Background
Insomnia has been closely associated with cardiovascular disease (CVD) including myocardial infarction (MI). Our study aims to assess the eligibility of insomnia as a potential risk factor ...for MI.
Methods
PubMed, Scopus, and Web of Science were searched using terms; such as “Insomnia” and “MI.” Only observational controlled studies with data on the incidence of MI among insomniacs were included. Revman software version 5.4 was used for the analysis.
Results
Our pooled analysis showed a significant association between insomnia and the incidence of MI compared with noninsomniacs (relative risk RR = 1.69, 95% confidence interval CI = 1.41–2.02, p < .00001). Per sleep duration, we detected the highest association between ≤5 h of sleep, and MI incidence compared to 7−8 h of sleep (RR = 1.56, 95% CI = 1.41–1.73). Disorders of initiating and maintaining sleep were associated with increased MI incidence (RR = 1.13, 95% CI = 1.04–1.23, p = .003). However, subgroup analysis of nonrestorative sleep and daytime dysfunction showed an insignificant association with MI among both groups (RR = 1.06, 95% CI = 0.91–1.23, p = .46). Analysis of age, follow‐up duration, sex, and comorbidities showed a significant association in insomniacs.
Conclusion
Insomnia and ≤5 h of sleep are highly associated with increased incidence of MI; an association comparable to that of other MI risk factors and as such, it should be considered as a risk factor for MI and to be incorporated into MI prevention guidelines.
Background
Early oral feeding has been previously postulated to contribute to developing postoperative complications following head and neck reconstructive surgeries using free flaps. This study ...assessed the association between the timing of oral feeding (early vs. late) and postoperative complications and length of hospital stay among these patients.
Method
PubMed, Scopus, Cochrane, and Web of Science were searched using terms such as “oral feeding” and “head or neck cancer.” We utilized RevMan software version 5.4 for the analysis. The study defined early oral feeding as feeding within 5-day post-operation, while late oral feeding was defined as feeding after the fifth postoperative day. Five papers that met the inclusion criteria were included in the analysis, with 1097 patients.
Results
The results showed that early feeding was not significantly associated with postoperative fistulas (
RR
0.49, 95%
CI
0.23 to 1.05,
p
-value = 0.07), hematoma/seroma (
RR
0.71, 95%
CI
0.33 to 1.51,
p
-value = 0.38), or flap failure (
RR
0.84, 95%
CI
= 0.38 to 1.87,
p
-value = 0.67). However, early oral feeding was significantly associated with shorter hospital stays than late oral feeding (
MD
−3.18, 95%
CI
−4.90 to −1.46,
p
-value = 0.0003).
Conclusion
No significant difference exists between early and late oral feeding regarding the risk of postoperative complications in head and neck cancer (HNC) patients who underwent free flap reconstruction surgery. However, early oral feeding is significantly associated with a shorter hospital stay than late oral feeding. Thus, surgeons should consider implementing early oral feeding after free flap reconstruction in HNC patients.
There is a scarcity of studies focusing on irritable bowel syndrome (IBS) and anxiety in Egypt. Accordingly, our study aimed to assess the association between anxiety and IBS symptomatology among ...Egyptian females. Three hundred eighty-three females (145 IBS and 238 controls) were included in the study, and data were obtained using structured predesigned questionnaires. IBS and anxiety symptoms were assessed according to the Rome IV criteria and the Arabic version of the beck anxiety inventory, respectively. Both IBS and non-IBS groups showed increased anxiety during the pandemic, without a significant difference between both groups (P value = .657). Higher levels of education were significantly associated with severe anxiety (P value = .031). Multivariate analysis of IBS patients showed that intermediate education was significantly associated with 75% lower odds for increased IBS symptoms compared with illiterate or read-and-write IBS patients odds ratio (OR): 0.25, 95% confidence interval (CI) 0.06-0.95, P value = .042. Urban residence was significantly associated with 13.5 times greater odds of increased IBS symptoms, compared with rural residence (OR: 13.48, 95% CI 3.55-51.25, P value < .001). Moreover, patients who lost their job during the pandemic were 12.9 times more likely to have increased symptoms (OR: 12.89, 95% CI 1.84-90.15, P value = 0.01). A unit increase in patients age and beck anxiety inventory score was associated with 68% and 75% greater odds for increased IBS symptoms, respectively (OR: 1.68, 95% CI 1.12-2.53, P value = .012; OR: 1.75, 95% CI 1.08-2.84, P value = .024). Increasing anxiety is associated with increased IBS symptoms. Therefore, IBS patients should be screened for anxiety, and the role of psychiatric management of anxiety in the amelioration of IBS symptoms must be explored.
