Planning a sustainable neurosurgery mentorship program in a war-torn country: experience from Iraq.

The importance of mentorships in medical education and neurosurgery is highly attributed to the support and encouragement of the advances and learning opportunities for medical students and junior neurosurgeons. Planning a mentorship program according to the target audience offers to satisfy different interests and enhance education. One of the main issues with most of the already implemented programs is the sustainability and inability to maintain continuous cycles of mentorship, which have a negative impact and have led to an interrupted pattern of learning which eventually leads to a decline in the engagement of participants and loss of interest. This problem is most pronounced in war-torn countries, with Iraq as an example, where external circumstances lead to an arrest in the educational process and a depletion of the resources useful for such programs and training courses. This paper aims to address the main pathways essential in planning a sustainable mentorship program in a war-torn country by highlighting our experience in maintaining an ongoing mentorship with nine consecutive courses over the last 6 years in Iraq.

HDL-C, ApoA1 and VLDL-TG as biomarkers for the carotid plaque presence in patients with metabolic syndrome.

AIM: Hypercholesterolemia and hyper LDL-C are associated with the atherosclerosis (AS). The current study was performed to evaluate the implication of the others lipoproteins (HDL, LDL, VLDL) and apolipoproteins (ApoA1, ApoB100) with subclinical atherosclerosis (carotid plaque) in patients with metabolic syndrome (MetS) free from cardiovascular disease (CVD). METHODS: Prospective transversal study was conducted in patients with MetS free from cardiovascular disease (CVD). The lipids, lipoproteins and apolipoproteins were measured. The lipoproteins (HDL, LDL, VLDL) were obtained by the precipitation method. The carotid plaque (CP) was evaluated by ultrasonography, method for assessing AS. Logistic regression and analysis tree were used to look for the association and the incrimination of the lipoproteins with the presence of CP. RESULTS: The CP incidence was 60% among the participants, 34.29% on the right and the left plaque against 25.71% for only one plaque. The HDL-C was the only lipoprotein associated with the CP after adjustment of the age, the sex and BMI (OR: 0.007 P: 0.046) with the logistic regression analysis, HDL-C (<0.35 g/l), ApoA1 (<1.43 g/l) and VLDL-TG (>0.656 g/l) are implicated in the presence of CP with the analysis tree analysis. CONCLUSION: Lower level of HDL-C is associated with CP, HDL-C, ApoA1, and high level VLDL-TG but not total cholesterol, and LDL-Care useful parameters in the assessment of initial atherosclerosis in metabolic syndrome.

Initiating or switching to biphasic insulin aspart 30 in type 2 diabetes patients from Algeria: a sub-analysis of the A1chieve study.

AIM: To determine the safety and effectiveness of biphasic insulin aspart 30 (BIAsp 30) in Algerian patients with type 2 diabetes initiating insulin or switching from prior insulin therapy. METHODS: Insulin-naive and insulin-experienced patients, including prior basal insulin users, starting BIAsp 30 were evaluated in this sub-analysis of the 24-week, open-label, non-interventional A1chieve study. Clinical safety and effectiveness was evaluated as a part of routine clinical care. RESULTS: A total of 134 insulin-naive patients initiating BIAsp 30 at a mean dose of 0.44 ± 0.23 U/kg and 283 insulin-experienced patients, including 129 prior basal insulin users, switching from a mean pre-study insulin dose of 0.51 ± 0.23 U/kg to BIAsp 30 (0.54 ± 0.20 U/kg) were evaluated. At Week 24, the average BIAsp 30 dose was 0.60 ± 0.25 U/kg and 0.66 ± 0.24 U/kg in insulin-naive and insulin-experienced patients, respectively. No serious adverse drug reactions were reported. From baseline to Week 24, the proportion of patients experiencing overall hypoglycaemia increased in the insulin-naive group (p = 0.0067) and no significant changes were reported in the insulin-experienced group including prior basal insulin users. Glucose control improved significantly in the insulin-experienced group (p < 0.001) and appeared to improve in the insulin-naive patients and prior basal insulin users as well. Body weight increased significantly in all patients (p < 0.001). Quality of life was positively impacted after 24 weeks of BIAsp 30 therapy. CONCLUSION: Initiating or switching to BIAsp 30 therapy in this Algerian cohort was well-tolerated and significantly improved glucose control.