Diabetes in day case general and vascular surgery: A multicentre regional audit.

BACKGROUND: People with Diabetes Mellitus (DM) are at increased risk of postoperative complications if their HbA1C readings are not well controlled. In the UK, there are clear national guidelines requiring all people with DM to have HbA1C blood testing within 6months before undergoing surgery and that these readings should be below 69 mmol/mol if this is safe to achieve. The aim of this study was to determine whether hospitals in the region were compliant with the guidelines. METHODS: Data were prospectively collected from seven hospitals across the East of England region from 1st October 2017 to 31st March 2018 (6 months) in all people with DM undergoing elective day case procedures in General and Vascular surgery for benign disease. RESULTS: A total of 181 people with DM were included in the study, of whom 77.9% were male patients and the median age was 63 years. The three most commonly performed operations were laparoscopic cholecystectomy (20.9%, n = 38/181), inguinal hernia repair (20.4%, n = 37/181) and umbilical/para-umbilical hernia repair (11.0%, n = 20/181). In keeping with the national guidelines, only 86.7% (n = 157/181) of patients had an HbA1C tested within 6 months prior to their surgery date. Of the patients who had a preoperative HbA1C, 14 (n = 14/157, 8.9%) had an HbA1C ≥ 69 mmol/mol, and 12 (n = 12/14, 85.7%) of these proceeded to surgery without optimisation of their HbA1C. CONCLUSION: A significant proportion of people with diabetes undergoing elective day case procedures in our region do not have HbA1C testing within 6 months of their procedure as recommended by the national guidelines. In patients who do have a high HbA1C, the majority still undergo surgery without adequate control of their DM. Greater awareness amongst healthcare workers and robust pathways are required for this vulnerable group of patients if we are to reduce the risk of developing postoperative complication rates.

Engineering planar antenna using geometry arrangements for wireless communications and satellite applications.

A triple-band microstrip patch antenna designed for the IEEE 802.16e WiMAX, IEEE 802.11a WLAN, C-band downlink communications, and Ku-band radar recent applications is suggested in this article. The planned antenna operates at 2.45, 6, and 14 GHz resonant frequencies. The antenna fulfilled triple-band physical characteristics covering industrial, scientific, and medical (ISM) bands between (2.1-2.8) GHz; (5.6-6.5) GHz for wireless local area network (WLAN) or ultra-wideband (UWB) services; and 12.7-16 GHz for future two-way 5G:6G either broadcasting or mobile satellite communications. To achieve better return loss performance, parametric studies are carried out using Microwave Studio (CST MWS). The proposed antenna is designed on the FR4 as a hosting medium of total size 46 × 38 × 1.6 mm3, combined with a planar transmission line (T.L.) feed and defected ground structure (DGS). The simulated antenna's input reflection coefficient (S11) results and the far-field measurements show good agreement. The fabricated prototype achieves peak gain values of 2.8, 3.8, and 4.7 dBi, respectively, and bidirectional radiation characteristics. A comparative study with other recent publications is implemented to validate the consistency of the design.