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Post Thyroidectomy Assessment of Intact Parathyroid Hormone for Early Prediction of Hypocalcaemia

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第2期13卷 71-84页

作者： Md. Masum Billah Ripon Kumar Sarkar Md. Yousuf Ali Saad Zaman Md. Nazmul Hasan Md. Shehab Uddin Md. Mosleh Uddin Kazi Shameemus Salam Farzana Binte Abedin Leera department of Otolaryngology-Head & Neck Surgery Universal Medical College Hospital Dhaka Bangladesh department of Otolaryngology-Head & Neck Surgery National Institute of Ear Nose and Throat Dhaka Bangladesh Shaheed Ahsan Ullah Master General Hospital Gazipur Bangladesh department of Otolaryngology-Head & Neck Surgery Cumilla Medical College Cumilla Bangladesh department of ent Oncology National Institute of Cancer Research & Hospital Dhaka Bangladesh department of ent Outdoor Rajshahi Medical College Hospital Rajshahi Bangladesh department of Otolaryngology-Head & Neck Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh department of Biochemistry Delta Medical College Hospital Dhaka Bangladesh

Background: As the half-life of intact parathyroid hormone (iPTH) is very low, it reflects parathyroid insufficiency within minutes to hours after total thyroidectomy. Therefore, iPTH level assessment in the postoperative period can be used to predict the development of hypocalcaemia. The optimal time point to measure serum iPTH is important for the accurate prediction of hypocalcaemia. Aim: This paper aims to evaluate the ability of iPTH as an early predictive marker of hypocalcaemia and determine which time iPTH is more able to predict postoperative hypocalcaemia. Method: This prospective observational study was conducted in the department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka, from July 2020 to December 2021, with 67 patients who underwent total thyroidectomy. iPTH levels were measured on the day before the operation and at 1 hour, 4 hours, and 24 hours after the operation. S.calcium levels were measured on the day before the operation and 1st postoperative day. All the data were compiled and sorted properly and were analyzed statistically. Results: Postoperative hypocalcaemia developed in 18 cases, with an incidence of 26.9%. Pearson correlation showed a significant correlation between postoperative iPTH at 1 hr, 4 h, and 24 hr with 1st postoperative calcium value. The Receiver operating characteristic (ROC) curve was processed for the postoperative iPTH at 1 hr, 4 h, and 24 hr. The sensitivity, specificity, cut-off value, and mean AUC found 93.9%, 94.4%, ≤14.0, 0.988;95.9%, 94.4%, ≤09.5, 0.993 and 91.8%, 94.4%, ≤11.0, 0.993 respectively. Conclusion: iPTH can be used as an early predictor of post-thy-roidectomy hypocalcaemia. 4 hr iPTH showed more sensitivity and specificity for a cut-off value near the laboratory reference range.

关键词： Total Thyroidectomy Hypocalcaemia Serum Intact Parathyroid Hormone Early Predictor of Hypocalcaemia

Contribution of Metabolic Imaging in the Exploration of Cognitive Disorders Related to COVID-19

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Advances in Molecular Imaging 2024年第1期13卷 1-5页

作者： Serigne Moussa Badiane Amadou Barro Elhadji Amadou Lamine Bathily Louis Augustin Diaga Diouf Biophysics and Nuclear Medicine Gaston Berger University Saint-Louis Senegal ent department Fann University Hospital Dakar Senegal Biophysics and Nuclear Medicine Cheikh Anta Diop University Dakar Senegal

On March 11, 2019, the WHO declared COVID-19 a pandemic disease. It is a respiratory tropism SARS COV 2 infection. In the emergency of the pandemic, in medical imaging, only computed tomography (CT) of the lungs was favored to assess lung lesions. In addition, many cases of post-COVID-19 cognitive disorders have been reported. As the curve dips and services restart correctly, other imaging techniques have been used to better explore the disease. The objective of this presentation is to illustrate the contribution of metabolic imaging in the exploration of post COVID-19 cognitive disorders and to discuss the pathophysiological mechanisms. Hypometabolism brain lesions are objective signs of functional impairment whose pathophysiological mechanism is not yet fully understood. Metabolic imaging with PET-SCAN is a suitable tool for exploring these disorders, both for the severity and extent of the lesions and for the topography of the brain damage.

