Magnetic resonance spectroscopy of the frontal region in patients with metabolic syndrome : correlation with anthropometric measurement

Purpose: to demonstrate 1H-MR spectroscopy of the frontal region in patients with metabolic syndrome and to correlate the metabolic ratios with anthropometric measurement. Material and methods: A prospective study was conducted upon 20 patients with metabolic syndrome (10 male, 10 female; mean age 52 years) and 20 age- and sex-matched volunteers. Patients were mild-moderate (n = 14) and marked and morbid obesity (n = 6). Patients and volunteers underwent 1H-MR spectroscopy of the frontal region. The Ch/Cr and NAA/Cr ratio were calculated and correlated with anthropometric measurement. Results: The Cho/Cr and NAA/Cr of patients with Mets (1.03 ± 0.08 and 1.62 ± 0.08) were significantly different (p = 0.001) to those of volunteers (0.78 ± 0 and 1.71 ± 0.61, respectively). The Cho/Cr and NAA/Cr cutoffs used to differentiate patients from volunteers were 0.89 and 1.77 with areas under the curve of 0.992 and 0.867 and accuracy of 97% and 93%, respectively. There was a significant difference in Cho/Cr and NAA/Cr between patients with marked-morbid obesity and moderate-mild obesity (p = 0.001 respectively). Conclusions: We concluded that NAA/Cr and Cho/Cr ratios of the frontal region can differentiate patients with metabolic syndrome from volunteers and are well correlated with the anthropometric measurement

Curcumin ameliorates experimental autoimmune acute myocarditis in rats as evidenced by decrease in thioredoxin immunoreactivity

This study was performed to investigate the effect of curcumin on cardiac myosin-induced autoimmune myocarditis in rats and the change in thioredoxin (TRX) immunoreactivity in cardiomyocytes following curcumin treatment. Twenty-four six-week-old male Wistar rats were randomly allocated into 4 groups of 6 rats each. Group I received neither curcumin nor myosin. Group II received an oral solution of 1 g/kg/day of curcumin daily, from day 1 to day 21. To induce myocarditis, animals of both group III and group IV were injected by 1 mg of porcine cardiac myosin on days 1 and 8. In addition, animals of group IV received an oral solution of 1 g/kg/day of curcumin daily, from day 1 to day 21. Serum levels of creatine phosphokinase, troponin-T, tumour necrosis factor-alpha and interleukin-6 were estimated. Hearts were processed for histopathological and immunohistochemical studies. Serum biomarkers levels were significantly increased in myocarditis group as compared to other groups. The intake of curcumin significantly reduced the deviation in these markers. Sections of the wall of the heart from myocarditis group were characterised by inflammatory cell infiltration. Most of cardiomyocytes showed pyknotic nuclei and increased sarcoplasmic eosinophilia with strong immunoreactivity for TRX. Sections from myocarditis-curcumin group showed normal architecture with moderate immunoreactivity for TRX. The present study demonstrated that curcumin ameliorates acute myocarditis in rats and encouraged the estimation of serum level of TRX as a relevant indicator for the evaluation of the progress of acute myocarditis

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Rapid One-Step Test for detection of Feline and Canine Parvoviruses in Cats

Feline parvovirus infection (FPV) is one of the serious diseases in Kittens that causes substantial morbidity and death. For the treatment of affected cats and the prevention of disease spread, early diagnosis of FPV infection is critical. To our knowledge, there have been no reports about the disease’s situation in Egypt’s Assiut province. As a result, the goal of this study was to find out how common FPV infection is among ill cats in this province. A total of 30 cats suspected of being infected with FPV were screened using an antigen rapid test to determine whether they were clinically suspicious. To determine the prevalence of FPV, each investigated cat’s age, sex, breed, season, lifestyle (whether kept indoors or outdoors), and immunization were all documented. Overall, 26.7% of examined cats were affected. FPV infection was more common in young, unvaccinated cats who lived outdoor. Epizootiological monitoring of the prevalence rate based on cat breeds and sex revealed no statistically significant differences. In terms of season, spring had the highest infection rate (57.1%), followed by winter (33.3%), and autumn (7.69%). The rapid one-step test is a useful diagnostic tool for detecting FPV, which was found in the research area’s cats

Virtual reality balance training versus core stability exercises on balance in patients with unilateral lymphedema

