Weight reduction among females undergoing laparoscopic ventral hernia repair: The role of Calcium and Vitamin D3.

Objective: To evaluate the role of Vitamin-D and calcium supplementation on preoperative weight reduction in obese women before laparoscopic ventral hernia repair. Methods: This double-blind clinical trial was conducted at the affiliated health centers of King Faisal University, Al-Ahsa, Saudi Arabia from January 2021 to December 2021. It included forty-five obese women aged 24-56 years, with body mass index (BMI) of 34.0-48.0kg/m2. They were randomly allocated into two groups; the Group-A (N=22) included obese women who received supplementation of 5000IU cholecalciferol (Vitamin-D3), and 1000mg calcium daily for 12 months, while the Group-B (N=23) received no treatment. Measurement of change in weight and BMI and comparison of their pre-operative weight reduction, laparoscopic operative time, and length of hospital stay was done. Results: There were no differences in patients' biographic data between the two groups. During the study, Vitamin-D level in the patients increased and there was a significant positive association with weight loss. In group-A, the mean weight loss was 11.8±3.5 kg. At the end of first year, their BMI decreased from 36.1±1.6kg/m2 at baseline to 29.7±2.6 kg/m2, whereas in-group-B, the mean weight loss was 6.8±3.1 kg and their BMI decreased from 36.9±2.69kg/m2 at baseline to 32.7±0.93kg/m2. The operation time and the length of hospital stay were shorter in group-A (107 vs.128.min) and (3 vs. 5 days) respectively as compared to Group-B. Conclusion: Vitamin-D and calcium supplementation contributes to a remarkable weight reduction of preoperative obese female patients, which in turn is associated with significantly better outcome of laparoscopic repair of ventral hernia.

Outcome of the incarcerated abdominal wall hernias managed by open and laparoscopic approaches.

Background & Objective: Laparoscopic surgery is generally considered as better than open surgery in terms of less complications, minimal hospital stays and quick healing of the wounds. Our objective was to compare the immediate and early outcome of the different incarcerated hernias of anterior abdominal wall operated on as emergency cases by open and laparoscopic approach. Methods: This is a retrospective comparative study which was conducted at two hospitals of AlAhsa city of the Eastern region of the Kingdom of Saudi Arabia from July, 2017 to June, 2022. The data were retrieved from the medical records of the hospitals. All male and female patients having different types of incarcerated hernias of anterior abdominal wall presenting to the emergency room were included in the study. The patients were divided in two groups; those who were operated on by open approach (Group-I) and those who were operated on by laparoscopic approach (Group-II). Results: Out of total 70 male and female patients, 42 were in Group-I and 28 in Group-II. The variety of the incarcerated hernias in both groups overall was para-umbilical 26(37.14%), incisional 18(25.71%), inguinal (right & left) 17(24.28%) and epigastric 9(12.86%). The mean operative time taken by Group I and II was 126.07 (±9.728) and 98.57 (±10.079) minutes respectively with a difference of 27.50 minutes (p=0.807). The mean hospital stay of the patients in Group I and II was 1.36(±0.719) and 1.57(±0.997) days respectively (p=0.482). The post-operative complications rate in Group-I was 6(14.28%) and in Group-II, 6(21.43%) (p=0.658). Overall, 12(17.14%) patients developed the complications in both groups. When the number of the complications is compared, it shows that there was no significant difference between the two groups (p=0.583). Conclusion: Laparoscopic approach is not superior to the open approach in the terms of the immediate and early outcome/complications of the incarcerated hernias of the anterior abdominal wall operated as emergency cases in this study.

Improved Early Outcomes With Off-Pump Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction: A Systematic Review and Meta-Analysis.

