The Effect of Carbohydrate Loading On Gastric Residual Volume And Hunger Score: A Single Blind, Randomised Controlled Trial Study

Background Carbohydrate loading is one of the key steps in Enhanced Recovery After Surgery (ERAS) protocol which aims to expedite post-operative recovery. Body response to surgery and prolong fasting by releasing of stress hormone and inflammatory marker leads to insulin resistance and catabolic state. Objective Effectiveness of carbohydrate loading versus plain water on gastric residual volume and patient’s well being. Methodology This is a single centre, single-blinded, parallel, placebo-controlled, stratified randomized controlled trial at Endoscopy Unit, Hospital Universiti Sains Malaysia(HUSM) from May 2019 to March 2020. Patients older than 18 years old were randomly assigned to either carbohydrate loading (237mls of resource) or control group (250mls of plain water). Randomization sequence was computer generated and allocation sequence was sealed in sequentially numbered and opaque envelopes. The drinks were served 2 hours prior to OGDS procedure. During the OGDS, all the gastric contents were aspirated into a reservoir bottle and recorded as gastric residual volume for comparison later. The patients’ well-being (hunger, thirst, anxiety, tiredness, and weakness) were assessed using visual analogue scale (VAS) before (pre) and after (post) drink consumption. Results 78 patients were randomised and analysed with equal allocation between groups. Their mean age was 49 years old with standard deviation (SD) of 14.3 years old. The means (SD) gastric residual volume in carbohydrate loading group was 58.54(52.98)mls, whereas 13.97(14.93)mls in plain water group. There was significantly more gastric residual volume in carbohydrate group (p<0.001). Carbohydrate loading group significantly showed reduction in VAS score of hunger (p=0.043) and thirst (p=0.021). There was improvement of VAS score for anxiety, tiredness, and weakness over time in carbohydrate loading group compared with plain water group, but not statistically significant. Conclusion Carbohydrate loading is associated with higher gastric residual volume compared to plain water. However, they were associated with significantly better well-being

Brain Metastasis from Breast Cancer in a Male Patient

Male breast cancer is a rare disease and has contributed to <1% of all cancers in the male population. Delay in diagnosis is common, due to its rarity and lack of awareness of the disease among the male patient and physicians. Most cases were detected at an advanced stage and up to 30% of them were diagnosed with metastasis on the initial presentation. The authors presented a case of a 60-yearold man who presented with seizure and right hemiparesis. In addition, he also has left breast mass for one year. Computed tomography of the brain showed a left frontal intra-axial brain lesion and biopsy of the breast lesion confirmed triple-negative invasive breast cancer. He was planned for whole-brain radiotherapy, however, he succumbed prior to the treatment

Mitochondrial neurogastrointestinal encephalomyopathy disease in three siblings from Pakistan with a novel mutation

Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare multisystem autosomal recessive disorder. The disease is clinically heterogeneous with gastrointestinal symptoms of intestinal dysmotility and cachexia as well as neurological symptoms of ophthalmoplegia, neuropathy, sensorineural hearing impairment, and diffuse leukoencephalopathy being most prominent. MNGIE is caused by mutations in TYMP , a gene that encodes thymidine phosphorylase (TP)-a cytosolic enzyme. Mutations in TYMP lead to very low TP catalytic activity, resulting in dramatically increased thymidine and deoxyuridine in plasma. We describe the clinical, biochemical, and neuroimaging findings of three boys with MNGIE from a Pakistani family with a novel homozygous mutation, c.798_801dupCGCG p. (Ala268Argfs*?), in exon 7 of TYM

Search for diphoton events with large missing transverse momentum in 1 fb(-1) of 7 TeV proton-proton collision data with the ATLAS detector ATLAS Collaboration

A search for diphoton events with large missing transverse momentum has been performed using 1.07 fb -1 of proton-proton collision data at s=7 TeV recorded with the ATLAS detector. No excess of events was observed above the Standard Model prediction and 95% Confidence Level (CL) upper limits are set on the production cross section for new physics. The limits depend on each model parameter space and vary as follows: Λ&lt;(22-129) fb in the context of a generalised model of gauge-mediated supersymmetry breaking (GGM) with a bino-like lightest neutralino, σ&lt;(27-91) fb in the context of a minimal model of gauge-mediated supersymmetry breaking (SPS8), and σ&lt;(15-27) fb in the context of a specific model with one universal extra dimension (UED). A 95% CL lower limit of 805 GeV, for bino masses above 50 GeV, is set on the GGM gluino mass. Lower limits of 145 TeV and 1.23 TeV are set on the SPS8 breaking scale Λ and on the UED compactification scale 1/R, respectively. These limits provide the most stringent tests of these models to date. © 2012 CERN

Search for WH production with a light Higgs boson decaying to prompt electron-jets in proton-proton collisions at s\sqrt{s}=7 TeV with the ATLAS detector

A search is performed for WH production with a light Higgs boson decaying to hidden-sector particles resulting in clusters of collimated electrons, known as electron-jets. The search is performed with 2.04 fb-1 of data collected in 2011 with the ATLAS detector at the LHC in proton-proton collisions at $\sqrt{s}$=7 TeV. One event satisfying the signal selection criteria is observed, which is consistent with the expected background rate. Limits on the product of the WH production cross section and the branching ratio of a Higgs boson decaying to prompt electron-jets are calculated as a function of a Higgs boson mass in the range from 100 GeV to 140 GeV.Peer Reviewe