Effects of Curcuma Longa Ethanol Extract on Isolated Guinea Pigthile Smooth Muscle in Acetylcholine Induction

Epidemiological studies show that nearly 20% of the world's population suffers from diseases related to allergies and asthma. The main compound of turmeric is curcumin has several pharmacological properties, antioxidant properties, anti-inflammatory, asthma treatment. The study aimed to determine the effects of ethanol extract Curcuma longa on the smooth muscle of the isolated guinea pigtic trachea in acetylcholine induction. This research method was experimental to observe the relationship of Curcuma longa ethanol extract (EECL) to the relaxing effects of isolated smooth muscle trachea marmot (tracheal ring chain) inserted into a bath organ filled with Kreb's physiological fluid by maintaining a temperature of 35-370C and associated with a Matlab recorder. Samples used by male guinea pigs and ethanol extract Curcuma longa (EECL). The results of the study that ethanol extract Curcuma longa has a relaxing effect on the smooth muscles of the trachea isolated from the experimental rats contracted with acetylcholine. Ethanol extract Curcuma longa has the ability not dising from theophylline 2 x 10-4 M in reducing smooth muscle contraction of insulated Cavia porcelain trachea induced by acetylcholine, acetylcholine strength without incubation contraction compared to acetylcholine with EECL incubation showed statistically different results (p <0.05). The mechanism of Curcuma longa relaxation effect on isolated guinea pig smooth muscle is mediated through inhibition of the enzyme PDE.

​Comparative Gross Anatomical and Biometrical Studies on Thyroid Gland of Buffalo, Sheep and Goat

Background: The thyroid gland is vital endocrine gland which secretes three hormones i.e. thyroxin (T4), triiodothyronine (T3) and Calcitonin hormones. The thyroxin (T4) and triiodothyronine (T3) hormones are biologically active and are required for maintenance of normal levels of metabolic activity. The thyroid also produces calcitonin from the parafollicular cells which act directly on osteoclast to decrease the bone resorption which lower the blood calcium level. Deficient or excessive production of thyroid hormones may lead to serious pathological states with outward symptoms. Methods: The gross anatomical and biometrical studies were conducted on thyroid gland of buffalo, sheep and goat (n=12) collected immediately after slaughtering from slaughter house and local meat shop. The weight of thyroid gland was measured by weighing balance, volume by water displacement method, length and width of lateral lobes and isthmus by calibrated scale and inelastic thread and thickness of lateral lobes and isthmus was measured by digital vernier calliper. The data was analysed statistically. Result: The lateral lobes were roughly triangular in buffalo and elongated in sheep and oval in goat. The surfaces were granular and rough in buffalo but smooth in sheep and goat. It extended from thyroid cartilage to 2nd tracheal ring in buffalo, 1st to 6th tracheal ring in sheep and 1st to 7th tracheal ring in goat. The left lobe was larger than the right lobe in all the three species studied. The thyroid gland was biggest in buffalo followed by goat and smallest in sheep. The density of isthmus was more than the lobes in sheep and goat but not in buffalo.

Viscera of the neck

The thyroid gland is a symmetrical H-shaped endocrine structure in the lower neck. It consists of two lobes, each extending from the oblique line of the thyroid cartilage above to the sixth tracheal ring below – united by a median isthmus covered by the anterior jugular veins. The small, (usually) paired and inconsistent parathyroid glands lie behind the lobes of the thyroid gland. They measure 6mm by 4mm by 2mm and are ordinarily four in number – two superior and two inferior. They are involved in the careful regulation of the body’s calcium levels. Both superior and inferior glands are ordinarily supplied by the inferior thyroid artery. Drainage is into the venous plexus on the anterior surface of the thyroid.

Percutaneous Tracheostomy in COVID-19 Critically Ill Patients: Experience from 30 Consecutive Procedures