The ongoing debate surrounding coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass persists, particularly in individuals with left ventricular dysfunction. The objective of this study was to evaluate the safety and efficacy of these 2 strategies through a comprehensive meta-analysis of existing studies. A systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Central Registry was conducted from inception to July 2023. The primary focus was on studies comparing on-pump versus off-pump CABG as the primary treatment for multivessel coronary artery disease in patients with left ventricular dysfunction (ejection fraction ≤40%), with mortality as the primary outcome. The meta-analysis included 26 studies with a total of 35,863 patients. The results revealed a significant reduction in mortality risk [risk ratio (RR), 0.75; 95% confidence interval (CI), 0.60-0.93; P = 0.009] and other perioperative morbidities associated with off-pump CABG. These included stroke (RR, 0.67; 95% CI, 0.54-0.82; P = 0.0002), myocardial infarction (RR, 0.74; 95% CI, 0.56-0.97; P = 0.03), pulmonary complications (RR, 0.71; 95% CI, 0.55-0.92; P = 0.010), postoperative transfusion (RR, 0.70; 95% CI, 0.55-0.88; P = 0.002), neurological dysfunction (RR, 0.80; 95% CI, 0.64-1.00; P = 0.05), infection (RR, 0.74; 95% CI, 0.56-0.97; P = 0.03), renal failure (RR, 0.79; 95% CI, 0.67-0.95; P = 0.010), and reoperation for bleeding (RR, 0.66; 95% CI, 0.52-0.84; P = 0.0006). However, no significant difference was observed between the 2 groups regarding postoperative atrial fibrillation (RR, 0.97; 95% CI, 0.84-1.12; P = 0.69). In conclusion, off-pump CABG demonstrates a lower perioperative mortality risk and improved overall early outcomes compared with on-pump techniques in individuals with reduced left ventricular function.

Comparison of the Conventional and Laser Etching on the Bonding of the Orthodontic Brackets: An Original Research.

Background: Acid etching enamel improves resin-enamel adhesion and adhesive characteristics, but has pros and cons. The effects of laser etching on the bonding of orthodontic brackets vary depending on the wavelength, power output, exposure duration, and energy delivered. Materials and Methods: This study used a new 1064-nm diode laser to irradiate 30 freshly extracted human premolars. They were divided into three groups: group A, group B, and group C. Acid etching was used for 1 min to bond bracket to tooth surface, and Indian ink was used for 30 s. Group C uses acid etching for 1 min following 30 s of laser irradiation with Indian ink. Results: In comparison to the other groups, group C's acid etching after laser irradiation has considerably stronger bond strength (P = 0.05). Orthodontic brackets in group B exhibited considerably poorer shear bond strength than those in the other groups. Conclusion: Acid etching improves the adhesion of orthodontic composite resin to human enamel following laser irradiation, but can interfere with the adhesion of composite resin.

Establishing superfine nanofibrils for robust polyelectrolyte artificial spider silk and powerful artificial muscles.

Spider silk exhibits an excellent combination of high strength and toughness, which originates from the hierarchical self-assembled structure of spidroin during fiber spinning. In this work, superfine nanofibrils are established in polyelectrolyte artificial spider silk by optimizing the flexibility of polymer chains, which exhibits combination of breaking strength and toughness ranging from 1.83 GPa and 238 MJ m-3 to 0.53 GPa and 700 MJ m-3, respectively. This is achieved by introducing ions to control the dissociation of polymer chains and evaporation-induced self-assembly under external stress. In addition, the artificial spider silk possesses thermally-driven supercontraction ability. This work provides inspiration for the design of high-performance fiber materials.

Free-Flowing Polymer-Bonded Powder Composition of Hexahydro-1,3,5-trinitro-1,3,5-triazine Using Solvent-Slurry Coating.

A number of coating techniques have been used to improve the processability of high explosives. These techniques are typically used for developing compositions, such as boosters and fillers. The most typically used technique is the "solvent-slurry coating". Several compositions of polymer-bonded explosives have been industrialized using this technique. The NUPC-6 polymer-bonded powder composition of hexahydro-1,3,5-trinitro-1,3,5-triazine is optimized using the solvent-slurry coating. It involved multiple processes, i.e., preparing a slurry of high explosives in an aqueous phase, dissolving the modified polymer binder in an organic solvent, maintaining both the solvent and slurry at controlled temperatures, introducing polymer binder solution and ingredients in the slurry, distilling the solvent, mixing contents homogeneously, filtering the polymer-coated hexahydro-1,3,5-trinitro-1,3,5-triazine composition, and drying in a vacuum oven. The phlegmatizing and hydrophobic agents enhance flowability and hydrophobicity. The mass flow rate, bulk density, tapped density, compressibility index, and Hausner ratio are determined to evaluate its flowability during filling operations. The results show that the composition is flowable using a filling funnel, with a 150 mm upper diameter, 25 mm flow diameter, and 136 mm total funnel height. The raw polymer binder was modified using diisooctylsebacate and SAE-10 oil. The additives in the composition enhance its flowability, and it might be used in underwater applications.

