EFFECT OF COMMON CARP AND AFRICAN CATFISH OILS ON RATS FED ON HIGH-FAT DIET

Objective: The present study was designed to study the effect of common carp and African catfish oils on the lipid profiles and liver functions in rats fed on high-fat diets, also fatty acids were assessed in both oils by gas-liquid chromatography (GLC).Methods: A biological experiment on rats was designed to raise fat in the diet and to study the effect of treatment with common carp and African catfish oils for 6 w (by the stomach tube) and then evaluate their impact on blood lipid profile and liver functions (Alanine transaminase [ALT], aspartate transaminase [AST] total protein and albumin).Results: GLC analysis of fatty acids (FAs) revealed the presence of oleic, palmitic, palmitolic, and linoleic acids more than 70% from total fatty acids in two oils. High-fat diet resulted in a significant increase in plasma lipid profile as well as liver functions. The treatment of rats fed high fat diets with common carp and African catfish oils resulted in a significant decrease in levels of triglycerides (TGs), total cholesterol (TC), low-denisty lipioprotein cholesterol (LDL-c), total cholesterol (TC)/high-denisty lipoprotein cholesterol (HDL-c) and TGs/HDL-c ratios compared with positive control group, while the same treatment with these oils resulted in a significant increase in HDL-c levels compared with positive control group. The intake of common carp and African catfish oils also significantly reduced ALT and AST activities compared with positive control group. Common carp and African catfish oils showed an anti-hyperlipidemic effect in rats feeding on hypercholesterolemic diets.Conclusion: It could be concluded that these fish oils have a promising role in reducing the harmful effects of high-fat diets.Â

Value of Neutrophil to Lymphocyte Ratio as a Predictor of Mortality in Patients Undergoing Aortic Valve Replacement

Background: Neutrophil to lymphocyte ratio (NLR) has been studied as a measure of inflammation and as a prognosticating factor in various medical conditions including neoplastic, inflammatory and cardiovascular. The prognostic role of NLR in predicting mortality in patients with aortic stenosis undergoing surgical aortic valve replacement (AVR) has not been studied. The aim of our study is to explore the utility of NLR as a predictor of both, short and long-term mortality, in patients undergoing surgical AVR. Methods: Consecutive patients with aortic stenosis admitted for AVR to our institution were evaluated for study inclusion. Of the 335 patients admitted from January 2007 to September 2011, 234 met study inclusion criteria. Patients were divided into two groups depending on their initial preoperative NLR level with a cutoff value of 3. Three-year vital status was accessed with electronic medical records and Social Security Death Index. Survival analysis, stratified by NLR, was used to evaluate the predictive value of preoperative NLR levels. Results: Patients with NLR \u3e/=3, when compared to those with NLR /=3 had 4.77 fold increase in 3-year mortality (1.48-15.32, P=0.0090). Conclusions: NLR is an independent predictor of short-term and long-term mortality in patients with aortic stenosis undergoing AVR surgery, especially those with NLR \u3e/=3. We strongly suggest the use of NLR as a tool to risk stratify patients with aortic stenosis undergoing AVR surgery

Cantharidin Poisoning due to Blister Beetle Ingestion in Children : Two case reports and a review of clinical presentations

Cantharidin is an intoxicant found in beetles in the Meloidae (Coleoptera) family. Ingestion may result in haematemesis, impaired level of consciousness, electrolyte disturbance, haematurea and renal impairment. Here, we report two paediatric cases of meloid beetle ingestion resulting in cantharidin poisoning and the clinical presentation of the ensuing intoxication

Consensus evidence-based recommendations for treat-to-target management of immunoglobulin A vasculitis

IgA vasculitis (IgAV), formerly known as Henoch-Schönlein purpura, is the most common cause of systemic vasculitis in childhood. Given its potential life-threatening systemic complications, early and accurate diagnosis as well as management of IgAV represent a major challenge for health care professionals. This study was carried out to attain an evidence-based expert consensus on a treat-to-target management approach for IgAV using Delphi technique. The preliminary scientific committee identified a total of 16 key clinical questions according to the patient, intervention, comparison, and outcomes (PICO) approach. An evidence-based, systematic, literature review was conducted to compile evidence for the IgAV management. The core leadership team identified researchers and clinicians with expertise in IgAV management in Egypt upon which experts were gathered from different governorates and health centers across Egypt. Delphi process was implemented (two rounds) to reach a consensus. An online questionnaire was sent to expert panel (n = 26) who participated in the two rounds. After completing round 2, a total of 20 recommendation items, categorized into two sections were obtained. Agreement with the recommendations (rank 7–9) ranged from 91.7–100%. Consensus was reached (i.e. ⩾75% of respondents strongly agreed or agreed) on the wording of all the 20 clinical standards identified by the scientific committee. Algorithms for the diagnosis and management have been suggested. This was an expert, consensus recommendations for the diagnosis and treatment of IgAV and IgA vasculitic nephritis, based on best available evidence and expert opinion. The guideline presented a strategy of care with a pathway to achieve a state of remission as early as possible