关键词： COVID-19 Nuclear Medicine Cognitive Disorders PET-SCAN

Effect of transcranial direct current stimulation on postoperative sleep disturbance in older patients undergoing lower limb major arthroplasty:a prospective,double-blind,pilot,randomised controlled trial

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General Psychiatry 2024年第2期37卷 224-233页

作者： Jie Yang Mingshu Tao Rongguang Liu Jiaxing Fang Chunyan Li Dexian Chen Qi Wei Xingyu Xiong Wenxin Zhao Wen Tan Yuan Han Hongxing Zhang He Liu Song Zhang Junli Cao department of Anesthesiology The Affiliated Hospital of Xuzhou Medical UniversityXuzhouJiangsuChina department of Anesthesiology Hospital of Chengdu University of Traditional Chinese Medicine&Traditional Chinese Medicine Hospital of Sichuan ProvinceChengduSichuanChina NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs&Jiangsu Province Key Laboratory of Anesthesiology&Jiangsu Key Laboratory of Applied Technology of Anesthesia and Analgesia Xuzhou Medical UniversityXuzhouJiangsuChina department of Anesthesiology Eye&ENT Hospital of Fudan UniversityShanghaiChina department of Anesthesiology&Clinical Research Center for Anesthesia and Perioperative Medicine&Huzhou Key Laboratory of Basic Research and Clinical Translation for Neuromodulation The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University||Huzhou Central Hospital||The Affiliated Huzhou HospitalZhejiang University School of Medicine||Affiliated Central Hospital Huzhou UniversityHuzhouZhejiangChina department of Anesthesiology Renji Hospital School of MedicineShanghai Jiao Tong UniversityShanghaiChina

Background Postoperative sleep disturbance(PSD)is a common and serious postoperative complication and is associated with poor postoperative outcomes.Aims This study aimed to investigate the effect of transcranial direct current stimulation(tDCS)on PSD in older patients undergoing lower limb major arthroplasty.Methods In this prospective,double-blind,pilot,randomised,sham-controlled trial,patients 65 years and over undergoing lower limb major arthroplasty were randomly assigned to receive active tDCS(a-tDCS)or sham tDCS(s-tDCS).The primary outcomes were the objective sleep measures on postoperative nights(N)1 and N2.Results 116 inpatients were assessed for eligibility,and a total of 92 patients were enrolled;47 received a-tDCS and 45 received s-tDCS.tDCS improved PSD by altering the following sleep measures in the a-tDCS and s-tDCS groups;the respective comparisons were as follows:the promotion of rapid eye movement(REM)sleep time on N1(64.5(33.5-105.5)vs 19.0(0.0,45.0)min,F=20.10,pentages of light sleep and REM sleep on N1 and N2(pents were reported.Conclusion In older patients undergoing lower limb major arthroplasty,a single session of anodal tDCS over the left dorsolateral prefrontal cortex showed a potentially prophylactic effect in improving postoperative short-term objective sleep measures.However,this benefit was temporary and was not maintained over time.

关键词： sleep stimulation postoperative

Quantitative assessment of the impact of a triage physician on the Accreditation Council for Graduate Medical Education resident milestones in the emergency department

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World Journal of Emergency Medicine 2024年第3期15卷 220-222页

作者： Julie Cueva Duncan Grossman Vishnu Muppala Arlene Chung Mahlaqa Butt Jefferson Drapkin Antonios Likourezos Errel Khordipour department of Emergency Medicine Maimonides Medical CenterNew York 11219USA

The “door-to-doctor” time for patients to be seen by a physician is an increasingly studied metric.Hospitals may shorten this time by implementing a triage physician (TP).The exact role of a TP may vary across departments.TPs put in preliminary orders for lab work,imaging,and treatment,and decide treatment location for further evaluation.As the prevalence of TPs grows,its effect on resident education in academic emergency departments (EDs) remains unclear.We implemented a TP in the spring of 2016 and assessed resident physicians before and after implementation.