Awareness of First-Aid Management of Epistaxis Among Individuals in Al-Ahsa Region.

Introduction Epistaxis is among the most common emergencies in the Ear, Nose, and Throat department. The vast majority of these patients are treated with basic first-aid management. Our study aims to assess the awareness of first­aid management of epistaxis among individuals in the Al-Ahsa region, Kingdom of Saudi Arabia. Materials and methods This is a cross-sectional study conducted among the male and female population in Al-Ahsa, Saudi Arabia, during March 2023, and it included all participants available at the time of the study. All the data were obtained using an online questionnaire. Results The study included 385 participants; 213 (55.3%) were females and 172 (44.7%) were males. Based on the correlation between our variables, 235 (61%) of the participants had a good awareness score while only 150 (39%) had a poor score. Our findings show that 113 (65.7%) of males had a good level of awareness and 122 (57.3%) of females had a good level of awareness regarding epistaxis. Participants who had gone through an experience of the treatment of any patients with epistaxis had better awareness about first-aid management of epistaxis than participants who had never gone through the experience. Conclusion The knowledge and awareness regarding first-aid management of epistaxis among the general population was satisfactory. However, we should increase the level of knowledge of individuals who did not treat any people with epistaxis because there are many cases of epistaxis in Al-Ahsa However, more integrated educational materials should be available to the general population to improve their overall knowledge. Social campaigns in public areas will enhance the level of knowledge regarding epistaxis management among the general population.

Efficacy of automated fasteners versus hand-tied knots in cardiac surgery: a systematic review and meta-analysis.

Valve surgery is common in cardiac procedures, with fasteners like COR-KNOT® and hand-tied knots used for knot securing. This study compares their efficacy in valve surgery patients. We searched PubMed, SCOPUS, and Cochrane Central until August 2023. Outcomes assessed included aortic cross-clamp time (AXT), cardiopulmonary bypass (CPB) time, valvular regurgitation, mortality, prolonged ventilatory support, atrial fibrillation, postoperative left ventricular ejection fraction (LVEF), and renal failure. Subgroup analysis was performed for minimally invasive and open cardiac surgery. We used a random effects model for analysis. We included eight observational studies and two randomized controlled trials (RCTs) with a total of 1.411 participants. COR-KNOT significantly reduced AXT [MD -15.14, 95 % CI (-18.57, -11.70), P<0.00001] and CPB time [MD -12.38, 95 % CI (-14.99, -9.77), P<0.00001]. Valvular regurgitation [RR 0.40, 95 % CI (0.26, 0.61), P<0.0001] and need for prolonged ventilatory support [RR 0.29, 95 % CI (0.13, 0.65), P=0.003] were significantly lower with COR-KNOT. There were no significant differences in mortality [RR 0.39, 95 % CI (0.09, 1.69), P=0.44], atrial fibrillation [RR 1.03, 95 % CI (0.83, 1.27), P=0.81], LVEF changes [MD 0.05, 95 % CI (-1.37, 1.47), P = 0.95], or renal failure [RR 0.87, 95 % CI (0.16, 4.80), P = 0.87]. COR-KNOT devices reduce operative time and valvular regurgitation without increasing mortality or adverse outcomes. This supports their use in enhancing surgical efficiency and patient outcomes. However, ongoing discussions about suturing techniques, especially in minimally invasive procedures, highlight the need for further research and consensus among practitioners. See also the graphical abstract(Fig. 1).

Mitochondrial metabolism in Drosophila macrophage-like cells regulates body growth via modulation of cytokine and insulin signaling.

