A Comparison between single-dose pregabalin and magnesium sulfate in induced hypotension during functional endoscopic sinus surgery: A prospective randomized double-blinded study

Background: Functional Endoscopic sinus surgery (FESS) is a surgical intervention during which controlled hypotension can improve visibility. Magnesium sulfate is used for controlled hypotension. Pregabalin is also effective in hypotensive anesthesia. Objectives: This study aimed to detect the effect of single preoperative oral pregabalin versus intravenous magnesium sulfate to facilitate induced hypotension during functional endoscopic sinus surgery. Patients and methods: In a randomized, double-blind, prospective study, 60 patients of either sex were divided into 2 equal groups. Group P received an oral pregabalin capsule of 150 mg 30 minutes before general anesthesia. Group M received a single-dose 2 grams of magnesium sulfate 30 minutes before induction of anesthesia. The primary outcome was the total intraoperative consumption of nitroglycerin required to maintain the mean arterial blood pressure (MAP) at the range of 55– 65 mmHg. The secondary outcomes were the quality of the surgical field assessed by the Fromm and Boezaart grading scale, surgeon satisfaction assessed by the five-point Likert scale, and the visual analog pain scores (VAS). Results: The pregabalin group P showed statistically significant lower nitroglycerine doses (1.3±1.2 mg) compared to group M (3.3±1.5 mg) with a P value of <0.001. The surgical field quality and the surgeon satisfaction scales showed statistically significant better scores in group P (1.7±0.6 and 5±0.6 respectively) than in group M (3.2±0.9 and 2.1±0.6 respectively) with P values of (0.023 and 0.001 respectively). The VAS showed statistically significant lower scores in group P (1.3±0.9) compared with group M (3.4±0.6) with a p value= 0.001. Conclusion: A single preoperative pregabalin dose was more effective than magnesium sulfate in reducing the total intraoperative consumption of nitroglycerin. It also provides a dryer surgical field that achieves better surgeon satisfaction and provides postoperative analgesia

Bioactive injectable mucoadhesive thermosensitive natural polymeric hydrogels for oral bone and periodontal regeneration

Periodontitis is an inflammation-related condition, caused by an infectious microbiome and host defense that causes damage to periodontium. The natural processes of the mouth, like saliva production and eating, significantly diminish therapeutic medication residency in the region of periodontal disease. Furthermore, the complexity and diversity of pathological mechanisms make successful periodontitis treatment challenging. As a result, developing enhanced local drug delivery technologies and logical therapy procedures provides the foundation for effective periodontitis treatment. Being biocompatible, biodegradable, and easily administered to the periodontal tissues, hydrogels have sparked substantial an intense curiosity in the discipline of periodontal therapy. The primary objective of hydrogel research has changed in recent years to intelligent thermosensitive hydrogels, that involve local adjustable sol-gel transformations and regulate medication release in reaction to temperature, we present a thorough introduction to the creation and efficient construction of new intelligent thermosensitive hydrogels for periodontal regeneration. We also address cutting-edge smart hydrogel treatment options based on periodontitis pathophysiology. Furthermore, the problems and prospective study objectives are reviewed, with a focus on establishing effective hydrogel delivery methods and prospective clinical applications

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Capacity Development for Managing Disaster Risks of Flash Floods in Sudan

The Second International Symposium on Flash Floods in Wadi Systems: 25-27 October 2016. Technische Universität Berlin, Campus El Gouna, Egypt

Immunological profile and dyslipidemia in Egyptian Systemic Lupus Erythematosus patients

Aim of the work: To study the relation of the immune profile to dyslipidemia in a cohort of Egyptian Systemic Lupus Erythematosus (SLE) patients. Patients and methods: This study included 221 SLE patients with a disease duration >6 months at study entry. Disease activity was assessed using the SLE Disease Activity Index (SLEDAI) and severity using the Systemic Lupus International Collaborating Clinics/Damage Index (SLICC/DI). Patients were investigated for the anti-nuclear antibody (ANA), anti-double stranded deoxy-ribonucleic acid (anti-dsDNA), anti-cardiolipin (ACL) antibodies (IgG and IgM), anti Ro (SSA) and anti La (SSB). Dyslipidemia was considered if the high density lipoproteins (HDL), low density lipoproteins (LDL), total cholesterol (TC) or triglycerides (TG) were abnormal. Results: The mean age of the patients was 28.8 ± 7.8 years and the median disease duration was 5 years. The clinical manifestations of the patients were pleurisy (52.9%), pericarditis (24.9%), nephritis (68.3%), CNS lupus (23.1%), vasculitis (14.9%) and musculoskeletal manifestations (57.9%). All patients were on corticosteroids (median dose 35 mg/day; range 5–80 mg/day), while 92 (43.4%) of them received cyclophosphamide during their disease course. The mean SLEDAI was 12.1 ± 7.4 and SLICC/DI was 1.4 ± 1.6. Patients with positive anti-Ro (n = 44; 19.9%) showed statistically significant lower level of HDL (p = 0.01). Conclusion: Positive anti-Ro may be associated with increased incidence of low HDL in lupus patients which in turn may increase the incidence of cardiovascular accidents

