The Obesity Epidemic and its Implications in Anesthesia

Background: Obesity is among the most prevalent risk factors affecting the physical and mental well-being of overweight patients, resulting in lower survival rates. This study aimed to evaluate clinical outcomes associated with the impact of obesity on anesthesia management. Patients and methods: A total of 133 patients aged 25 years and above were diagnosed in different hospitals in Iraq between 17th February 2022 and 26th March 2023. The patients were categorized based on their obesity into three classes (Class I, Class II, Class III) and underwent two types of surgeries - gastric sleeve surgery and gastric bypass. Additionally, patients' postoperative well-being was evaluated using the WHOQOL-BREF questionnaire. Results: The clinical results showed that obesity was the most important risk factor affecting the quality of life of elderly patients over the age of 60, and the infection rate reached 42.11%, with males having a higher infection rate, 62.41%, than females, 37.59%. Most patients were obese and had a body mass index. Body mass index (31-34.9) was 51.13%, and patients with BMI (>35) was 30.08%. The results of the WHOQOL-BREF quality of life assessment showed that the hospital was successful in managing the surgical procedure and improving patients' quality of life after surgery, despite the difficulty of the operation and the adverse effects of general anaesthesia. The assessment results showed that social relationships (71.88%), mental health (68.55%), and physical aspects (63.11%) were the most improved and effective for patients after surgery. Conclusion: According to this recent study, patients' levels of obesity significantly affect their ability to undergo various bariatric surgery procedures. Nonetheless, our study revealed a definite improvement in the post-operative quality-of-life evaluation of obese patients regarding their physical, social, and mental health

Mental stress causes vasoconstriction in subjects with sickle cell disease and in normal controls

Vaso-occlusive crisis (VOC) is a hallmark of sickle cell disease (SCD) and occurs when deoxygenated sickled red blood cells occlude the microvasculature. Any stimulus, such as mental stress, which decreases microvascular blood flow will increase the likelihood of red cell entrapment resulting in local vaso-occlusion and progression to VOC. Neurally mediated vasoconstriction might be the physiological link between crisis triggers and vaso-occlusion. In this study, we determined the effect of mental stress on microvascular blood flow and autonomic nervous system reactivity. Sickle cell patients and controls performed mentally stressful tasks, including a memory task, conflict test and pain anticipation test. Blood flow was measured using photoplethysmography, autonomic reactivity was derived from electrocardiography and perceived stress was measured by the State-Trait Anxiety Inventory questionnaire. Stress tasks induced a significant decrease in microvascular blood flow, parasympathetic withdrawal and sympathetic activation in all subjects. Of the various tests, pain anticipation caused the highest degree of vasoconstriction. The magnitude of vasoconstriction, sympathetic activation and perceived stress was greater during the Stroop conflict test than during the N-back memory test, indicating the relationship between magnitude of experimental stress and degree of regional vasoconstriction. Baseline anxiety had a significant effect on the vasoconstrictive response in sickle cell subjects but not in controls. In conclusion, mental stress caused vasoconstriction and autonomic nervous system reactivity in all subjects. Although the pattern of responses was not significantly different between the two groups, the consequences of vasoconstriction can be quite significant in SCD because of the resultant entrapment of sickle cells in the microvasculature. This suggests that mental stress can precipitate a VOC in SCD by causing neural-mediated vasoconstriction

<em>Bacillus megaterium</em> Biodegradation Glyphosate

The Bacillus megaterium ability was evaluated in this paper to degrade the Glyphosate. organophosphorus pesticides, The bacteria re-cultured that isolated from other researches of Baghdad soils and morphological identification and biochemical tests besides by selectivity media. The (5 and 25) ppm showed the highest growth results were within two days to two months on mineral salt media. The highest glyphosate degradation ratio % were (70) % per 25 ppm/two months. Incubation period Increasing led to highest glyphosate degradation ratio% at (25) ppm led to conclusion that bacteria digestive the pesticides as carbon and nitrogen sources and will be well harvest it form contaminated areas

The Crucial Role of Anesthesia in Cholecystectomy: A Comprehensive Guide

&lt;p&gt;&lt;strong&gt;Background:&nbsp;&lt;/strong&gt;Spinal anaesthesia serves as a substitute for general anaesthesia during cholecystectomy surgeries. &lt;strong&gt;Objective:&lt;/strong&gt; This study was aimed to analyse and assess anesthesia effective during and after cholecystectomy surgery. &lt;strong&gt;Patients and methods:&lt;/strong&gt; A cross-sectional study was conducted that involved 117 patients who underwent laparoscopic cholecystectomy with anesthesia techniques. To achieve the study's purpose, clinical data were categorized into two groups: GA (50 cases) and SA (67 cases).&nbsp; The study aimed to compare the hospital stay duration and pain levels before and after surgery measured by the VAS scale between the two groups. &lt;strong&gt;Results:&lt;/strong&gt; Our clinical findings indicate that males were more likely to receive cholecystectomy to compare with women. Additionally, males exhibited a higher incidence of complications, longer surgical durations, and protracted hospital stays, representing 57.26% of cases compared to 42.74% for females.&nbsp; The postoperative records documented patient complications, revealing that bleeding occurred in 5 cases, infection in 3 cases, and infection of the bile duct during general anaesthesia in 4 cases. On the other hand, bleeding occurred in 4 cases, infection in 1 case, and bile duct infection in 2 cases. Additionally, it was observed that spinal anaesthesia resulted in a shorter hospital stay and less postoperative analgesia requirements in comparison to general anaesthesia. Furthermore, the clinical findings demonstrated that pain levels were better managed in the cohort of patients receiving spinal anaesthesia during the initial three days following surgery in contrast to those given general anaesthesia.&nbsp;&lt;strong&gt;Conclusion:&lt;/strong&gt; Spinal anaesthesia is regarded as the optimal form of anaesthesia or the most efficacious method for pain control during cholecystectomy surgery, both intraoperatively and postoperatively&lt;/p&gt

