Relationship between Type 2 Diabetes and Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency and Their Effect on Oxidative Stress

Objective: Though the relationship between glucose-6-phosphate dehydrogenase (G6PD) deficiency and type 2 diabetes (T2D) has been reported, their interaction to influence oxidative stress is not fully understood. This study was conducted to investigate the relationship between T2D and G6PD deficiency and assessed their effect on oxidative stress. Methodology: A total of 73 T2D and 75 non-diabetic (ND) out-patients at Enugu State University Teaching Hospital (ESUTH) in Enugu, Nigeria were recruited. They were screened for G6PD deficiency, oxidative stress markers; lipid peroxidation, protein peroxidation and glycated haemoglobin (HbA1c) and antioxidant enzymes; superoxide dismutase (SOD) and catalase activities were assayed. Results: Oxidative stress was influenced by T2D as malondialdehyde (MDA), protein carbonyl and HbA1c levels were significantly higher (p0.05) interaction between G6PD deficiency and T2D to influence oxidative stress in patients. Conclusion: The interaction between G6PD deficiency and T2D did not influence oxidative stress though there was a possible relationship between G6PD deficiency and T2D in male patients.This study was partially supported by the competitive research grant of Godfrey Okoye University, Enugu Nigeria.Published onlin

Is it really advantageous to operate proximal femoral fractures within 48 h from diagnosis? – A multicentric retrospective study exploiting COVID pandemic-related delays in time to surgery

Objectives: Hip fractures in the elderly are common injuries that need timely surgical management. Since the beginning of the pandemic, patients with a proximal femoral fracture (PFF) experienced a delay in time to surgery. The primary aim of this study was to evaluate a possible variation in mortality in patients with PFF when comparing COVID-19 negative versus positive. Methods: This is a multicentric and retrospective study including 3232 patients with PFF who underwent surgical management. The variables taken into account were age, gender, the time elapsed between arrival at the emergency room and intervention, pre-operative American Society of Anesthesiology score, pre-operative cardiovascular and respiratory disease, and 10-day/1-month/6-month mortality. For 2020, we had an additional column, “COVID-19 swab positivity.” Results: COVID-19 infection represents an independent mortality risk factor in patients with PFFs. Despite the delay in time-to-surgery occurring in 2020, no statistically significant variation in terms of mortality was detected. Within our sample, a statistically significant difference was not detected in terms of mortality at 6 months, in patients operated within and beyond 48 h, as well as no difference between those operated within or after 12/24/72 h. The mortality rate among subjects with PFF who tested positive for COVID-19 was statistically significantly higher than in patients with PFF who tested. COVID-19 positivity resulted in an independent factor for mortality after PFF. Conclusion: Despite the most recent literature recommending operating PFF patients as soon as possible, no significant difference in mortality was found among patients operated before or after 48 h from diagnosis

The Bull or Bear Characterization of Bitcoin Market Conditions

The bear and bull market conditions have attracted a lot of attention as economic phenomena, thus characterizing the bitcoin markets as bullish or otherwise bearish goes a long way in describing the behaviour of the market. However, this paper will use the regime switching method to identify the turning points of the Bitcoin market conditions, predict the bull and bear Bitcoin market conditions and also emphasize the properties of the bear and bull market conditions that would aid investors in making the right investment decisions

Review on Atherogenic Index of Plasma Lipids and Dyslipidemia

Dyslipidemia is defined as abnormally levels of lipids in the blood. Different types of lipids and lipoproteins have been identified. Dyslipidemia is a single strong risk factor for the development of cardiovascular events and atherosclerosis is the most common. It has been described as a disease of the economically advanced societies, but recently, it has found its way into the semi-urban societies and among its dwellers, who are at the increasing risk of developing cardiovascular accidents. Hence, early identification and diagnosis of dyslipidemia at its earliest stage among this populace is a worthwhile cardiovascular preventive measure. The study of hyperlipidaemia is of considerable importance, mainly because of the involvement of lipids in cardiovascular diseases. The classification system of hyperlipidaemia is based on which plasma lipoprotein concentrations were increased. Fredrickson classification helped to put lipidology on the clinical map, though it was not a diagnostic classification. It gives little clue as to the aetiology of the disorder. Currently, a more descriptive classification is used for the primary hyperlipidaemia although they can be genetic or secondary factors. This review presents the overview of plasma lipids. This article illustrates the theoretical background and details about dyslipidemias. Keywords: Dyslipidemia, Atherogenic index, Hyperlipidaemia, Atherosclerosis, Lipoprotein

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)