Transversus abdominis plane (TAP) block: Review article

Background: The transversus abdominis plane (TAP) block is a localized analgesic method for the abdomen wall on the anterolateral side. Ultrasound (US) guided TAP blocks are currently regarded as the gold standard. It is simple to obtain US images; it could be utilized in several surgical procedures including the abdominal wall on the anterolateral side. Though, US-guided TAP blocks’ effectiveness varies, that may be owing to the variety of techniques used. The approach chosen has an effect on the area included and the duration of the block. To examine the true analgesic consequences of TAP blocks, we standardized the nomenclature system and defined all methods. While a single-shot TAP block has a restricted period, it remains an applicant for the analgesia threshold for abdominal wall operation due to the possibility of overcoming this restriction using the catheter method and liposomal bupivacaine. TAP blocks could be used more effectively to attain improvement of pain control with an integrated nomenclature and the advance of catheter method and/or local liposomal analgesics. Objective: This review discusses the nomenclature system and current improvements in TAP block approaches. Methods: The databases were searched for articles published in English in 4 data bases [PubMed – Google scholar- Egyptian bank of knowledge -Science direct] and Boolean operators (and, or, not) had been used such as [Transversus abdominis plane block AND Internal Oblique Muscle OR Ultrasound guided] and in peer-reviewed articles between January 2000 and August 2021.Conclusion: With the improvement in US method, the successful rate and protection of TAP blocks have clearly enhanced

Effect of Watermelon Rind Powder on Gut Microbiome and Weight Loss in Obese Rats

The purpose of this research was to examine the impact of watermelon rind powder on the blood lipid profile of male albino rats (Sprague-Dawley strain), weighing about 200–250 g) were separated randomly into two main groups as follows: The first main group -ve control = 6 rats) was given a basic diet. The second main group (24 rats) was fed a high-fat diet (10% sheep fat) for one month to induce obesity and hypercholesterolemia. Six rats were separated and fed on a high fat diet only as a control (positive group + ve), then the remaining 18 rats were separated into 3 subgroups (6 rats per group). These subgroups 1, 2, and 3 were fed on a basal diet mixed with watermelon rind powder at 5%, 10%, and 15%, respectively. All rats were killed after 8 weeks of experimentation in order to get their blood. LDL, HDL, VLDL, TG, ALT, AST, TC, and HB were determined. Results: Hypercholesterolemia rats fed on a basal diet mixed with watermelon rind powder showed significantly (P<0.05) decreasing liver function enzymes, VLDL, LDL, TC, TG, and VLDL, with significantly (P<0.05) increasing hemoglobin and HDL levels when contrasted with the control groups. Conclusion: Feeding on a basal diet mixed with watermelon rind powder could be utilized as a suitable therapy for obese cases and may lead to microbial diversity

Oral Health-Related Quality of Life in Single Implant Mandibular Overdenture Retained by CM LOC versus Ball Attachment: A Randomized Controlled Trial

AIM: This randomised clinical study aimed to detect whether CMLOC attachment could improve Oral Health-Related Quality of Life (OHRQOL) when compared to ball attachment. METHODS: Eighty edentulous patients were recruited to receive a single symphyseal implant for mandibular overdenture, after three months, randomisation was done to divide them into two groups; Dalbo ball (control group) and Cendres and Metaux locator (CM-LOC) (intervention) attachments respectively, oral health impact profile for edentulous patients (OHIP-EDENT)questionnaire was recorded before implant placement, two weeks after pick up, at 3, 6, 9, and 12 months. RESULTS: Results revealed a lack of statistical significance between the two groups except for psychological discomfort at 2 weeks after pick-up (p-value = 0.029) CONCLUSION: Single implant overdenture is a simple, reliable treatment modality for treating edentulous mandible and both CM LOC and Ball attachments are good alternatives for such treatment modality

Assessment of Pulpine Mineral effect on root maturation for immature dog teeth with infected pulp

The aim of the study was to assess the effect of pulpine mineral on root maturation for immature dog teeth with infected pulp and compare the results with Mineral Trioxide Aggregate (MTA). Materials and methods: Sixty (60) permanent dog teeth from six mongrel dogs were selected. Dogs were randomly divided into 2 equal study groups (3 dogs/ group), according to the post-treatment evaluation period. Group one (1 month, n= 30 teeth), Group two (3 months, n= 30 teeth). Each main group was then subdivided according to the materials used into 4 experimental subgroups: Pulpine mineral, n=9, MTA group, n=9, Positive control group, n=6 and negative control group, n=6. Radiographic evaluation was performed to assess the increase in the root length. Results: The results showed that after 1 month; the radiographic evaluation regarding root length revealed that the difference in root length between one month after treatment and the preoperative condition was recorded 9.94±5.19 mm in the pulpine mineral group while it was recorded 5.38±3.78 mm in the MTA group, the positive control group showed the least one in the change in the root length 1.00±1.87 mm, while the negative control group was 7.00±4.06 mm. After 3 months; results showed The difference in root length between three months after treatment and the preoperative condition was recorded 8.36±2.45 mm in the pulpine mineral group while it was recorded 8.63±5.83 mm in the MTA group, the least change in the root length was detected 1.60±3.13 mm, while the highest change was 12.00±4.90 mm which was the negative control group. Conclusion: PMIN is a promising alternative to MTA when used for pulpotomy. Clinical relevance: Vital pulp therapy in immature teeth can be done using PMIN as an alternative to MTA

Targeting p53 in chronic lymphocytic leukemia.

