Paracetamol 650mg / Ascorbic acid 50mg oral powder sachets

Background/Objectives: Postoperative pain occurs in approximately 80% of patients undergoing surgery. Although opioids remain the mainstay of postoperative pain management, their side effects have led to the development of multimodal analgesia strategies that aim to limit their use. Some studies have shown a correlation between vitamin C supplementation and a reduction in postoperative pain. The aim of this review was to describe the effect of vitamin C administration on postoperative pain intensity and opioid consumption. Methods: A systematic review was conducted in the fourth quarter of 2024. Results: Two authors systematically searched PubMed, CINAHL, Web of Science, and Cochrane Library databases. A total of 14 studies were included in the analysis. In these studies, the visual analog scale (VAS) was most often used to assess the postoperative pain intensity. In all studies, regardless of the measurement time, a reduction in the pain intensity was demonstrated compared to control or placebo groups. The analysis showed that intraoperative or preoperative vitamin C infusion reduced opioid consumption. The administered vitamin C doses ranged from 1 g to 3 g or 50 mg/kg intravenously during the perioperative period. Conclusions: The results showed a reduction in opioid requirements and pain intensity in patients receiving perioperative vitamin C, suggesting that vitamin C can be incorporated into multimodal postoperative analgesia strategies for surgical patients.

Abstract licence: CC BY

BACKGROUND: Type 2 diabetes (T2D) is a leading cause of morbidity and mortality worldwide. Despite the availability of multiple glucose-lowering agents, only half of individuals with T2D achieve the recommended HbA1c target of < 7.0%. Precision medicine approaches that leverage patient-specific markers offer a promising strategy to improve therapeutic outcomes. The PAM gene encodes the sole enzyme responsible for amidating bioactive hormones, including GLP-1, and harbors two hypomorphic T2D-risk alleles (p.D563G and p.S539W); however, whether PAM regulates GLP-1, a key amidated incretin hormone, and whether this influences response to GLP-1 receptor agonist (GLP-1RA) therapy, remains unknown. METHODS: PAM amidation activity, postprandial GLP-1 levels, and the incretin effect were measured in carriers of PAM T2D-risk alleles and matched non-carriers from the Oxford Biobank in a prospective observational study and in Danish cohorts. Inducible whole-body Pam knockout mice were generated; gastric emptying was assessed by paracetamol absorption assay with and without exendin-4. Glycemic response to GLP-1RAs was evaluated in a meta-analysis of 1,119 participants across three cohorts (IMI-DIRECT, GoDARTS, PRIBA), with comparative assessment of sulphonylurea, metformin, and DPP-4 inhibitor response. RESULTS: Carriers of p.S539W and p.D563G alleles demonstrated 52% and 20% reductions in serum PAM amidation activity, respectively. Both human carriers and Pam knockout mice exhibited elevated circulating GLP-1 levels; however, p.S539W carriers showed an 18% reduction in endogenous GLP-1 sensitivity. PamKO mice displayed accelerated gastric emptying that was refractory to exendin-4, alongside impaired cAMP signaling downstream of the GLP-1 receptor in the pylorus. In the clinical meta-analysis, p.S539W carriers showed a significantly attenuated HbA1c reduction following GLP-1RA therapy (− 0.69% vs. − 1.24% in non-carriers; p = 0.025), representing a 44% relative loss of glycemic benefit; only 11.5% of carriers achieved HbA1c < 7% compared with 25.3% of non-carriers. No differences in response to sulphonylureas, metformin, or DPP-4 inhibitors were observed. CONCLUSIONS: Hypomorphic PAM T2D-risk alleles reduce amidating enzyme activity, elevate circulating GLP-1 levels, and impair GLP-1 post-receptor signaling, culminating in a selective and clinically meaningful reduction in GLP-1RA efficacy. These findings establish PAM genotype as a novel pharmacogenomic determinant of GLP-1RA response, supporting its incorporation into precision medicine frameworks to optimize drug selection in T2D management. TRIAL REGISTRATION: NCT02723110, NCT02465515 and NCT01144338.

Abstract licence: CC BY

Background: This study aimed at comparing gingival depigmentation by locally injected vitamin C with surgical depigmentation, in terms of effectiveness and patient acceptability. Methods: Forty-two patients presenting with ethnicity-related hyperpigmentation were randomly divided into two groups, Group I (n = 21) was treated with locally injected vitamin C and Group II (n = 21) was treated by surgical depigmentation. The outcome was assessed using Gingival Pigmentation Index (GPI) and Skin Hyperpigmentation Index (SHI). Results: Both the techniques were successful in treating gingival hyperpigmentation, but the patients who underwent vitamin C-based depigmentation showed significantly higher satisfaction with the treatment result, based on patient reported Visual Analog Scale (VAS) scoring. Conclusion: Based on the findings of this study, it was concluded that locally injected vitamin C and surgical depigmentation are comparable in their effectiveness for treating gingival hyperpigmentation. Trial Registration: ClinicalTrials.gov identifier: CTRI/2023/02/050127.

