Study on chemical composition and physical properties of the Hamri (Barbus luteus) and Balaout (Chondrostoma regium) fish meat, oil and impact of its oils on cholesterol, triglyceride, HDL and blood sugar of laboratory rats.

The study aimed at investigating the meat chemical composition and physical properties of oil of the Hamri (Barbus luteus) and Balaout (Chondrostoma regium) fish and its oil content or fatty acids, and also to know the impact of its oils on the level of cholesterol, triglyceride, high density lipoprotein (HDL) and blood sugar levels of laboratory rats. The study area extended from the province of Shirqat and Balad district to the province of Salah al-Din. The approximate percentages of meat from Hamri were 72.13, 19.74, 5.07 and 1.60 % for the moisture, protein, fat and ash respectively, and 71.63, 19.98, 4.96 and 2.04% respectively from Balaout. The extract oil from 2 types of fish differed significantly in Iodine value, Peroxide value, and Acid value and in saponification number. The fatty acids profiles results showed that oils from Hamri and Balaout fish meat consisted of 44.31 and 55.76% of Saturated fatty acid, 36.10 and 25.41% of poly unsaturated fatty acid, and 18.17 and 25.41% poly unsaturated fatty acids respectively. The experiment laboratory rats showed decreases in cholesterol, triglyceride and blood sugar level, and increases in high density lipoprotein (HDL). In conclusion, it is recommended that this oil can be used in human diet for health benefits.

Perioperative care of obstructive sleep apnea patients: A survey of European anesthesiologists.

BACKGROUND: Obstructive sleep apnea (OSA) is prevalent in the surgical patient population and is associated with high risk of perioperative complications. There are limited guidelines and wide practice variations regarding the perioperative care of obese and OSA patients. This is a study of European anesthesiologists' clinical practice of perioperative care of OSA patients. METHODS: This survey evaluated United Kingdom anesthesiologists' clinical practice of the perioperative care of OSA patients. Outcomes and variables were compared between 4100 anesthesiologists of different clinical experience and hospital settings. RESULTS: Approximately 45% of respondents manage OSA patients rarely, 42% occasionally, and 13% regularly. Most respondents order OSA screening tests if patients have tonsillar hypertrophy, head/neck tumor, BMI >35, increased neck circumference, craniofacial anomaly, and right-sided electrocardiography (ECG) anomaly. Majority request preoperative polysomnography, ECG, overnight pulse oximetry, and arterial blood gas analysis. Majority recommend preoperative weight loss, optimisation, smoking cessation, reduction of substance use, and regular mask-CPAP use. Majority consider endoscopy, and ophthalmology as appropriate day case procedures, but not laparoscopy. Majority postpone elective airway, laparoscopic, laparotomy, and head/neck surgery; if patients are not optimized preoperatively. For major surgery, combined general + neuraxial anesthesia was ranked as 3rd option. For major limb surgery, neuraxial anesthesia without sedation was ranked as 1st option, nerve block without sedation was ranked 2nd, and general anesthesia + nerve block was ranked 3rd or 4th. At anesthesia emergence, majority ensure that patients have normal consciousness, respiration and neuromuscular function. Majority ensure postoperative oximetry, telemetry, and oxygen supplementation. CONCLUSION: This study highlights variations in anesthesiologists' perioperative care of OSA patients; even in developed countries with advanced medical training and standards. The study outcomes will improve perioperative care of OSA patients.

Our experience of controlling diabetes in the peri-operative period of patients who underwent cardiac surgery.

AIMS: We have different protocols applied in our cardiac center for control of blood glucose (BG), we like to see which protocol can achieve our goal. METHODS: From a prospective study of 120 diabetic patients randomly assigned to either simple sliding scale or Braithwaite protocol who underwent open heart surgical procedures between 2005 and 2008. The study group included 80 patients treated with Braithwaite protocol; the control group included 40 patients treated with simple sliding scale in an attempt to maintain BG level less than 200 mg/dl. RESULTS: In the study group all the patients were under 200 mg/dl at the end of 48 h postoperatively, which was not achieved in the control group (P<0.01). There was a significant reduction in hospital stay in the study group compared to the control group (mean in days 9.1+/-2.3/12.3+/-7.6) (P<0.001) and also there was no wound infection compared to the control group (0/5 cases). CONCLUSION: The study showed that control of DM in peri-operative period using Braithwaite regimen was of great benefit and safety.

Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: a case series.

INTRODUCTION: Perioperative spinal myoclonus is extremely rare. Many anaesthetists and perioperative practitioners may not diagnose or manage this complication appropriately when it occurs. This case report of unusual acute spinal myoclonus following regional anaesthesia highlights certain aspects of this rare complication that have not previously been published. CASE PRESENTATIONS: A series of four consecutive patients who developed acute lower-limb myoclonus following spinal or epidural anaesthesia are described. The case series occurred at three different hospitals and involved four anaesthetists over a 3-year period. Two Caucasian men, aged 90-years-old and 67-years-old, manifested unilateral myoclonus. Two Caucasian women, aged 64-years-old and 53-years-old, developed bilateral myoclonus. Myoclonus was self-limiting in one patient, treated with further regional anaesthesia in one patient and treated with intravenous midazolam in two patients. The overall outcome was good in all patients, with no recurrence or sequelae in any of the patients. CONCLUSION: This case series emphasizes that spinal myoclonus following regional anaesthesia is rare, has diverse pathophysiology and can have diverse presentations. The treatment of perioperative spinal myoclonus should be directed at the aetiology. Anaesthetists and perioperative practitioners who are unfamiliar with this rare complication should be reassured that it may be treated successfully with midazolam.