Off versus On pump coronary artery bypass grafting; a single-center experience

Background: The debate about on-pump vs. off-pump coronary artery bypass grafting (CABG) continues. The present study compared the short-term outcomes after off-pump vs. on-pump CABG. Methods: The study was conducted on 67 patients who underwent CABG from 2021 to 2022. Patients were divided into two groups according to the CABG technique. Group 1 included 33 patients who underwent off-pump CABG, and Group 2 included 34 patients who underwent on-pump CABG. The study outcomes were operative time, hospital complications, and mortality. Results: On-pump patients were significantly older than off-pump patients (64.78±7.12 vs. 59.09±6.29; p= 0.004). There were no differences in comorbidities, presenting symptoms, or ejection fraction between groups. Operative time was significantly shorter in off-pump patients (227.47±13.73 vs. 321.12±27.49; p< 0.001). Blood transfusion was lower in off-pump patients (1.06± 0.311 vs. 1.79± 0.25; p< 0.001). Bleeding was lower in off-pump patients (0.81±0.13 vs. 0.91±0.20 ml, p= 0.01). Off-pump patients had significantly shorter ICU (3.5±2.6 vs. 4.9±4.7; p<0.001) and hospital stay (7.6±4.8 vs. 9.5±6.1; p<0.001). No patient had reexploration for bleeding, wound infection, or mortality in our series. One patient had renal impairment in the on-pump group (p>0.99). Conclusion: Off-pump and on-pump CABG seem to be safe approaches for managing coronary artery disease in our institution. Off-pump could be superior to on-pump CABG regarding shorter ICU and hospital stay. Studies with data from a large number of patients are recommended

Novel protocol to establish the myocardial infarction model in rats using a combination of medetomidine-midazolam-butorphanol (MMB) and atipamezole

BackgroundMyocardial infarction (MI) is one of the most common cardiac problems causing deaths in humans. Previously validated anesthetic agents used in MI model establishment are currently controversial with severe restrictions because of ethical concerns. The combination between medetomidine, midazolam, and butorphanol (MMB) is commonly used in different animal models. The possibility of MMB combination to establish the MI model in rats did not study yet which is difficult because of severe respiratory depression and delayed recovery post-surgery, resulting in significant deaths. Atipamezole is used to counter the cardiopulmonary suppressive effect of MMB.ObjectivesThe aim of the present study is to establish MI model in rats using a novel anesthetic combination between MMB and Atipamezole.Materials and methodsTwenty-five Sprague Dawley (SD) rats were included. Rats were prepared for induction of the Myocardial infarction (MI) model through thoracotomy. Anesthesia was initially induced with a mixture of MMB (0.3/5.0/5.0 mg/kg/SC), respectively. After endotracheal intubation, rats were maintained with isoflurane 1% which gradually reduced after chest closing. MI was induced through the left anterior descending (LAD) artery ligation technique. Atipamezole was administered after finishing all surgical procedures at a dose rate of 1.0 mg/kg/SC. Cardiac function parameters were evaluated using ECG (before and after atipamezole administration) and transthoracic echocardiography (before and 1 month after MI induction) to confirm the successful model. The induction time, operation time, and recovery time were calculated. The success rate of the MI model was also calculated.ResultsMI was successfully established with the mentioned anesthetic protocol through the LAD ligation technique and confirmed through changes in ECG and echocardiographic parameters after MI. ECG data was improved after atipamezole administration through a significant increase in heart rate (HR), PR Interval, QRS Interval, and QT correction (QTc) and a significant reduction in RR Interval. Atipamezole enables rats to recover voluntary respiratory movement (VRM), wakefulness, movement, and posture within a very short time after administration. Echocardiographic ally, MI rats showed a significant decrease in the left ventricular wall thickness, EF, FS, and increased left ventricular diastolic and systolic internal diameter. In addition, induction time (3.440 ± 1.044), operation time (29.40 ± 3.663), partial recovery time (10.84 ± 3.313), and complete recovery time (12.36 ± 4.847) were relatively short. Moreover, the success rate of the anesthetic protocol was 100%, and all rats were maintained for 1 month after surgery with a survival rate of 88%.ConclusionOur protocol produced a more easy anesthetic effect and time-saving procedures with a highly successful rate in MI rats. Subcutaneous injection of Atipamezole efficiently counters the cardiopulmonary side effect of MMB which is necessary for rapid recovery and subsequently enhancing the survival rate during the creation of the MI model in rats