Abstract licence: CC BY

Background Gingival pigmentation (GP), characterized by the presence of melanin in the gingival tissues, is a common aesthetic concern in dental practice. While it poses no inherent health risks, the visible discoloration may cause psychological distress for individuals seeking optimal dental aesthetics. Understanding the efficacy of various methods is essential for refining treatment strategies and enhancing patient satisfaction in the realm of gingival depigmentation (GD). Aim The objective of the study was to compare the effectiveness of scalpel and microneedling (MN) with ascorbic acid in the treatment of GD. Materials and methods Sixteen patients who had a complaint of GP were included in the study, of whom eight were allocated for depigmentation with a scalpel, and the other eight patients were treated with the MN technique with ascorbic acid. Postoperative wound healing scores were evaluated on the first and seventh days, respectively. The intensity of depigmentation was assessed at baseline, in the first month, and at the end of the third month, respectively. Results The mean Dummett-Gupta Oral Pigmentation Index (DOPI) score at baseline was 2.65±0.16 and 2.61±0.17 in the surgical and microneedling groups with ascorbic acid, respectively. The mean DOPI score at the end of the third month was 1.67±0.39 and 0.87±0.17 in the scalpel and MN with ascorbic acid groups, respectively. There was a statistically significant difference between the scalpel and MN with ascorbic acid groups at the end of the first and third months, respectively, where MN with ascorbic acid showed aesthetically pleasing outcomes. Patients treated with the scalpel technique showed incomplete healing and ulceration on the first and seventh days after the procedure when compared to the MN technique with ascorbic acid. The healing index scores were statistically significant in the MN with ascorbic acid group. Conclusion The MN technique with ascorbic acid is a successful technique for treating GD. It showed aesthetically gratifying outcomes when compared to the conventional surgical technique.

Abstract licence: CC BY

The design of electrochemical sensors is crucial considering important factors such as efficiency, low cost, biocompatibility, and availability. Manganese oxides are readily available, low-cost, and biocompatible materials, but their low conductivity limits their efficiency as sensors. Today, morphology engineering of manganese oxide has been one of the most common research topics, because manganese oxides' electrochemical properties are highly dependent on their morphologies. In this study, a method for reducing the charge transfer resistance (Rct) of MnO2-based electrodes was established by the cyclic voltammetry technique accompanied by step-by-step heat treatment to electrodeposition MnO2 nanofilm, which remarkably improved the Rct. Next, the sensing performance of MnO2/FTO for two separate measurements was examined, one for the simultaneous measurement of paracetamol (PAR) and 4-aminophenol (4-APh), and the other for the measurement of 4-nitrophenol (4-NP). Under the optimum conditions, the linear ranges of 4-APh, PAR, and 4-NP, were 0.8 to 22.0 µM, 2.0 to 55.0 µM, and 0.1-250 µM, with limits of detection (LOD) of 0.19 µM, 0.60 µM, and 0.01 µM, respectively. It also was unaffected by a 200-fold excess of interferences. In addition, the designed sensor was successfully applied to the analysis of real samples.

Abstract licence: CC BY-NC-ND

Background: The collection of microorganisms that colonize the human genital and urinary tract is referred to as the genitourinary microbiome. Urinary tract infections (UTIs), which predominantly affect women, are linked to alterations in the genitourinary microbiome. Cranberries (Vaccinium oxycoccos), rich in proanthocyanidins, and ascorbic acid (vitamin C), known for their urinary acidification properties, are commonly used for UTI prevention. However, their effects on the genitourinary microbiome remain inadequately characterized. This pilot study assesses the genitourinary microbiome composition in healthy women and evaluates the influence of cranberry and ascorbic acid supplementation. Methods: In a randomized, controlled, and open-label trial, 27 healthy women in their reproductive age (18-40 years) were assigned to three groups: cranberry (n = 8), ascorbic acid (n = 10), and control (n = 9). Urine samples were collected at three time points and processed for 16S rRNA gene amplicon-based microbial community composition analysis. Microbiome composition was compared within and between groups, and between study visits. Results: Sufficient microbial DNA was extracted from all midstream urine samples. The genitourinary microbiome was predominantly composed of Lactobacillus spp., as reported previously. No significant shifts in microbial composition were observed in response to cranberry or ascorbic acid supplementation, and no statistically significant differences were detected between the intervention and control groups or between study visits. Conclusion: The genitourinary microbiome of healthy women remained stable during cranberry or ascorbic acid supplementation. Further studies in patients with recurrent UTIs are needed to explore the potential impacts of these supplements on the genitourinary microbiome in disease states.

Abstract licence: CC BY