Study of serum levels of visfatin amongst pre-diabetic obese patients

Background: Insulin resistance, pre-diabetes, and obesity have all been linked to excess adiposity. Proinflammatory adipokine visfatin is thought to play a key role in type 2 diabetes inflammation. Objective: This study aimed to estimate visfatin level among prediabetic obese patients and to observe and detect the interplay between visfatin, insulin resistance and obesity.Patients and methods: 96 adult subjects were studied in case-control research at Internal Medicine Department and Clinical Pathology Department, Zagazig University Hospital. The study was carried out from January 2021 to November 2021. Subjects were divided into 3 groups: Group (1) included 24 healthy individuals as a control group, group (2) included 48 prediabetic individuals and group (3) that included 24 patients type 2 diabetes who never been treated in any of these. Serum visfatin was assessed in all participants.Results: Diabetes mellitus (DM) patients had higher visfatin levels than those with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). Visfatin had a significant positive correlation with BMI, WC, FBS, PPS, HA1c, LDL, fasting insulin, and HOMA IR, while HDL had a significant negative correlation.Conclusion: Visfatin levels were significantly linked to type 2 diabetes. HOMA-IR, fasting insulin, and BMI all showed a strong positive correlation with visfatin levels, suggesting that it may be a useful biomarker for detecting type 2 diabetes

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

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

studying the functional characteristics of the outwear textile produced by various weaving technics

The study of the change in the shape of textiles in turn leads to a rigorous study of the structural compositions of the fabrics using geometric methods for the establishment of mathematical relations between structural installation agents on the one hand and fabric properties on the other hand, these were adopted Engineering methods are mainly based on theoretical hypotheses and on geometric models where the problem of research lies in the presence of many of the Twill fabrics produced under different labels and varieties with canonical stereotype specifications, but this research creates a mathematical relationship between the threads produced by some Different cotton spinning methods and the production of well-balanced twill fabrics with the calculations of the miseries and cover factor for the best laboratory and appropriate results with the functional performance of exterior cotton garment fabrics produced from the twill fabrics. The research presumes the possibility of arriving at a mathematical formula with a new constant, depending on the method of spinning and influencing on crimping in fabrics, and the research aims to study the effects of the sap on the aesthetic and functional characteristics of the producing fabrics, including the importance of research on the study of Woven structure Mathematically  and calculation of coverage of the products produced by search variables The research methodology is based on the analytical experimental approach of the research samples produced, The results of the research  are illustrated by the fact that by examining the mathematical relations and the calculation of the diameter  used in both warp and weft yarns, in turn to be able to assume all the mechanical and functional properties produced for textiles, ants are given mathematical, balanced fabrics suitable for the functional purpose used

Archaeological Exploration using Magnetic and GPR Methods at the First Court of Hatshepsut Temple in Luxor, Egypt

The Hatshepsut Temple at Luxor, southern Egypt was built as a garden for Amun, and the first court indeed had exotic trees and vegetations. The pathway to the temple was along a sphinx-lined causeway linking the valley to pylons, which are missing now. As an effort to outline remains of the vanished garden and missing pylons and any other possible archaeological structures at this first court site, an extensive integrated magnetic/ground-penetrating radar (GPR) geophysical survey was conducted. The magnetic survey covered the entire area of the first court (100 x 60 m), while the GPR survey covered only an area of 50 x 50 m. The acquired GPR data were processed and presented as 2-D depth sections providing a reasonable vertical/horizontal resolution for the upper 6 m of the investigated site. The acquired magnetic data was processed and presented as 2-D image. The integrated interpretation of the acquired GPR and magnetic data revealed some archaeological features including a rectangular depression which is presumably an ancient man-made pond in the garden of the temple, a rectangular feature that may be a foundation of the missing pylon of the temple, and a suite of aligned anomalies that could be the remnants of sphinx. Such findings reflect the archaeological potentiality of the surveyed site and outline the extension of the temple. Meanwhile, these results necessitate further geophysical investigation or archaeological excavation to be confirmed

Predictive value of S100B and brain derived neurotrophic factor for radiofrequency treatment of lumbar disc prolapse

Abstract Background This work aimed to analyze serum S100B levels and brain-derived neurotrophic factor (BDNF) in patients with lumbar disc prolapse to test their predictive values concerning the therapeutic efficacy of pulsed radiofrequency. Methods This prospective interventional study was carried out on 50 patients candidates for radiofrequency for treating symptomatic lumbar disc prolapse. Pain severity and functional disability were assessed using the Numeric Rating Scale (NRS) and Functional rating index (FRI) before as well as two weeks, 1, 3, and 6 months after the radiofrequency. Quantitative assessment of serum S100B level and BDNF was done for all the included patients one day before radiofrequency. Results The scores of NRS and FRI were significantly improved at two weeks, 1, 3, and 6 months following radiofrequency (P-value < 0.001 in all comparisons). Statistically significant positive correlations were found between duration of pain, NRS, and S100B serum level before radiofrequency, and both NRS (P-value = 0.001, 0.035, < 0.001 respectively) and FRI (P-value = < 0.001, 0.009, 0.001 respectively) 6 months following radiofrequency. Whereas there were statistically significant negative correlations between BDNF serum level before radiofrequency and both NRS and FRI 6 months following radiofrequency (P-value = 0.022, 0.041 respectively). NRS and S100B serum levels before radiofrequency were found to be independent predictors of NRS 6 months following radiofrequency (P-value = 0.040. <0.001, respectively). Conclusion Serum level of S100B is a promising biomarker that can predict functional outcomes after pulsed radiofrequency in patients with lumbar disc prolapse

Comparative effect of deliberate hypotensive anesthesia using nitroglycerine vs. phentolamine on event related potentials and cognitive functions in patients undergoing septoplasty: a randomized controlled trial

Abstract Background Postoperative cognitive dysfunction is a noteworthy complication of deliberate hypotensive anesthesia. The aim of this work was to compare the effect of deliberate hypotensive anesthesia using nitroglycerine versus phentolamine on event-related potentials and cognitive function in patients undergoing septoplasty surgery. Methods This prospective randomized controlled trial was conducted on 80 patients indicated for septoplasty under general anesthesia; 40 patients received intra-operative Nitroglycerine and 40 patients received intra-operative Phentolamine. Cognitive assessment (using Paired Associate Learning test (PALT) and Benton Visual Retention test (BVRT)) and P300 recording were done for all included patients pre-operatively and one week postoperatively. Results The scores of PALT and Benton BVRT significantly declined one week following surgery in both Nitroglycerine and Phentolamine groups. There was no statistically significant difference between Nitroglycerine and Phentolamine groups in the postoperative decline in either PALT or BVRT (P-value = 0.342, 0.662 respectively). The values of P300 latency showed a significant delay one week following surgery in both Nitroglycerine and Phentolamine groups (P-value ≤ 0.001, 0.001), but in Nitroglycerine group, the delay is significantly higher than in Phentolamine group (P-value = 0.003). The values of P300 amplitude significantly decreased one week following surgery in both Nitroglycerine and Phentolamine groups (P-value ≤ 0.001, 0.001), but there was no statistically significant difference between Nitroglycerine and Phentolamine groups (P-value = 0.099). Conclusion Phentolamine is preferred over nitroglycerin in deliberate hypotensive anesthesia because it has less harmful effect on cognitive function than nitroglycerin