Abstract Purpose Postoperative hypotony following PRESERFLO MicroShunt (PMS) implantation is a frequent cause of complications such as choroidal detachment and hypotony maculopathy. This study aims ...at evaluating the impact of intraluminal stenting of the PMS during the early postoperative period. Methods We retrospectively analyzed the data of 97 patients who underwent PMS implantation with intraoperative placement of a Nylon 10–0 suture as intraluminal stent (PStent) and compared the outcomes to those of an existing database of the traditional MicroShunt implantation technique (PTrad, n = 120). The primary outcome measure was the intraocular pressure (IOP) at one week postoperatively. As a secondary outcome measure, adverse hypotony, defined as an IOP ≤ 5 mmHg with significant choroidal effusion and/or anterior chamber shallowing or the presence of macular folds was also assessed. Additionally, the time to stent removal and the IOP one week after stent removal were reported. Results Preoperative median IOP was 25.0 (20.5–30.3) mmHg in PStent and 25.0 (19.3–32.0) mmHg in PTrad ( p = 0.62). One week after surgery, the median IOP dropped to 10.0 (8.0–13.0) mmHg in PStent and 7.0 (5.0–9.0) in PTrad ( p < 0.01). At one month, the IOP was 12.0 (10.0–14.0) mmHg in PStent and 10.0 (8.0–11.0) mmHg in PTrad ( p < 0.01). After 3 months, both groups showed similar median IOP levels of 11.0 (8.0–13.5) mmHg and 10.0 (9.75–13.0) mmHg in PStent and PTrad, respectively ( p = 0.66). The presence of adverse hypotony was significantly lower in PStent compared to PTrad (6.2% vs 15.8%, p < 0.05). In PStent the stent was removed after 30.0 (21.0–42.5) days. One week after stent removal the mean IOP drop was 6.1 ± 0.5 mmHg ( p < 0.01). Conclusion In the early follow-up period, intraluminal stenting of the PMS appears to be safe and effective in controlling the IOP while reducing early postoperative hypotony. Surgical success is not compromised by stent placement. Based on our data, it is recommended to remove the suture two to six weeks after surgery for most patients with uncomplicated postoperative clinical findings.
Surgery plays a major role in the management of patients with lung cancer. Surgery is not only the main curative treatment modality in patients with early-stage lung cancer but it also has a ...significant role in the initial workup for the diagnosis and staging of lung cancer. This article describes the surgical management of patients with lung cancer. Surgical resection for lung cancer is still regarded as the most effective method for controlling the primary tumor, provided it is resectable for cure and the risks of the procedure are low. The 5-year survival rare following complete resection (R0) of a lung cancer is stage dependent Table 1. 1-3 Incomplete resection (R1, R2) rarely, if ever, cures the patient.
Purpose
To compare two approaches for the implantation of the PRESERFLO microshunt: an anterior approach (A) with a 6–8-mm peritomy and a posterior approach (P) with a 3-mm incision.
Methods
We ...retrospectively analyzed 126 patients who received a PRESERFLO microshunt. We compared intraocular pressure (IOP), surgical time, medication count, and postoperative complications over nine months.
Results
The baseline IOP was similar in A (21.8 ± 8.5 mm Hg) and P (23.9 ± 8.1 mm Hg) (
p
= 0.08). Surgical duration was significantly shorter in P (10 ± 0.4 min) than in A (26 ± 0.8 min) (
p
< 0.001). Postoperative IOP levels were comparable in A (10.8 ± 5.9 mm Hg) and P (10.6 ± 4.5 mm Hg) at 30 days (
p
= 0.62) and throughout the study (all intra-group
p
-values > 0.08). The preoperative medication count was 3.2 ± 1.3 drops in A and 3.3 ± 1.0 drops in P (
p
= 0.4). Postoperative values were 0.2 ± 0.6 in A and 0.3 ± 0.7 in P at nine months. There were no significant differences in complications and surgical revisions between groups (
p
-values > 0.05).
Conclusion
Both techniques achieved satisfactory IOP and medication count reductions and had similar safety profiles, but the posterior incision technique was 2.6 times faster than the anterior incision technique.
Abstract Accurate staging of lung cancer is very critical to determine the proper management approach of each patient and to address prognosis issues. In this manuscript, we will discuss the impact ...of the most recent staging categories (7th TNM staging) on the management of non-small cell lung cancer.
Saudi Arabia faces a burgeoning obesity epidemic, with a significant impact on the prevalence of Type 2 Diabetes Mellitus (T2DM). This comprehensive review examines the effectiveness of bariatric ...surgery as a pivotal treatment option for managing T2DM in the context of Saudi Arabias socioeconomic and health landscape. Our review highlights the profound impact of bariatric surgery procedures on weight loss and T2DM remission rates, demonstrating a significant advantage over conventional medical management. The review also delves into the socio-cultural factors influencing the obesity and T2DM epidemic in Saudi Arabia, the economic burden of these conditions, and the national strategies implemented to combat them. We further discuss the importance of a multidisciplinary approach to treatment, encompassing lifestyle and dietary modifications, psychological support, and post-operative care, to ensure the long-term success of bariatric interventions. Our findings suggest that bariatric surgery offers a viable and effective treatment modality for T2DM management in Saudi Arabia, underscoring the need for patient-specific treatment planning and the importance of comprehensive post-surgical care. Future research directions include evaluating the long-term outcomes of bariatric surgery and optimizing patient selection criteria to enhance treatment efficacy and patient quality of life.
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