Comparison of two surgical approaches for the treatment of atrial septal defects

Background: Cardiac surgery has adopted less invasive procedures in the last two decades, aiming to reduce surgical insult and achieve early patient recovery. The present study compared median sternotomy and minimally invasive techniques for managing atrial septal defects. Methods: The current study is a prospective cohort comparative study that included 67 patients randomly divided into two groups. Group A included 34 patients with median sternotomy; their ages ranged from 2 to 40 years (mean± SD 36.12±7.3 years). Group B (n= 33) underwent minimally invasive surgery, and their ages ranged from 21 to 46 years (mean± SD 32.09±7.35). Results: Minimally invasive patients had fewer blood transfusions (1.06±0.24 vs. 1.79±0.25 units, P<0.001), less pain on the second day (3.73±0.72 vs. 7.94±1.01, P<0.001) and fifth day (2.09±0.52 vs. 5.38±.49, P<0.001) of the operation, and a shorter duration of hospital stay (4.85±0.75 vs. 6.38±0.78 days, P<0.001) than median sternotomy patients. Wound infection was reported in three cases with minimally invasive surgery, while nine patients had wound infection with median sternotomy. However, both groups had no reported mortality after two months of follow-up. Conclusion: Atrial septal defect closure with minimally invasive approaches could be safe with low morbidity, a fast recovery phase, and the ability to restore normal activities

Geochemical characterization of recent Nile Delta inner shelf sediments: Tracing natural and human-induced alterations into a deltaic system

Abstract The present study deals with the geochemical changes observed along Nile Delta inner shelf sediments over a period of 20 years (1995–2015). Major, minor, and trace constituents as well as rare earth elements (REE) were investigated in the surface sediments collected from seven transects along the inner shelf on five years intervals. Geochemical composition of sediments in Nile Delta inner shelf exhibits continuous changes over time due to the depositional and sediment transport processes. The sediments are generally enriched with Fe and Ti oxides, as well as Ta, Nb, Y in comparison to the Upper Continental Crust (UCC). These alterations signify the impact of processes such as erosion and sediment transport, as well as the impact of anthropogenic interferences such as damming the Nile River Flow. The reduction of the sediment input from the Nile River has somehow altered the geochemical signature of the inner shelf sediments. The REE patterns indicate weathering in areas subjected to erosion, while trace elements and major oxides spatial and temporal distributions concentrate eastwards under the influence of the easterly sediment transport pattern. Nile Delta inner shelf presented a typical case for understanding the link between geochemistry and sedimentary processes in nearshore and deltaic systems

A review on experimental surgical models and anesthetic protocols of heart failure in rats

Heart failure (HF) is a serious health and economic burden worldwide, and its prevalence is continuously increasing. Current medications effectively moderate the progression of symptoms, and there is a need for novel preventative and reparative treatments. The development of novel HF treatments requires the testing of potential therapeutic procedures in appropriate animal models of HF. During the past decades, murine models have been extensively used in fundamental and translational research studies to better understand the pathophysiological mechanisms of HF and develop more effective methods to prevent and control congestive HF. Proper surgical approaches and anesthetic protocols are the first steps in creating these models, and each successful approach requires a proper anesthetic protocol that maintains good recovery and high survival rates after surgery. However, each protocol may have shortcomings that limit the study's outcomes. In addition, the ethical regulations of animal welfare in certain countries prohibit the use of specific anesthetic agents, which are widely used to establish animal models. This review summarizes the most common and recent surgical models of HF and the anesthetic protocols used in rat models. We will highlight the surgical approach of each model, the use of anesthesia, and the limitations of the model in the study of the pathophysiology and therapeutic basis of common cardiovascular diseases

Effect Of Various Sintering Protocols On The Translucency Of Highly Translucent Cubic Zirconia

Aim of the study: This study was carried out to evaluate the effect of various sintering protocols on the translucency of highly translucent cubic zirconia. Materials and methods: A total of forty discs of two types of zirconia ceramics were used in this study. The specimens were divided into two main groups according to the type of zirconia; Group 1 (n=20): Cubic zirconia (DD Cube X2 98color) and Group 2 (n=20): Tetragonal zirconia (BioZX2color). Each group was subdivided into two subgroups, where 10 discs were per subgroup according to the sintering protocol. Cubic and tetragonal zirconia blanks of dimensions (98 mm diameter × 25 mm thickness) were CAD/CAM milled into cylindrical-shaped blocks of dimensions (15 mm diameter × 25 mm thickness). Cylinders of both materials were cut with a diamond cutting saw into discs with larger dimensions (15 mm diameter × 1.2 mm thickness) to compensate for the approximately 23% shrinkage of the material during sintering, so as the final dimensions would be (12 mm diameter × 1 mm thickness). Discs were dried under a heating lamp and then conventionally and speed sintered according to the manufacturer\u27s instructions. The translucency of each subgroup was evaluated by measuring contrast ratio (CR) and translucency parameter (TP). Results: For both cubic or tetragonal zirconia, conventional sintering showed statistically significantly lower mean CR and higher mean TP than speed sintering (P-value \u3c0.001). Conclusion: Different sintering protocols showed a significant effect on the translucency of cubic and tetragonal zirconia