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 years; 78.2% included were male with a median age of 37 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

Risk Factors for Graft-versus-Host Disease in Haploidentical Hematopoietic Cell Transplantation Using Post-Transplant Cyclophosphamide

Post-transplant cyclophosphamide (PTCy) has significantly increased the successful use of haploidentical donors with a relatively low incidence of graft-versus-host disease (GVHD). Given its increasing use, we sought to determine risk factors for GVHD after haploidentical hematopoietic cell transplantation (haplo-HCT) using PTCy. Data from the Center for International Blood and Marrow Transplant Research on adult patients with acute myeloid leukemia, acute lymphoblastic leukemia, myelodysplastic syndrome, or chronic myeloid leukemia who underwent PTCy-based haplo-HCT (2013 to 2016) were analyzed and categorized into 4 groups based on myeloablative (MA) or reduced-intensity conditioning (RIC) and bone marrow (BM) or peripheral blood (PB) graft source. In total, 646 patients were identified (MA-BM = 79, MA-PB = 183, RIC-BM = 192, RIC-PB = 192). The incidence of grade 2 to 4 acute GVHD at 6 months was highest in MA-PB (44%), followed by RIC-PB (36%), MA-BM (36%), and RIC-BM (30%) (P = .002). The incidence of chronic GVHD at 1 year was 40%, 34%, 24%, and 20%, respectively (P < .001). In multivariable analysis, there was no impact of stem cell source or conditioning regimen on grade 2 to 4 acute GVHD; however, older donor age (30 to 49 versus <29 years) was significantly associated with higher rates of grade 2 to 4 acute GVHD (hazard ratio [HR], 1.53; 95% confidence interval [CI], 1.11 to 2.12; P = .01). In contrast, PB compared to BM as a stem cell source was a significant risk factor for the development of chronic GVHD (HR, 1.70; 95% CI, 1.11 to 2.62; P = .01) in the RIC setting. There were no differences in relapse or overall survival between groups. Donor age and graft source are risk factors for acute and chronic GVHD, respectively, after PTCy-based haplo-HCT. Our results indicate that in RIC haplo-HCT, the risk of chronic GVHD is higher with PB stem cells, without any difference in relapse or overall survival

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Beneficial effect of adding pentoxifylline to processed semen samples on ICSI outcome in infertile males with mild and moderate asthenozoospermia: A randomized controlled prospective crossover study

Background: No extensive studies were done that included the use of pentoxifylline or verify its effect on the outcome of ICSI in cases of mild and moderate asthenozoospermia.\ud Objective: The aim of this study was to evaluate the effect of pentoxifylline used in preparation of semen samples which doesn't need motility enhancement prior to ICSI.\ud Materials and Methods: The study was carried on 30 infertile patients where pentoxifylline was used for semen processing (group I), another 30 patients without pentoxifylline (group II) in addition to 60 infertile patients where crossing over of the semen sample was done further subdividing it into 2 subgroups in which the first half of the semen sample was incubated with pentoxifylline (group IIIA) and the second half of the sample without pentoxifylline (group IIIB).\ud Results: The numbers of oocytes injected, numbers of oocytes fertilized, fertilization rate, the total numbers of embryos, numbers of good embryos and the numbers of embryos transferred of group IIIA were found significantly higher than that of Group IIIB (p=0.00). The overall 6 month pregnancy rate of group I was significantly higher than that of group II (73.3% vs. 60% respectively, p=0.04). The abortion rate of (Group I) and that of (Group II) was found non – significantly different (20% vs. 27.8% respectively, p=0.53).\ud Conclusion: Pentoxifylline can be used as a useful compound for improving ICSI outcome in semen samples preparation prior to oocytes injection regardless of the state of sperm motility or the degree of asthenozoospermi

Work-in-Progress: A Novel Fault Tolerant Scheme for a Wireless Modular Prosthetic Limb

[abstract not available