Introduction Percutaneous tracheostomy (PT) in the intensive care unit (ICU) is a well-established practice that shows a reduced risk of wound infection compared with surgical tracheostomy, thus facilitating mechanical ventilation, nursing procedures, reduction in sedation and early mobilization. Objective This is an observational case-control study that compares the results of PT in ICU patients with coronavirus disease 2019 (COVID-19) prospectively enrolled to a similar group of subjects, retrospectively recruited, without COVID-19. Methods Ninety-eight consecutive COVID-19 patients admitted to the ICU at Pisa Azienda Ospedaliero Universitaria Pisana between March 11th and May 20th, 2020 were prospectively studied. Thirty of them underwent PT using different techniques. Another 30 non-COVID-19 ICU patients were used as a control-group. The main outcome was to evaluate the safety and feasibility of PT in COVID-19 patients. We measured the rate of complications. Results Percutaneous tracheostomy was performed with different techniques in 30 of the 98 COVID-19 ICU patients admitted to the ICU. Tracheostomy was performed on day 10 (mean 10 ± 3.3) from the time of intubation. Major tracheal complications occurred in 5 patients during the procedure. In the control group of 30 ICU patients, no differences were found with regards to the timing of the tracheostomy, whereas a statistically significant difference was observed regarding complications with only one tracheal ring rupture reported. Conclusion Percutaneous tracheostomy in COVID-19 patients showed a higher rate of complications compared with controls even though the same precautions and the same expertise were applied. Larger studies are needed to understand whether the coronavirus disease itself carries an increased risk of tracheal damage.

Morphometry, Topography and Arterial Supply of the Thyroid Gland in Brazilian Shorthair Cats

Background: Thyroid gland diseases are the most common endocrinopathies in feline practice. Diagnosis and surgical treatment must base on solid anatomical knowledge about the gland size, localization, and blood supply. However, some textbooks provide a general anatomical description of the thyroid gland of domestic carnivores. Thus, specific details of the feline gland are missing. The present study aimed to investigate the dimensions, topography, and arterial supply of the thyroid gland in Brazilian shorthair cats and, therefore, provide additional data to diagnose and treat feline thyroid diseases.Materials, Methods & Results: Thirty Brazilian shorthair cats formalin-fixed cadavers (15 male and 15 female) were injected with red-stained latex solution by a canula in the thoracic aorta. The necropsy unit of the Rural Federal University of Rio de Janeiro donated the specimens. The study included only adult animals with no history of thyroid disease. After the fixation period, the cadavers were dissected to investigate the measurements (length, width at cranial and caudal poles, and thickness), topography, and in situ arterial supply of the thyroid lobes. The mean measurements of the length, cranial pole width, caudal pole width, and thickness in the right lobe were 19.39 ± 3.10 mm, 5.36 ± 1.40 mm, 3.67 ± 0.93 mm, and 1.30 ± 0.29 mm, respectively; and 20.29 ± 3.35 mm, 4.85 ± 1.58 mm, 3.88 ± 0.91 mm, 1.64 ± 0.65 mm in the left lobe, respectively. There were no statistical differences (P > 0.05) in the comparison of the measures between sexes or antimers (sides). Pearson's linear correlation detected a positive, moderate (r = 0.55), and significant (P < 0.05) correlation between the right and left lobe lengths. In 70% of the cats, both left and right lobes had the cranial poles located at the same level. Typically, the lobes extended between the first to the eighth tracheal ring. However, the cranial pole of some lobes located as cranially as the cricoid cartilage level, and the caudal pole as caudally as the 12th tracheal ring. Fifty-six percent of the cats had a ventrally located isthmus. In all the sampling, one single thyroid artery emerged as a branch of the common carotid artery and provided branches directly to the thyroid lobe, isthmus and the adjacent muscles and esophagus.Discussion: Besides establishing average dimensions of normal thyroid lobes in Brazilian shorthair cats, this study detected no significant difference between the average measurements of right and left lobes. Also, a positive linear correlation between the length and width of the right and left lobes became evident. Therefore, the practitioner must consider suspicious any length asymmetry between right and left thyroid lobes until further endocrine test proves otherwise. Most of the cats had the right and left thyroid lobe positioned at the same transversal level; however, positional asymmetries are not uncommon. Unlike dogs, Brazilian shorthair cats have only a single artery to supply each lobe: the thyroid artery. In a feline thyroidectomy, the surgeon must avoid blindly ligating the thyroid artery since this vessel also provided numerous branches to adjacent muscles and esophagus. In a bilateral thyroidectomy, the ventral region between lobes should be thoroughly inspected for the common presence of an isthmus. Sometimes, the surgeon may need to extend the incision caudally beyond the 12th tracheal ring level to visualize the gland tissue entirely.Keywords: endocrinology, feline anatomy, morphometrics, thyroidectomy.