关键词： physician doctor treatment

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Surgery of the Goiter in the ent department of Chu Gabriel Toure: Problematic and Perspective

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第6期8卷 283-291页

作者： Kassim Diarra N’faly Konaté Youssouf Sidibé Tiguida Sissoko Fatogoma Issa Koné Boubacary Guindo Harouna Sanogo Bagayoko Drissa Kaloga Siaka Soumaoro Doumbia Kadidiatou Singare Samba Karim Timbo Mohamed Amadou Keita ent and Head and Neck Surgery department Gabriel Toure University Hospital Bamako Mali ent and Head and Neck Surgery department Mother-Child “Luxembourg” Hospital Bamako Mali ent and Head and Neck Surgery department Reference Health Kalanbancoro Bamako Mali Anesthesia Resuscitation department Mother-Child “Luxembourg” Hospital Bamako Mali

Aims: To describe the diagnostic aspects, surgical indications and post-operative complications of thyroidectomies performed in our department. Materials and method: A descriptive retrospective study that took place in the ent department and Cervicofacial Surgery of Gabriel TOURE University Hospital of Bamako. We did a comprehensive sampling of all goiter cases from January 2013 to December 2018. Were included in the study, the records of patients of all ages and genders, admitted into the ward and scheduled for thyroidectomy (partial or total). The exclusion criteria were incomplete hospitalization records. There were a total of 139 files were retained. Results: In 60 months, 139 cases were collected out of 1720 patients hospitalized for surgery, representing a hospital prevalence of 8.08%. The average age was 46.89 years. (123 women and 16 men). The socio-professional categories were dominated by housewives (68.34%). The reported functional signs were tachycardia, asthenia and other signs of dysthyroidism in 59% as well as signs of compression in 24.46%. In 72 cases or 51.80%, the patients consulted between 2 and 10 years of disease progression. Twenty patients or 14.39% had a history of familial goiter and 2 patients had a history of thyroid surgery. On physical examination the swelling was antero-cervical in 56.83% of cases. In 96 cases or 69.06% the glandular diameter was between 5 and 9 cm. In 2 cases or 1.43% we noted cervical adenopathy in the jugulo-carotid chain. Ultrasound, TSHus and fT4 were performed first-line and systematically in all our patients. Ultrasound objectified an appearance of multinodular goiter in 106 cases or 76.26%. In 60.43% of cases the patients were TI classes RADS 3, they were TI RADS 4A in 16 cases or 11.51%. CT scans were performed in 3 patients or 2.15% to specify the loco-regional extension, to look for possible lymph node invasion, and to compress or dipping the goiter. Surgical indication was placed in front of a multinodular goiter (GMN) in 106 cases or 76.26%, a single go

关键词： Goiter Thyroidectomy Recurrent Surgery

Phytochemical analysis, antioxidant, acetylcholinesterase, and α-amylase inhibitors from Hippeastrum hybridum extract

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Journal of Traditional Chinese Medicine 2024年第3期44卷 496-504页

作者： Naila Sher Mushtaq Ahmed Nadia Mushtaq department of Biotechnology University of Science and Technology department of Botany University of Science and Technology

