Video-Assisted Mini-Thoracotomy Versus Anterior Thoracotomy Mitral Valve Replacement: Intraoperative Time and Hospitalization

Objectives: Minimally invasive mitral valve surgery (MIMVS) was introduced to avoid a full sternotomy through smaller or alternative chest wall incisions to reduce complications. We present our experience with MIMVS through two of its techniques. Methods: This prospective single-centre study was conducted on a total of 34 cases, divided into two groups: Group A (VAMVR) included 17 patients who underwent video-assisted mitral valve replacement. Group B (ATMVR) included 17 patients who underwent right anterior thoracotomy mitral valve replacement, comparing intraoperative procedures and the results of both techniques .Results: In the studied cases, the mean intraoperative time was 4.38 ± 0.69 hours, which widely ranged from 3 to 6 hours, with no significant difference between both techniques. It was 4.35 ± 0.7 hours in VAMVR and 4.41 ± 0.7 in ATMVR. mean ventilation time of 3.96 ± 1.08 hours. The mechanical ventilation time was 4.24 ± 1.1 hours in VAMVR cases and 3.68 ±1.1 hours in the ATMVR group. The mean overall ICU stay duration was 1.75 ± 0.33 days, with no impact of the technique used on this time, as it was 1.71 ± 0.25 days in VAMVR patients and 1.79 ± 0.4 in ATMVR patients. The total hospital stay time was about 5.71 ± 0.91 days, ranging from 4 to 8 days, with no impact of the procedure used on this time as it was 5.6 ± 0.94 days in VAMVR cases and 5.8 ± 0.88 days in ATMVR cases. Conclusions: There was no impact of the technique used in MIMVS, whether video-assisted or right anterior thoracotomy mitral valve replacement, on intraoperative time and ICU and hospital stays

APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing

The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on “APASL consensus statements and recommendations for management of hepatitis C” in March 2015 to revise the “APASL consensus statements and management algorithms for hepatitis C virus infection” (Hepatol Int 6:409–435, 2012). The working party consisted of expert hepatologists from the Asian–Pacific region gathered at the Istanbul Congress Center, Istanbul, Turkey on 13 March 2015. New data were presented, discussed, and debated during the course of drafting a revision. Participants of the consensus meeting assessed the quality of the cited studies. The finalized recommendations for hepatitis C prevention, epidemiology, and laboratory testing are presented in this review

Utilizing Extension Character ‘Kashida’ With Pointed Letters For Arabic Text Digital Watermarking

This paper exploits the existence of the redundant Arabic extension character, i.e. Kashida. We propose to use pointed letters in Arabic text with a Kashida to hold the secret bit ‘one’ and the un-pointed letters with a Kashida to hold ‘zero’. The method can be classified under secrecy feature coding methods where it hides secret information bits within the letters benefiting from their inherited points. This watermarking technique is found attractive too to other languages having similar texts to Arabic such as Persian and Urd

Relationship between obesity, physical activity, sleeping hours and red blood cell parameters in adult Sudanese population: Effect of exercise and sleep hours on RBC parameters

Ideal body weight with proper physical activity and good sleep are essential parameters for good quality of life. This study is concerned with assessing the association of general obesity, physical activity and sleeping hours with hemoglobin (Hb) concentration and red blood cell (RBC) parameters in healthy adults in Sudan. In this cross sectional study, 1086 healthy adults between 20 and 60 years were included out of which 275 were males and 811 were females. A complete blood count (CBC) was performed for Hb, RBC count, PCV, MCH and MCHC using Sysmex KX-21 automated hematology analyzer. The median and 95 percentile (2.5th to 97.5th) range values for Hb and RBC count in underweight were 13.0 (Range: 9.6-16.7) g/dl and 4.6 (Range: 3.6-5.8) ×103/µL respectively, while Hb and RBC count in obese were 13.1 (Range: 10.4-17.0) g/dl and 4.6 (Range: 3.7-5.9) ×103/µL respectively, with no significant difference. The RBC count (p=0.004) and Hb (p?0.001) were significantly high in physically active compared to physically inactive participants; whereas the hemoglobin concentration (p=0.047), red blood cells (p=0.007) and hematocrit (p?0.001) values were significantly low in long-term sleep compared to normal sleeping hours. In conclusion, there were no significant differences in hemoglobin concentration, RBC count, PCV, MCH and MCHC between unde weight, normal weight, overweight and obese persons. Increased physical activity was associated with higher Hb levels and RBC counts, while long-term sleep showed lower Hb and RBCs