Macrophages play critical roles in regulating and maintaining tissue and whole-body metabolism in normal and disease states. While the cell-cell signaling pathways that underlie these functions are becoming clear, less is known about how alterations in macrophage metabolism influence their roles as regulators of systemic physiology. Here, we investigate this by examining Drosophila macrophage-like cells called hemocytes. We used knockdown of TFAM, a mitochondrial genome transcription factor, to reduce mitochondrial OxPhos activity specifically in larval hemocytes. We find that this reduction in hemocyte OxPhos leads to a decrease in larval growth and body size. These effects are associated with a suppression of systemic insulin, the main endocrine stimulator of body growth. We also find that TFAM knockdown leads to decreased hemocyte JNK signaling and decreased expression of the TNF alpha homolog, Eiger in hemocytes. Furthermore, we show that genetic knockdown of hemocyte JNK signaling or Eiger expression mimics the effects of TFAM knockdown and leads to a non-autonomous suppression of body size without altering hemocyte numbers. Our data suggest that modulation of hemocyte mitochondrial metabolism can determine their non-autonomous effects on organismal growth by altering cytokine and systemic insulin signaling. Given that nutrient availability can control mitochondrial metabolism, our findings may explain how macrophages function as nutrient-responsive regulators of tissue and whole-body physiology and homeostasis.

New roles for Bacillus thuringiensis in the removal of environmental pollutants.

For a long time, the well-known Gram-positive bacterium Bacillus thuringiensis (Bt) has been extensively studied and developed as a biological insecticide for Lepidoptera and Coleoptera pests due to its ability to secrete a large number of specific insecticidal proteins. In recent years, studies have found that Bt strains can also potentially biodegrade residual pollutants in the environment. Many researchers have isolated Bt strains from multiple sites polluted by exogenous compounds and characterized and identified their xenobiotic-degrading potential. Furthermore, its pathway for degradation was also investigated at molecular level, and a number of major genes/enzymes responsible for degradation have been explored. At present, a variety of xenobiotics involved in degradation in Bt have been reported, including inorganic pollutants (used in the field of heavy metal biosorption and recovery and precious metal recovery and regeneration), pesticides (chlorpyrifos, cypermethrin, 2,2-dichloropropionic acid, etc.), organic tin, petroleum and polycyclic aromatic hydrocarbons, reactive dyes (congo red, methyl orange, methyl blue, etc.), and ibuprofen, among others. In this paper, the biodegrading ability of Bt is reviewed according to the categories of related pollutants, so as to emphasize that Bt is a powerful agent for removing environmental pollutants.

Morphology modulation of artificial muscles by thermodynamic-twist coupling.

Human muscles can grow and change their length with body development; therefore, artificial muscles that modulate their morphology according to changing needs are needed. In this paper, we report a strategy to transform an artificial muscle into a new muscle with a different morphology by thermodynamic-twist coupling, and illustrate its structural evolution during actuation. The muscle length can be continuously modulated over a large temperature range, and actuation occurs by continuously changing the temperature. This strategy is applicable to different actuation modes, including tensile elongation, tensile contraction and torsional rotation. This is realized by twist insertion into a fibre to produce torsional stress. Fibre annealing causes partial thermodynamic relaxation of the spiral molecular chains, which serves as internal tethering and inhibits fibre twist release, thus producing a self-supporting artificial muscle that actuates under heating. At a sufficiently high temperature, further relaxation of the spiral molecular chains occurs, resulting in a new muscle with a different length. A structural study provides an understanding of the thermodynamic-twist coupling. This work provides a new design strategy for intelligent materials.

Development of Hybrid Composite Utilizing Micro-Cellulose Fibers Extracted from Date Palm Rachis in the Najran Region.

Environmental effects can be reduced by using renewable resources in various applications. The date palm fibers (DPF) used in this study were extracted from waste date ranches of the Najran region by retting and manual peeling processes. The biocomposites were developed by reinforcing the silane-treated DPF (SDPF) at different wt.% in eugenol phthalonitrile (EPN) and difunctional benzoxazine (BA-a) copolymer. The impact strength, tensile, flexural, and dynamic mechanical properties and thermogravimetric analysis were evaluated to understand the mechanical, thermomechanical, and thermal properties. Results confirmed that 30 wt.% SDPF-reinforced poly (EPN/BA-a) composites produced the highest mechanical and thermomechanical properties, and were considered optimized SDPF reinforcement. Furthermore, hybrid composites with 30 wt.% SDPF and 15 wt.% silane-treated glass fibers (SGF) reinforcement having different lamination sequences were also studied. The lamination sequences showed a significant impact on the mechanical and thermomechanical properties, as properties were further enhanced by adding a core layer of SGF in hybrid composites. However, the thermal properties of SDPF/SGF laminates were higher than SDPF biocomposites, but the SGF lamination sequence did not produce any impact. According to the limiting oxygen and heat resistance indexes, the developed SDPF/SGF laminates are self-extinguishing materials and can be used in temperature-tolerant applications up to 230 °C.