Sleep quality, anxiety, depression, and quality of life in rheumatoid arthritis patients and impact of disease activity

Abstract Background Rheumatoid arthritis (RA) is an autoimmune lifelong disease. Systemic manifestations represent a significant aspect of the disease burden. This study aimed to assess sleep quality and psychosocial aspects among RA patients and the impact of disease duration and activity. Results The mean age for included RA patients was 50.00 ± 9.37 years. The median disease duration was 9.50 (Interquartile range (IQR)=5–15) years and 90% of patients were females. Disease activity score 28 was 4.65 ± 1.66. Anxiety and depression were significantly higher among RA participants. Regarding sleep quality assessment, RA group had significantly higher levels of insomnia than the control group (Insomnia Severity Index median (IQR) was 4.5 (0–15) versus 1 (0–3); p value = 0.013) and daytime sleepiness (Epworth Sleepiness Scale median (IQR) was 4 (1–11.25) versus 1 (0–3); p value = 0.002). RA patients showed significantly higher values of Pittsburgh Sleep Quality Index components as well as the global score indicating poor sleep quality. The 36-item short-form health survey domains, representing physical and mental health, were significantly lower among RA cases versus control subjects. Higher disease activity was positively correlated with anxiety, depression, insomnia, sleep quality, sleep efficiency, and daytime dysfunction, while negatively correlated with all domains of the 36-item short-form health survey. Conclusions RA patients have increased anxiety and depression levels in addition to poor sleep quality. High disease activity is linked to increased anxiety and depression levels, impaired quality of life, and poor sleep quality

Comparative Virological and Pathogenic Characteristics of Avian Influenza H5N8 Viruses Detected in Wild Birds and Domestic Poultry in Egypt during the Winter of 2016/2017

The surveillance and virological characterization of H5N8 avian influenza viruses are important in order to assess their zoonotic potential. The genetic analyses of the Egyptian H5N8 viruses isolated through active surveillance in wild birds and domestic poultry in the winter of 2016/2017 showed multiple introductions of reassortant viruses. In this study, we investigated and compared the growth kinetics, infectivity, and pathogenicity of the three reassortant forms of H5N8 viruses detected in wild birds and domestic poultry in Egypt during the first introduction wave in the winter of 2016/2017. Three representative H5N8 viruses (abbreviated as 813, 871, and 13666) were selected. The 871/H5N8 virus showed enhanced growth properties in vitro in Madin Darby canine kidney (MDCK) and A549 cells. Interestingly, all viruses replicated well in mice without prior adaptation. Infected C57BL/6 mice showed 20% mortality for 813/H5N8 and 60% mortality for 871/H5N8 and 13666/H5N8, which could be attributed to the genetic differences among the viruses. Studies on the pathogenicity in experimentally infected ducks revealed a range of pathogenic effects, with mortality rate ranging from 0% for 813/H5N8 and 13666/H5N8 to 28% for 871/H5N8. No significant differences were observed among the three compared viruses in infected chickens. Overall, different H5N8 viruses had variable biological characteristics, indicating a continuous need for surveillance and virus characterization efforts

Biophysical markers of the peripheral vasoconstriction response to pain in sickle cell disease

<div><p>Painful vaso-occlusive crisis (VOC), a complication of sickle cell disease (SCD), occurs when sickled red blood cells obstruct flow in the microvasculature. We postulated that exaggerated sympathetically mediated vasoconstriction, endothelial dysfunction and the synergistic interaction between these two factors act together to reduce microvascular flow, promoting regional vaso-occlusions, setting the stage for VOC. We previously found that SCD subjects had stronger vasoconstriction response to pulses of heat-induced pain compared to controls but the relative degrees to which autonomic dysregulation, peripheral vascular dysfunction and their interaction are present in SCD remain unknown. In the present study, we employed a mathematical model to decompose the total vasoconstriction response to pain into: 1) the neurogenic component, 2) the vascular response to blood pressure, 3) respiratory coupling and 4) neurogenic-vascular interaction. The model allowed us to quantify the contribution of each component to the total vasoconstriction response. The most salient features of the components were extracted to represent biophysical markers of autonomic and vascular impairment in SCD and controls. These markers provide a means of phenotyping severity of disease in sickle-cell anemia that is based more on underlying physiology than on genotype. The marker of the vascular component (BM_v) showed stronger contribution to vasoconstriction in SCD than controls (p = 0.0409), suggesting a dominant myogenic response in the SCD subjects as a consequence of endothelial dysfunction. The marker of neurogenic-vascular interaction (BM_n-v) revealed that the interaction reinforced vasoconstriction in SCD but produced vasodilatory response in controls (p = 0.0167). This marked difference in BM_n-v suggests that it is the most sensitive marker for quantifying combined alterations in autonomic and vascular function in SCD in response to heat-induced pain.</p></div

Standardized FBV responses to a blood pressure pulse and derived biophysical marker BM_v.

<p>(a) <i>h</i>_<i>BPC</i>, standardized FBV responses to a blood pressure increase (mean ± SEM) of SCD (N = 22, thick line) and non-SCD (N = 23, thin line); (b) biophysical marker BM_v reflecting vasoconstriction as a result of blood pressure increase. Error bars show mean ± SEM. SCD had significantly stronger vasoconstriction than non-SCD after adjusting for age and sex (p = 0.0409).</p