APASL HCV guidelines of virus-eradicated patients by DAA on how to monitor HCC occurrence and HBV reactivation

In the direct-acting antiviral (DAA) era for hepatitis C virus (HCV) infection, sustained virological response (SVR) is very high, but close attention must be paid to the possible occurrence of hepatocellular carcinoma (HCC) and reactivation of hepatitis B virus (HBV) in patients with co-infection who achieved SVR in short term. HCC occurrence was more often observed in patients with previous HCC history. We found occurrence of HCC in 178 (29.6%) of 602 patients with previous HCC history (15.4 months mean follow-up post-DAA initiation) but, in contrast, in only 604 (1.3%) of 45,870 patients without previous HCC history (18.2 months mean follow-up). Thus, in these guidelines, we recommend the following: in patients with previous HCC history, surveillance at 4-month intervals for HCC by ultrasonography (US) and tumor markers should be performed. In patients without previous HCC history, surveillance at 6- to 12-month intervals for HCC including US is recommended until the long-term DAA treatment effects, especially for the resolution of liver fibrosis, are confirmed. This guideline also includes recommendations on how to follow-up patients who have been infected with both HCV and HBV. When HCV was eradicated in these HBsAg-positive patients or patients with previous HBV infection (anti-HBc and/or anti-HBs-positive), it was shown that HBV reactivation or HBV DNA reappearance was observed in 67 (41.4%) of 162 or 12 (0.9%) of 1317, respectively. For these co-infected patients, careful attention should be paid to HBV reactivation for 24 weeks post-treatment

Mixed microalgae-food waste cake f or feeding of Hermetia illucens larvae in characterizing the produced biodiesel

The industrial use of insects, their products, interactions, or activities has been known as industrial entomology. The current study focused on evaluating the effect of mixing the organic food waste with its half percentage of microalgae on the biodiesel production and characterization. The black soldier fly larvae (BSFL) were reared on the organic waste (OW) (fruits, vegetables, and kitchen) only and OW mixed with microalgae, Chlorella vulgaris. Additionally, the levels of oxidants and antioxidants in the biodiesel, after the antioxidants' incorporation (ascorbic acid, α-tocopherol, and catechin), were evaluated. The BSFLBD was produced from lipid extraction of BSFL biomass by chloroform/methanol mixture, followed by acid catalyzed esterification and alkaline catalyzed transesterification. The biodiesel yield from the larvae fed on mixed OW-microalgae for 14 days was enhanced by 1.4 folds than the yield of OW group. The unsaturated oleic acid has the most dominant pattern in the fatty acid profile of BSFBD, even in different cases. Lauric (12:0) and myristic (14:0) acids constitute the majority of the methyl ester component of the biodiesel, with amounts of 25.6 and 7.1 for larvae fed on OW, and 25.9 and 7.7 for those fed on OW-microalgae. Following the antioxidants addition, the oxidant’s concentration decreased in the biodiesel especially in the insects fed on mixed OW-microalgae. The microalgae added to the organic food waste enhanced the biodiesel quality and quantity of BSFL biomass. Also, the introduction of antioxidants didn’t only improve the efficiency of the biodiesel, but also helped in the management of the stress parameters

HIV case reporting and HIV treatment outcomes in Qatar

AimThe aim of the paper is to provide an overview of available HIV case reporting and treatment data for in Qatar for the period 2015–2020.MethodsHIV case reporting data were analyzed by sex and mode of transmission. To construct HIV care continuum from the data available, we obtained information on the total number of HIV diagnosed patients on antiretroviral treatment (ART) between January 1st 2015 and December 31st 2020, number of patients on ART who had an HIV viral load test and the number who were virally suppressed (defined as having the viral load of less than 1,000 copies/mL).ResultsA total of 515 HIV cases were reported to the Ministry of Public Health since beginning of reporting in 1986, and that included Qatari nationals and expatriate residents diagnosed in Qatar. There was an increase in the annual number of newly reported HIV cases from 16 cases in 2015 (of these, 14 were males) to 58 cases in 2020 (of these, 54 were males). The total number of HIV diagnosed people on ART increased from 99 in 2015 to 213 in 2020. During 2020 the overall viral load testing coverage and viral load suppression among those tested for viral load in men were 72.5% and 93.1%, respectively, while in women these values were 60.4% and 84.4%, respectively.ConclusionDue to increase in newly reported HIV cases, there is a need to develop an effective HIV strategic information system in Qatar and data-driven and targeted national HIV response

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