OBJECTIVE:To investigate the effects of Hippeastrum hybridum（HH） as a free radical scavenger,and an inhibitor of the two enzymes i-e Alpha-amylase（α-amylase） and acetylcholinesterase（AChE）.METHODS:In this study,HH plant was preliminary analyzed for phytochemical screening and then tested for its antioxidant,anti-α-amylase,and anti-AChE efficiency via standard procedures.RESULTS:Phytochemical analysis shows the existence of different compounds;while Coumarins and quinones were absent.The total phenolic,flavonoid,and tannins content were found to be（78.52±0.69） mg GAE/g,（2.01±0.04） mg RUE/g,and（58.12±0.23） mg TAE/g of plant extract respectively.28.02%±0.02% alkaloid and 2.02%±0.05% saponins were present in the HH extract.The HH extract showed the anti-oxidant property with IC50（50%inhibition） of（151.01±0.13）(HH),（79.01±0.04）(Ascorbic acid) for ferric reducing,（91.48±0.13）(HH),（48.02±0.11）(Ascorbic acid) against Ammonium molybdenum,（156.02±0.31）(HH),（52.38±0.21）(Ascorbic acid) against DPPH,136.01±0.21（HH）,52.02±0.31（Ascorbic acid） against H2O2,and 154.12±0.03（HH）,（40.05±0.15）(Ascorbic acid)μg/mL against ABTS respectively.Statistical analysis indicated that HH caused a competitive type of inhibition of α-amylase(Vmaxremained constant and Km increases from 10.65 to84.37%) while Glucophage caused the un-competitive type of inhibition i-e both Km and Vmaxdecreased from40.49 to 69.15%and 38.86 to 69.61%respectively.The Ki,（inhibition constant）;KI,（dissociation constant）,Km,（Michaelis-Menten constant）,and IC50 were found to be62,364,68.1,and 38.08±0.22 for HH and 12,101.05,195,34.01±0.21 for Glucophage.Similarly,HH causes an anon-competitive type of inhibition of AChE i-e Km remains constant while Vmaxdecreases from 60.5%to74.1%.The calculated Ki,KI,Km,and IC50 were found to be 32,36.2,0.05,and 18.117±0.018.CONCLUSION:From the current results,it is concluded that HH extract contains bioactive compounds,and could be a good alternative to controlling oxidants,Alzheimer‘s and Type-Ⅱ diabetic diseases.

关键词： Hippeastrum hybridum acetylcholinesterase alpha-amylase antioxidant phytochemicals

Homogeneous Microscopic Abnormalities in Sperm Morphology and Immotility as A Cause of Male Infertility

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Journal of Reproduction and Contraception 2014年第2期25卷 102-118页

作者： Delia Acevedo León Josep Ventura Gayete Carmen Aguado Mu?oz Carmen Carda Batalla Miguel Armengot Carceller Jerónimo Forteza Vila department of Biochemistry Clinical Analysis Universitary Hospital Dr. Peset 46017 Valencia Spain Cytology Unit Prince Felipe Research Centre (CIPF) Pathology Medical School University of Valencia General and Universitary Hospital Rhinology Unit ENT Department Surgery Department University of Valencia Valencian Institute of Pathology (IVP) Catholic University of Valencia San Vicente Mártir 46003 ValenciaSpain

Objective To study the identification of the cause of specific sperm abnormatities. Methods Two adult men with specific alterations in sperm morphology causing 100% immobility were included in this study. The study of sperm used： transmission electron microscopy （both patients）; apoptotic markers, DNA fragmentation test and fluorescence in-situ hybridization （patient 1） and immunoeytochemistry study of sperm flagellum using anti-β tubulin antibodies and ciliary activity test （patient 2）.Results Increased DNA fragmentation （52.6%） and apoptosis biomarkers were detected in patient 1, and loss of the central pair of mierotubules in patient 2 （‘9＋0＇ axoneme）; the nasal ciliary activity was normal. Conclusion Results suggest an apoptotic origin of the abnormalities in the sperm from patient 1 and dysplasia of the fibrous sheath in patient 2.