Purpose: The purpose of this study is to compare the effects between Wii fit balance board and core stability exercises on balance dysfunction in patients with unilateral lymphedema. Method: Sixty patients (women) aged 40-60 years with grade 1 or 2 lymphedema were randomly assigned into the following two groups. Group A received the Wii fit balanced exercises for three times per week for four weeks as total treatment duration in form of (Ski Slalom, Advanced Skiing, Ski Jumping followed by Header and Jump Rope).; Group B received core stability exercises for 4 weeks (3times/week) in form of {1- Abdominal bracing (10 repetitions x10 second holds), 2- Curl up (3 sets x 10 repetitions), 3- Supine bridge (3 sets x 10 repetitions), 4- Supine unilateral bridge (3 sets x 10 repetitions for each leg), 5- Plank (3 sets x 10 repetitions) and 6- Bird dog (3 sets x 10 repetitions for each limb)}. Balance was determined using time up and go (TUG) and Wii fit results by using the Wii fit balance board. Balance was measured before and 4 weeks after the treatment program.&nbsp

Evaluation of fermented soybean meal by Bacillus subtilis as an alternative to fishmeal on the growth, and physiological status of Nile tilapia Oreochromis niloticus fingerlings

A feeding trial was conducted to investigate the effect of fermented soybean meal with Bacillus subtilis bacteria on growth performance, feed utilization, carcass composition, and hematological, and histological section of the liver and intestine of Nile tilapia Oreochromis niloticus fingerlings. Commercial soybean meal (SBM) containing 44% Crude Protein (CP) was fermented using the solid-state fermentation method which depended on autoclaving of SBM, then bacterial treatment injection by Bacillus subtilis, and finally incubation at 40C for 72 h then autoclaved to stop the growth of bacteria. Five isonitrogenous (25% crude protein) and isocaloric (4.4 kcal/g gross energy) experimental fish meal-free diets were formulated to compare with a common control diet containing fishmeal and unfermented soybean meal. Diets without fish meal contain fermented soybean meal (FSM) as a sole protein, FSM with corn gluten (CG), FSM with free amino acid methionine (Meth), FSM with corn gluten and methionine, and unfermented soybean meal. Eighteen glass aquaria, 80-L net volume, were used to stock 10 fingerlings (10.0 ± 0.1 g/fish) in each aquarium in the replicates group. The feed amount was given three times daily, six days a week throughout the 98 days experimental period. Fish were weighed biweekly and feed amounts were adjusted based on the new fish weight. Bacterial fermentation enhanced the protein content of commercial soybean meals by 6%. The crude protein of fermented soybean meal increased from 43.44% to 50.67%. Used of FSM as a sole dietary protein source resulted in a decrease in growth rate and feed utilization. However, the incorporation of FSM with corn gluten, and/or methionine amino acid led to an improvement in the performance of fish. Finally, the best final body weight, weight gain, specific growth rate, protein efficiency ratio, and protein productive value were recorded by a fish-fed mixed plant protein diet (FSM + CG + Meth). Also, Hematocrit and red blood cells were not significantly affected including the FSM

Analgesic Efficacy of Dexmedetomidine as Adjuvant to Levo-Bupivacine in Ultrasound Guided Erector Spinae Plan Block for Modified Radical Mastectomy

Background&amp; aim: There are several advantages to properly managing post-masctetomy pain. With single shot interfascial plane blocks, local anesthetic adjuvants enhance analgesia duration. They improve the analgesic impact of local anesthetics. Dexamethasone, magnesium sulphate and dexmedetomidine, are examples of adjuvants with diverse modes of action. This research examined the analgesic effects of dexmedetomidine in women who had undergone a modified radical mastectomy (MRM). Methods and Patients: The research included forty women with histopathologically confirmed breast cancer. They were all scheduled for MRM and were randomly assigned to one of two groups: those who got levobupivacaine alone (group C) or those who received dexmedetomidine plus levobupivacaine (group D) during ultrasound (US)-guided erector spinae plane block (ESPB). The two groups were compared in terms of their hemodynamics, demographics, time until the first request for analgesia, numeric rating scale (NRS) scores, Richmond Agitation &amp; Sedation scale (RASS) scores and total opioid use. Results: There were no statistically significant differences observed between the two groups in terms of baseline data. The set of participants referred to as group D had a statistically significant reduction in heart rate on many instances. Furthermore, it was discovered that group D had a substantial reduction in postoperative NRS ratings and a heightened degree of recovery from sedation, as shown by the RASS. Furthermore, it was noted that group D had a significantly reduced overall analgesic dose (9.12±0.46 vs. 6.24±1.37 mg; p= 0.02) and a prolonged duration until first analgesia (6.21±1.28 vs. 7.13±1.79 hours; p&lt; 0.001). Conclusion: The use of dexmedetomidine in combination with levobupivacaine ESPB has been shown to enhance postoperative analgesia compared to the use of levobupivacaine alone. This improvement in postoperative analgesia leads to enhanced comfort levels for patients. Further research is necessary to corroborate these results via future studies conducted in several places