In vitro tracheospasmolytic effect and acute toxicity screening of Coptosapelta flavescens Korth root ’s water extract

There are no data available regarding the bronchospasmolytic activity and toxicity of water extract of Coptosapelta flavescens Korth root (WECFR). Therefore, this study aimed to determine: a. the in vitro tracheospasmolytic effect of WECFR; b. safety of WECFR using the brine shrimp lethality test (BSLT) and immobilization of Daphnia magna larvae (IDL). In study, a guinea pig tracheal ring was contracted with methacholine and cumulative doses of WECFR solution were administered. A dose-response curve (DRC) was plotted of the percentage of the tracheal ring relaxation response. To test whether the relaxation mechanism occured through stimulation of beta2-adrenergic receptors, the tracheal ring was incubated with propranolol. Data analyzed using analysis of variance, showed that the DRC of WECFR was obtained with p < 0.05 compared to the DRC of control, indicating that WECFR had a tracheospasmolytic effect. The DRC for propranolol-blocked WECFR did not shift to the right compared to the DRC of WECFR, confirming that the relaxation mechanism did not occur through the beta2-adrenergic receptors. Study b. assessed safety using BSLT and IDL. After exposing the larvae to WECFR and control for 24 and 48 h, respectively, the number of dead larvae was counted. Data analyzed using Probit program, showed that the lethal dose 50 of WECFR towards Artemia salina and Daphnia magna larvae was > 1000 ppm, which means that it was not toxic. This studies demonstrate that WECFR exhibits tracheospasmolitic effect, but not through beta2-adrenergic receptors; WECFR is safe for Artemia salina and Daphnia magna larvae.

Comprehensive Comparison of Right and Left Recurrent Laryngeal Nerves in the Tracheoesophageal Groove

Objective A left-sided cervical approach to esophageal mobilization is considered safer given the perceived oblique path and more lateral orientation of the right recurrent laryngeal nerve (RLN) in the tracheoesophageal groove. Given the risk of recurrent laryngeal nerve, the current study investigated if there are differences in right and left RLN location in the tracheoesophageal groove. Methods Right and left RLNs were carefully exposed in human cadavers. Comparison of location was determined at tracheal rings 2, 4, and 6 using 3 parameters: depth of the RLN from the anterior margin of the tracheal ring, lateral distance of the RLN from the posterior margin of the tracheal ring, and distance of the RLN to the anterior midline trachea following the curvature of the trachea. Statistical analysis was used to determine differences between the right and left sides. Results Compared with the right RLN, the left RLN was slightly over 1 mm deeper at the second tracheal ring. Despite this trend, there was no significant difference in RLN location between individual sides or as an aggregate for any of the 3 parameters at tracheal rings 2, 4, or 6. Conclusions Careful characterization of RLN location precludes avoiding hoarseness, aphonia, and vocal cord paralysis. Counter to common surgical perception and educational beliefs, this study demonstrated that right and left RLN anatomical courses do not significantly differ along the trachea. Therefore, ensnarement on either side during a blind mobilization of the cervical esophagus is equally likely to occur.

KISSING SUPERIOR PARATHYROID GLANDS: A CASE REPORT

Parathyroid glands are responsible for maintaining the calcium level in blood and usually a pair of superior and inferior parathyroid glands are located in the thyroid gland. Parathyroid glands are smaller and have variations in their size, shape, number and location. Thus, it is difficult to identify the parathyroid gland and leads to its accidental removal during thyroidectomy. This case report is an incidental finding of two superior parathyroid glands in the left lobe of thyroid gland in 68-year female cadaver. Both superior parathyroid glands were located at the first tracheal ring, 2 mm in size, circular in shape, tan yellow in colour, covered by a thin capsule and separated from each other in a distance less than 1 mm. They appear similar as a twin pair and seems to kiss each other. Both were confirmed by the histological method as parathyroid tissues. Superior parathyroid gland developed from the dorsal wing of fourth pharyngeal pouch, get detached from its origin and assumed a relatively constant final location either at the cricothyroid junction or at first tracheal ring. In this present case, the dorsal wing of the fourth pharyngeal pouch have undergone earlier embryological division into two separate superior glands during its descent to the cervical region in the left side. Embryological development of thyroid gland is linked with the development of parathyroid, thymus and ultimobranchial body. Thyroid gland developed from two sources. The median one contributes to thyroid isthmus and parts of the lateral lobe of thyroid. Lateral thyroid lobes derived its contributions from the caudal pharyngeal endoderm of the 4th and 5th pharyngeal pouches. The fusion of median and lateral thyroid forms the Zuckerkandl’s tubercle. Superior parathyroid gland might have travelled along the superior border of isthmus and any changes in the development of thyroid might have influence in the development of parathyroid glands. Up to now a very few cases of kissing parathyroid glands are reported in the literature and this will provide an additional anatomical information of kissing superior parathyroid glands. KEY WORDS: Kissing superior parathyroid glands, Complications of thyroidectomy, Parathyroidectomy, Cricothyroid junction, Twin parathyroid.