关键词： apoptotic changes dysplasia of fibrous sheath midpiece thickening necrospermia sperm immotility

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Anti-vascular endothelial growth factor drugs combined with laser photocoagulation maintain retinal ganglion cell integrity in patients with diabetic macular edema: study protocol for a prospective, non-randomized, controlled clinical trial

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Neural Regeneration Research 2024年第4期19卷 923-928页

作者： Xiangjun Li Chunyan Li Hai Huang Dan Bai Jingyi Wang Anqi Chen Yu Gong Ying Leng department of Ophthalmology Affiliated Hospital of Beihua University department of Endocrinology Affiliated Hospital of Beihua University

The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting vision.The major clinical treatments for diabetic macular edema are anti-vascular endothelial growth factor drugs and laser photocoagulation.However,although the macular thickness can be normalized with each of these two therapies used alone,the vision does not improve in many patients.This might result from the incomplete recovery of retinal ganglion cell injury.Therefore,a prospective,non-randomized,controlled clinical trial was designed to investigate the effect of anti-vascular endothelial growth factor drugs combined with laser photocoagulation on the integrity of retinal ganglion cells in patients with diabetic macular edema and its relationship with vision recovery.In this trial,150 patients with diabetic macular edema will be equally divided into three groups according to therapeutic methods,followed by treatment with anti-vascular endothelial growth factor drugs,laser photocoagulation therapy,and their combination.All patients will be followed up for 12 months.The primary outcome measure is retinal ganglion cell-inner plexiform layer thickness at 12 months after treatment.The secondary outcome measures include retinal ganglion cell-inner plexiform layer thickness before and 1,3,6,and 9 months after treatment,retinal nerve fiber layer thickness,best-corrected visual acuity,macular area thickness,and choroidal thickness before and 1,3,6,9,and 12 months after treatment.Safety measure is the incidence of adverse events at 1,3,6,9,and 12 months after treatment.The study protocol hopes to validate the better efficacy and safety of the combined treatment in patients with diabetic macula compared with the other two monotherapies alone during the 12-month follow-up period.The trial is designed to focus on clarifying the time-effect relationship between imaging measures related to the integrity of retinal ganglion cells and best-corrected visual acuity.

关键词： choroidal thickness diabetic macular edema laser photocoagulation retinal ganglion cell-inner plexiform layer thickness retinal ganglion cells retinal nerve fiber layer thickness thickness of the macular area vascular endothelial growth factor visual acuity

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A Comprehensive Review on Charging Topologies and Power Electronic Converter Solutions for Electric Vehicles

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Journal of Modern Power Systems and Clean Energy 2024年第3期12卷 675-694页

作者： Abdelfatah Ali Hossam H.H.Mousa Mostafa F.Shaaban Maher A.Azzouz Ahmed S.A.Awad the department of Electrical Engineering American University of Sharjah the department of Electrical Engineering South Valley University the department of Electrical and Computer Engineering University of Windsor Electrical Engineering department Qatar University the department of Electrical and Computer Engineering Sultan Qaboos University

Electric vehicles(EVs) are becoming more popular worldwide due to environmental concerns, fuel security, and price volatility. The performance of EVs relies on the energy stored in their batteries, which can be charged using either AC(slow) or DC(fast) chargers. Additionally, EVs can also be used as mobile power storage devices using vehicle-to-grid(V2G) technology. Power electronic converters(PECs) have a constructive role in EV applications, both in charging EVs and in V2G. Hence, this paper comprehensively investigates the state of the art of EV charging topologies and PEC solutions for EV applications. It examines PECs from the point of view of their classifications, configurations, control approaches, and future research prospects and their impacts on power quality. These can be classified into various topologies: DC-DC converters, AC-DC converters, DC-AC converters, and AC-AC converters. To address the limitations of traditional DC-DC converters such as switching losses, size, and high-electromagnetic interference(EMI), resonant converters and multiport converters are being used in high-voltage EV applications. Additionally, power-train converters have been modified for high-efficiency and reliability in EV applications. This paper offers an overview of charging topologies, PECs, challenges with solutions, and future trends in the field of the EV charging station applications.

关键词： Topology DC-DC power converters Vehicle-to-grid Electric vehicle charging Batteries Transportation Electromagnetic interference