Burden of Parasitaemia, Falciparum Malaria and Serum Glucose, Urea and Creatinine among Patients in Abbs (Tehama-Hajjah), Yemen.

Hypoglycemia and kidney failure associated with malaria is common and depends to a large extent on the local prevalence of malaria. The present study is therefore aimed at assessment of glucose, creatinine, and urea in blood serum of Plasmodium falciparum malaria patients in 63 subjects with malaria parasitaemia were selected as test subject based on clinical symptoms and 30 healthy subjects without malaria infection were included as control subjects. The diagnosis of malaria was carried out by thin and thick blood films. The creatinine, urea and glucose were determined with malaria parasitaemia. P. falciparum malaria infection resulted in significant increase in serum urea and creatinine levels of patients with group mild, moderate and high parasitaemia when compared the respective healthy subject's. The serum glucose levels were significantly reduction with all groups parasitaemia. We conclude those kidney dysfunctions and hypoglycemia are clinical features of parasitaemia malaria. This study suggesting that hypoglycemia with malaria parasitaemia may be associated with status of renal impairment

Study of genetic variants in chromosome 5p15.33 region in non-smoker lung cancer patients

Introduction: Genome-wide association studies have identified that genetic polymorphisms in the telomerase reverse transcrip-tase (TERT) and cleft lip and palate transmembrane 1-like (CLPTM1L) genes may play important roles in the development of lung cancer in never smokers.Material and methods: This study was aiming to evaluate the associations between the risk of lung cancer in never smokers and single nucleotide polymorphisms in these genes by Real-Time Taqman assay, in forty lung cancer patients and forty apparently healthy age-matched controls selected from the chest department, Kasr Al-Ainy hospital from June 2018 to January 2019. Results: Adenocarcinoma was the most common histopathological subtype of lung cancer in the study patients. Also, the prevalence of females having adenocarcinoma was more common than males. The heterozygous form of the CLPTM1L occurred more frequently in the subjects aged above 46 years (P=0.019). There was a significant association between (rs 2730100) (c. 1574-3777C>A) TERT and CLPTM1L (rs 451360) (c.1532+ 1051C>A) genotypes and the incidence of lung cancer in never smokers, especially adenocarcinoma, a subtype of non-small cell lung carcinoma (NSCLC).Conclusions: Polymorphism in the telomerase reverse transcriptase (TERT) and cleft lip and palate transmembrane 1 like (CLPT-M1L) genes may play an important role in the development of NSCLC, especially adenocarcinoma subtype. The two genes are located in the chromosome 5p15.33

Parasitaemia and Its Relation to Hematological Parameters and Liver Function among Patients Malaria in Abs, Hajjah, Northwest Yemen

Plasmodium falciparum malaria is the most common infection in Yemen. The present study aims to investigate changes in hematological and hepatic function indices of P. falciparum infected individuals. This study included 67 suspected falciparum malarial patients attended in clinics and rural Abs Hospital (Tehama, Hajjah), Yemen, from October 2013 to April 2014. The diagnosis of malaria was confirmed by thick and thin film with Giemsa staining of malaria parasite. Hematological parameters and serum levels of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), and bilirubin (total and direct) as test indicators of liver function were studied. Patients with parasitaemia tended to have significantly lower hemoglobin, hematocrit, white blood cell count, lymphocytes, and platelets, compared with healthy normal subjects. Neutrophils levels were significantly higher in cases of falciparum malaria in comparison to healthy normal subjects. Serums AST, ALT, ALP, and bilirubin (total and direct) in falciparum malaria patients were significantly higher (p<0.0001) than those of falciparum malaria of free individuals. Hematological and liver dysfunctions measured parameters were seen associated with moderate and severe parasitaemia infection. This study concludes that hematological and hepatic dysfunction parameters could be indicator of malaria in endemic regions