Genomic studies have allowed to identify molecular predictors for chronic lymphocytic leukemia (CLL) treatment tailoring.The review covers the p53 biological pathway, its genetic alterations and clinical implications in CLL, and its druggable targets. The potential therapeutic options forThe key approach to improve CLL outcome is treatment tailoring in individual patients. BCR and BCL2 inhibitors have significantly improved CLL survival, howeve

Rumex dentatus L. phenolics ameliorate hyperglycemia by modulating hepatic key enzymes of carbohydrate metabolism, oxidative stress and PPARγ in diabetic rats

Rumex dentatus L. is a flowering plant with promising therapeutic effects. This study investigated the antioxidant efficacy of phenolic compounds isolated from R. dentatus L. in vitro and by conducting density function theory (DFT) studies to explore the mechanisms of action. The antioxidant, anti-inflammatory and antidiabetic effects of polyphenols-rich R. dentatus extract (RDE) were investigated in type 2 diabetic rats. Phytochemical investigation of the aerial parts of R. dentatus resulted in the isolation of one new and seven known compounds isolated for the first time from this species. All isolated phenolics showed in vitro radical scavenging activity. The antioxidant activity of the compounds could be oriented by the hydrogen atom transfer and sequential proton loss electron transfer mechanisms in gas and water phases, respectively. In diabetic rats, RDE attenuated hyperglycemia, insulin resistance and liver injury and improved carbohydrate metabolism. RDE suppressed oxidative stress and inflammation and upregulated PPARγ. In silico molecular docking analysis revealed the binding affinity of the isolated compounds toward PPARγ. In conclusion, the computational calculations were correlated with the in vitro antioxidant activity of R. dentatus derived phenolics. R. dentatus attenuated hyperglycemia, liver injury, inflammation and oxidative stress, improved carbohydrate metabolism and upregulated PPARγ in diabetic ratsThis work has DGI Project no. CTQ2015-63997-C2, a generous allocation of computing time at the Centro de Computación Científica of the UAM is also acknowledge

Sparsity-Based Joint NBI and impulse noise mitigation in hybrid PLC-Wireless transmissions

We propose a new sparsity-aware framework to model and mitigate the joint effects of narrow-band interference (NBI) and impulsive noise (IN) in hybrid powerline and unlicensed wireless communication systems. The proposed mitigation techniques, based on the principles of compressive sensing, exploit the inherent (non-contiguous or contiguous) sparse structures of NBI and IN in the frequency and time domains, respectively. For the non-contiguous NBI and IN, we develop a multi-level orthogonal matching pursuit recovery algorithm that exploits prior knowledge about the sparsity level at each receive antenna and powerline to further reduce computational complexity without performance loss. In addition, for the non-contiguous asynchronous NBI scenario, we investigate the application of time-domain windowing to enhance the NBI's sparsity and, hence, improve the NBI mitigation performance. For the contiguous NBI and IN scenario, we estimate the NBI and IN signals by modeling their burstiness as block-sparse vectors with and without prior knowledge of the bursts' boundaries. Moreover, we show how to exploit the spatial correlations of the NBI and IN across the receive antennas and powerlines to convert a non-contiguous NBI and IN problem to a block-sparse estimation problem with much lower complexity. Furthermore, we investigate a Bayesian linear minimum mean square error-based approach for estimating both non-contiguous and contiguous NBI and IN based on their second-order statistics to further improve the estimation performance. Finally, our numerical results illustrate the superiority of the joint processing of our proposed NBI and IN sparsity-based mitigation techniques compared to separate processing of the wireless and powerline received signals. 2013 IEEE.This work was supported by NPRP through the Qatar National Research Fund (a member of Qatar Foundation) under Grant NPRP 8-627-2-260.Scopu

Fuzzy logic controller equilibrium base to enhance AGC system performance with renewable energy disturbances

Owing to the various sources of complexity in the electrical power system, such as integrating intermittent renewable energy resources and widely spread nonlinear power system components, which result in sudden changes in the power system operating conditions, the conventional PID controller fails to track such dynamic challenges to mitigate the frequency deviation problem. Thus, in this paper, a fuzzy PI controller is proposed to enhance the automatic generation control system (AGC) against step disturbance, dynamic disturbance, and wind energy disturbance in a single area system. The proposed controller is initialized by using Equilibrium Optimization and proved its superiority through comparison with a classical PI optimized base. Results show that the fuzzy PI controller can reduce the peak-to-peak deviation in the frequency by 30–59% under wind disturbance, compared to a classical PI optimized base. Moreover, a fuzzy PID controller is also proposed and EO initialized in this paper to compare with the PIDA optimized by several techniques in the two-area system. Results show that the fuzzy PID controller can reduce the peak-to-peak deviation in the frequency of area 1 by 30–50% and the deviation of frequency in area 2 by 13–48% under wave disturbance, compared to the classical PIDA optimized base

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London