Laparoscopic Umbilical Hernia repair in male patients with abdominal obesity.

Objective: Obesity is a global health problem, and obese patients are subject to developing abdominal wall hernias. There are few prospective studies comparing the laparoscopic method of umbilical hernia mesh repair between abdominal obesity patients and normal abdominal waist patients. The aim of this study was to evaluate the short-term outcomes (operative time, early complications and hospital stay) in the patients having laparoscopic hernia repair with abdominal obesity. Methods: This prospective cohort study was conducted at King Fahad Hospital Hofuf, Kingdom of Saudi Arabia from June 2014 to June 2021. Fifty four (54) adult male patients with umbilical hernia were included in this study. The patients were divided into two groups: Group-A: Patients with abdominal obesity (n=26), and Group-B: Patients without abdominal obesity (n=28). All the patients underwent laparoscopic repair of umbilical hernia. The patients with abdominal obesity were defined as those having an abdominal girth more than 102 centimeters. Results: No significant differences were observed as related to age, co-morbidity and risk factors between the two groups. The statistically significant difference between the two groups observed was related to the mean operative time and the mean hospital stay. Conclusion: Laparoscopic umbilical hernia repair can be safely performed in abdominal obesity in male patients without an additional risk of complications.

Quantifying the Soil Arthropod Diversity in Urban Forest in Dera Ghazi Khan.

Arthropods can be either large or too small to be seen from the microscope. Their legs are jointed and perform a specific function in the soil. Several arthropods have been identified to date. Therefore, it is essential to identify them in a different type of soil. An experiment to quantify the soil arthropods in the urban forests of D.G. Khan was conducted at the Zoology lab of Ghazi University on four tree plants, i.e., neem (Azadirachta indica), mango (Mangifera indica), guava (Psidium guajava), and phalsa (Grewia asiatica). Soil samples were taken from different areas and on different months. The diversity of arthropods was analyzed through the Shannon index. The results were all significant. The total number of arthropods found in the experiment was 5151, with the following distributions: millipedes were 132 in neem, 133 in guava, 113 in mango, and 121 in phalsa; centipedes were 136 in neem, 142 in guava, 118 in mango, and 132 in phalsa; springtails were 138 in neem, 130 in guava, 120 in mango, and 134 in phalsa. There were a total of 12 different species of arthropods found. Neem (Azadirachta indica) have mites, centipede, and ants; guava (Psidium guajava) have centipedes and ants. Mango (Mangifera indica) have millipedes, centipedes, mites, springtail, and ants, and phalsa (Grewia asiatica) have mites, ants, and centipedes. The study reveals that millipedes, centipedes, springtails, and ants were found abundantly in the urban forest area of D.G. Khan, resulting in increased organic matter decomposition and appropriate distribution of nutrients through the soil having beneficial effects on the terrestrial ecosystem.

Biodegradation and Subsequent Toxicity Reduction of Co-contaminants Tribenuron Methyl and Metsulfuron Methyl by a Bacterial Consortium B2R.

AllyMax is a widely used herbicide formulation in wheat-rice cropping areas of the world. The residues of its active ingredients, tribenuron methyl (TBM) and metsulfuron methyl (MET), persist in soil and water as co-contaminants, and cause serious threats to nontarget organisms. This study was performed to assess the potential of a bacterial consortium for the degradation and detoxification of TBM and MET individually and as co-contaminants. A bacterial consortium (B2R), comprising Bacillus cereus SU-1, Bacillus velezensis OS-2, and Rhodococcus rhodochrous AQ1, capable of degrading TBM and MET in liquid cultures was developed. Biodegradation of TBM and MET was optimized using the Taguchi design of experiment. Optimum degradation of both TBM and MET was obtained at pH 7 and 37 °C. Regarding media composition, optimum degradation of TBM and MET was obtained in minimal salt medium (MSM) supplemented with glucose, and MSM without glucose, respectively. The consortium simultaneously degraded TBM and MET (94.8 and 80.4%, respectively) in cultures containing the formulation AllyMax, where TBM and MET existed as co-contaminants at 2.5 mg/L each. Mass spectrometry analysis confirmed that during biodegradation, TBM and MET were metabolized into simpler compounds. Onion (Allium cepa) root inhibition and Comet assays revealed that the bacterial consortium B2R detoxified TBM and MET separately and as co-contaminants. The consortium B2R can potentially be used for the remediation of soil and water co-contaminated with TBM and MET.

