Background and Aims: Limited studies are available comparing diagnostic accuracy of various airway predictors in geriatric patients. We conducted this study with primary aim to evaluate and validate the predictive value of 'standard airway predictors' like modified Mallampati test, thyromental distance (TMD), sternomental distance, neck movement (NM), mouth opening (MO), dentition and 'new airway predictors' like upper lip bite test (ULBT), ratio of height to thyromental distance and thyromental height test (TMHT) for predicting difficult laryngoscopy in geriatric patients. Methods: This prospective, observational study was conducted on 140 patients above 65 years of age of either sex, scheduled for elective surgery under general anaesthesia requiring endotracheal intubation. The age, weight, height, body mass index (BMI) and airway parameters were recorded. The laryngoscopic view was assessed by modified Cormack-Lehane scale. Standard formulae were used to calculate validity indexes. Results: The incidence of difficult larygoscopy found in our study was 25%. The mean age of our study population was 69.37 ± 4.23 years. TMD exhibited the highest sensitivity (80%) and negative predictive value (NPV) (91.86%) as compared to other studied airway predictors. The positive predictive value (PPV) of ULBT was 100%. Moreover, ULBT exhibited highest accuracy (82.14%) and odds ratio (86.88) and high specificity (91.30%) for predicting difficult laryngoscopy in geriatric patients. NM and TMHT also exhibited high accuracy (77.85%, 77.14%) and PPV (59.09%, 52.94%). Conclusions: TMD and ULBT both showed good predictive value in diagnosing difficult laryngoscopy in geriatric patients. Furthermore, NM and TMHT also exhibited higher diagnostic accuracy in predicting difficult airway in these patients.
In the emerging field of nanomedicine, nanoparticles have been widely considered as drug carriers and are now used in various clinically approved products. Therefore, in this study, we synthesized superparamagnetic iron-oxide nanoparticles (SPIONs) via green chemistry, and the SPIONs were further coated with tamoxifen-conjugated bovine serum albumin (BSA-SPIONs-TMX). The BSA-SPIONs-TMX were within the nanometric hydrodynamic size (117 ± 4 nm), with a small poly dispersity index (0.28 ± 0.02) and zeta potential of −30.2 ± 0.09 mV. FTIR, DSC, X-RD, and elemental analysis confirmed that BSA-SPIONs-TMX were successfully prepared. The saturation magnetization (Ms) of BSA-SPIONs-TMX was found to be ~8.31 emu/g, indicating that BSA-SPIONs-TMX possess superparamagnetic properties for theragnostic applications. In addition, BSA-SPIONs-TMX were efficiently internalized into breast cancer cell lines (MCF-7 and T47D) and were effective in reducing cell proliferation of breast cancer cells, with IC50 values of 4.97 ± 0.42 μM and 6.29 ± 0.21 μM in MCF-7 and T47D cells, respectively. Furthermore, an acute toxicity study on rats confirmed that these BSA-SPIONs-TMX are safe for use in drug delivery systems. In conclusion, green synthesized superparamagnetic iron-oxide nanoparticles have the potential to be used as drug delivery carriers and may also have diagnostic applications.
: Non-alcoholic fatty liver disease (NAFLD) is one of the leading causes of death related to liver diseases worldwide. Despite this, there is no specific treatment that is approved for the disease till now, which could be due to a poor understanding of the pathophysiology of this disease. In the past few decades, several scientists have speculated the root cause of NAFLD to be dysbalance in the gut microbiome resulting in a susceptibility totheinflammatory cascade in the liver. Herein, we hypothesize to fabricate a novel formulation containing prebiotic with probiotics, which, thereby would help in maintaining the gut homeostasis, and used for the treatment of NAFLD. The proposed novel formulation would contain a Bifidobacteriumsp. with Faecalibacteriumprausnitzii in the presence of a dietary fibre having hepatoprotective activity. These two strains of probiotics would help in increasing the concentration of butyrate in the gut, which in turn would inhibit intestinal inflammation and maintain gut integrity. The dietary fibre would serve a dual mechanism; firstly they would act as a prebiotic, which helps in the proliferation of administered probiotics and secondly, would protect the liver via own hepatoprotective action. This combinatorial approach would pave a new therapeutic avenue for the treatment of NAFLD.
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