Rocket seed meal (Eruca sativa) can replace soybean meal in fattening lamb diets improving performance, protein metabolism, and economic balance

The study determined the effects of replacing different levels of soybean meal (SBM) with rocket seed cake (RSC) in the diets of growing lambs on feed utilization and growth performance. Twenty‐eight male lambs (180 ± 5 d old) were divided into four groups in a complete randomized design with repeated measures for 105 d. Soybean meal was replaced with RSC at 0% (RSC0), 25% (RSC25), 50% (RSC50), and 75% (RSC75). The RSC75 group had the lowest final weight, total weight gain, and daily weight gain. The RSC25 increased (P &lt; 0.001) the intakes of DM, starch value (SV), total digestible nutrients (TDN), digestible energy (DE), and digestible crude protein (DCP) compared to the other diets, while the RSC75 decreased these values. Moreover, the RSC25 decreased (P &lt; 0.05) feed conversion of DM compared to other diets. Treatments did not affect nutrient digestibility or diet's nutritive values expressed as true SV, TDN, DCP, and DE. The RSC linearly increased albumin and urea and lowered the high‐density lipoprotein concentrations in lamb's blood. The inclusion of RSC in the diet increased economic efficiency, with the highest relative percentages of net revenue with the RSC25. Overall, RSC can replace SBM at 25% in the diet of growing lambs

Novel one-pot procedure for the preparation of 3-substituted 2-thioxo-4(3H)-quinazolinones

3-Substituted 2-thioxo-4(3H)-quinazolinones 3 are obtained in reasonable yields by a 'one-pot' procedure involving the reaction of a mixture of an anthranilic acid and a primary amine with carbon disulfide in the presence of potassium hydroxide. This provides a much more convenient approach than methods involving prior formation and isolation of isothiocyanates and is reasonably general. It fails, however, with the weakly nucleophilic 4-nitroaniline which produces benzo-3,l-thiazine-2,4(lH)-dithione 5a instead, via direct reaction between anthranilic acid and carbon disulfide. Other benzo-3,l-thiazine-2,4(lH)-dithiones 5 are obtained in excellent yields by a 'one-pot' procedure involving the reaction of the appropriate anthanilic acid and carbon disulfide in the presence of base. This method is much more convenient than the tedious reaction of phosphorus pentasulfide with isatoic anhydride. 3-Phenyl-2,4-quinazolinedithione 6 could be obtained in a reasonable yield from the reaction of the corresponding thioxoquinazolinone 3a with Lawesson's reagent or from the reaction of benzo-3,l-thiazine-2,4(lH)-dithione 5a with aniline in the presence of base

Filling Africa’s largest hydropower dam should consider engineering realities

The Grand Ethiopian Renaissance Dam (GERD) on the Nile River will double Ethiopia’s electricity generation and reduce the Nile flow to Sudan and Egypt during reservoir filling. We argue that multi-country negotiations over the initial filling and long-term operation of the GERD reservoir should not overlook key dam engineering features

Prognostic Value of Serum Thyroglobulin and Anti-Thyroglobulin Antibody in Thyroid Carcinoma Patients following Thyroidectomy

Well-differentiated thyroid cancer (WDTC) is a malignant head and neck tumor with a very high incidence. Thyroidectomized WDTC patients have been referred to nuclear medicine for radioactive iodine (RAI) ablation therapy and/or annual follow-up with diagnostic whole-body imaging. Serum thyroglobulin (TG) and thyroglobulin antibodies (TGAb) are biochemical tumor markers used to monitor WDTC. A global rise in the prevalence of WDTC is increasing the number of thyroidectomized patients requiring lifelong monitoring for persistent or recurrent diseases. The present study aimed to identify the most successful prognostic factors in well-defined thyroid carcinoma patients following total thyroidectomy and RAI therapy, followed by an estimation of the cutoff value of TG and TGAb. In this context, a total of 100 subjects were recruited and classified as follows: 60 thyroid carcinoma patients underwent total thyroidectomy and successful RAI therapy, while 40 normal healthy individuals matched for age, sex, and socioeconomic status constituted the control group. Interestingly, the levels of TG did not differ significantly between the relapsed and non-relapsed cases, but the levels of TGAb differed significantly between the relapsed and non-relapsed cases. Collectively, TG and TGAb are considered the most successful prognostic factors in well-defined thyroid carcinoma patients after total thyroidectomy and RAI therapy. The present study also concluded that the TGAb determination was better than that of the TG level, with a cutoff value of 10 ng/mL. These findings provide baseline information for follow-up and lifelong monitoring of thyroidectomized WDTC patients. Further research is warranted to explore more about serum TG and TGAb in thyroid carcinoma patients on a larger scale