with orange peel extract (OPE) showed stronger activity in quenching DPPH radicals and least development of PV, TBA and FFA than ghee incorporated with BHA and control. The study revealed that orange peel could be a good natural source of antioxidants which can be used in fat rich food products like ghee to retard oxidative deterioration.
PURPOSE Anaerobic necrosis in cervical cancer can lead to malodor, fistulae, and treatment abandonment. In this retrospective cohort study, we examined the association between maintenance metronidazole and the incidence of malignant fistulae in recurrent cervical cancer. METHODS We screened all cervical cancer records registered between 2007 and 2016 in the local palliative care database at Christian Medical College, Vellore, India. There were 208 eligible patients with post-treatment residual/recurrent pelvic disease. Among them, 76 had received oral maintenance metronidazole 200 mg once per day for 2 to 86 weeks (interquartile range, 4-16 weeks). RESULTS Seventy-two patients developed at least one fistula. Forty-nine had vesicovaginal fistulae, 10 had rectovaginal fistuale, and 13 developed both types of fistulae. Patients on maintenance metronidazole had fewer fistulae (22.4% v 41.7%; P = .005), a longer median fistula-free survival (42.9 months v 14.1 months; P < .001), and a postrecurrence survival of 11.5 months versus 8.7 months ( P = .112). We performed Cox multivariable proportional hazards regression analysis on the data from the subset of 146 patients observed until death. Bladder/rectal infiltration had a higher risk of fistula (HR, 5.24; P = .011), whereas distant metastases (HR, 2.46; P = .012) and Eastern Cooperative Oncology Group performance status greater than 1 (HR, 1.64; P = .008) were associated with a higher risk of death. Maintenance metronidazole was associated with a lower risk of fistula (hazard ratio [HR], 0.33; 95% CI, 0.16 to 0.67; P = .002) and a lower risk of death (HR, 0.56; 95% CI, 0.39 to 0.81; P = .002). CONCLUSION Our data indicate that there is a significant inverse association between oral maintenance metronidazole and malignant fistulae in locally recurrent cervical cancer. The impact of this simple intervention on pelvic symptoms, fistulae, and survival should be evaluated in prospective studies.
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by otorhinolaryngologist, and cystic lesion in external auditory canal was aspirated and CSF confirmed. Neurosurgeon excised the herniated glial tissue using bipolar cautery. Duroplasty was done, and fibrofatty tissue, bone wax, and temporalis fascia graft were placed. No postoperative complications were noted.Discussion Bone erosion and dural injury can be observed due to chronic suppuration or as a complication of mastoid surgery in chronic otitis media. It can be due to cholesteatoma or bone erosion with involvement of inflammatory process due to enzymatic destruction. Surgical approaches for meningoencephalocele, due to tegman defect, transmastoid approach, middle fossa approach, and combination of both. In our case, transmastoid approach was chosen by considering the localization and small size of defect. Postoperative complications like, epileptic seizures, CSF leak, transient ischemic attack/stroke, can be expected. However, these complications were not observed in our case.Conclusion Patients who underwent operation due to chronic otitis media with or without cholesteatoma must be evaluated for tegman defect and brain tissue or dural structures that may be herniated through this defect during and after the surgery. Possible defects must be repaired with appropriate surgery methods and graft materials by considering the localization and the size of the defected area.
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