Clinicohematological, Mutagenic, and Oxidative Stress Induced by Pendimethalin in Freshwater Fish Bighead Carp (Hypophthalmichthys nobilis).

Currently, aquatic and terrestrial ecosystems are continuously and chronically polluted by cocktails of countless chemical compounds. The susceptibility to infections is tremendously increasing in a variety of organisms due to exposure to environmental pollutants. Pendimethalin, an herbicide, is continuously used in agriculture to remove unwanted broadleaf weeds across the globe. Therefore, this study investigates the mechanisms of toxicity of pendimethalin in freshwater fish bighead carp upon exposure to low and environmentally relevant concentrations. For this purpose, 48 fish without any clinical abnormalities were kept in a glass aquarium in different experimental groups (T0, T1, T2, and T3). These groups were treated with pendimethalin at 0.00, 0.25, 0.50, and 0.75 mg/L, respectively. Four fish were randomly picked from each experimental group and killed at 72, 96, and 120 hours of the trial to study hematobiochemical parameters and visceral tissues including the brain, liver, heart, gills, and kidneys for histopathology. Herbicide-treated fish indicated various physical and behavioral abnormalities including hypersecretion of mucus, erratic swimming, operculum movement, air gulping, tremors of fins, loss of equilibrium, and increased surface breathing. Histopathologically, gills tissues of treated fish indicated atrophied lamellae, uplifting of secondary lamellae, necrosis of primary and secondary lamellar epithelial cells, telogenesis, congestion, and lamellar fusion. Histopathological examination of liver tissues of treated fish showed mild to moderate congestion, necrosis of hepatocytes, and atrophy of hepatocytes while kidneys revealed degeneration of renal tubules, glomerular atrophy, ceroid, and necrosis of renal tubules. The erythrocyte counts, monocyte and lymphocyte counts, and hemoglobin values were significantly (P < 0.05) reduced in pendimethalin-treated fish. Results on serum biochemistry showed that the biomarkers of kidneys, heart, and liver were significantly higher in fish of treated groups. In addition, values of different biochemical reactions like reactive oxygen species (ROS), thiobarbituric acid reactive species (TBARS), total proteins, and quantity of different antioxidant enzymes including reduced glutathione (GSH), catalase, and superoxide dismutase (SOD) were significantly different when compared to untreated fish. Moreover, the percentile of different nuclear abnormalities in red blood cells and frequency of DNA damage increased significantly in treated fish. It can be concluded from the findings that pendimethalin causes its toxic effects via disruption of physiological and hematobiochemical reactions of fish.

Adipose mitochondrial metabolism controls body growth by modulating systemic cytokine and insulin signaling.

Animals must adapt their growth to fluctuations in nutrient availability to ensure proper development. These adaptations often rely on specific nutrient-sensing tissues that control whole-body physiology through inter-organ communication. While the signaling mechanisms that underlie this communication are well studied, the contributions of metabolic alterations in nutrient-sensing tissues are less clear. Here, we show how the reprogramming of adipose mitochondria controls whole-body growth in Drosophila larvae. We find that dietary nutrients alter fat-body mitochondrial morphology to lower their bioenergetic activity, leading to rewiring of fat-body glucose metabolism. Strikingly, we find that genetic reduction of mitochondrial bioenergetics just in the fat body is sufficient to accelerate body growth and development. These growth effects are caused by inhibition of the fat-derived secreted peptides ImpL2 and tumor necrosis factor alpha (TNF-α)/Eiger, leading to enhanced systemic insulin signaling. Our work reveals how reprogramming of mitochondrial metabolism in one nutrient-sensing tissue can couple nutrient availability to whole-body growth.