2nd Hour Research Articles

The Application Research of FCN Algorithm in Different Severe Convection Short-Time Nowcasting Technology in China, Gansu Province

This study explores the application of the fully convolutional network (FCN) algorithm to the field of meteorology, specifically for the short-term nowcasting of severe convective weather events such as hail, convective wind gust (CG), thunderstorms, and short-term heavy rain (STHR) in Gansu. The training data come from the European Center for Medium-Range Weather Forecasts (ECMWF) and real-time ground observations. The performance of the proposed FCN model, based on 2017 to 2021 training datasets, demonstrated a high prediction accuracy, with an overall error rate of 16.6%. Furthermore, the model exhibited an error rate of 18.6% across both severe and non-severe weather conditions when tested against the 2022 dataset. Operational deployment in 2023 yielded an average critical success index (CSI) of 24.3%, a probability of detection (POD) of 62.6%, and a false alarm ratio (FAR) of 71.2% for these convective events. It is noteworthy that the predicting performance for STHR was particularly effective with the highest POD and CSI, as well as the lowest FAR. CG and hail predictions had comparable CSI and FAR scores, although the POD for CG surpassed that for hail. The FCN model’s optimal performances in terms of hail prediction occurred at the 4th, 8th, and 10th forecast hours, while for CG, the 6th hour was most accurate, and for STHR, the 2nd and 4th hours were most effective. These findings underscore the FCN model’s ideal suitability for short-term forecasting of severe convective weather, presenting extensive prospects for the automation of meteorological operations in the future.

Effect of peritoneal closure versus non closure after open hysterectomy on postoperative pain

Background: Hysterectomy is one of the widely performed gynecological surgeries. During closure of the abdomen, parietal peritoneum could be closed or not .Whether the parietal peritoneum should be closed at hysterectomy or not is an argumental topic. Aim: To assess the level of postoperative pain in women undergoing hysterectomy with closure of peritoneum versus non- closure of peritoneum. Patients and methods: A prospective observational study was conducted on women undergoing abdominal hysterectomy. Results: There was a statistically significant difference between the closures and non- closure groups during hysterectomy regarding VAS after 2 hours, 3 hours and 6 hours, 12 hours and 24 hours with p value > 0.001. Conclusion: Non closure of the peritoneum during abdominal hysterectomy was associated with less operative time and less pain during the 2nd, 3rd, 6th, 12th and 24th hours after hysterectomy.

Postoperative Pain in the General Surgery Department of Fousseyni Daou Hospital in Kayes

Goal: To study the management of postoperative pain in the general surgery department of the Fousseyni DAOU hospital in Kayes. Patients and Method: We conducted a prospective 6-month study from November 2022 to May 2023, involving 107 surgical patients, aged 15 to 81 years, who met the inclusion criteria. We assessed pain using the Visual Analogue Scale (VAS) at patient admission, at the second hour, and then every eight hours until seventy- second hours after analgesic use. Multimodal analgesia was the most widely used in the study. Administration of paracetamol alone and/or in combination with nefopam and/or ketoprofen and/or morphine. The evolution of pain as well as adverse effects after administration of analgesics were investigated. Results: The mean age of our patients was 35.9 years with extremes of 15 and 81 years. Male sex was the most represented at 64.5% with a sex ratio of 1.82 and the majority of patients were classified as ASA 1 (82.2%). VAS less than 3 (VAS≤ 4) was most observed during the first 2 hours postoperatively, i.e. 41.1% for VAS 0-2 and 28.9% VAS 3-4 at rest, respectively, and respectively 33.6% and 30.8% for no pain and mild pain. At 24 hours postoperatively, 87.2% of patients did not feel pain after the resting assessment, this figure increased from 89.8% at the 48th postoperative hour at rest, still after the use of analgesics. At the 72nd hour, we observed cases of pain, i.e. 0.9% of patients, which was related to a postoperative complication. The average cost of pain management was estimated at 23580 FCFA. Side effects observed were vomiting in 3 patients and drowsiness in one patient. Conclusion: Postoperative pain is still understudied, the evaluation with the visual analogue scale of patients before and after the use of analgesics has allowed us to better understand patients' pain and to improve pain management in the surgical department.

Efficacy of transcranial direct current stimulation for improving postoperative quality of recovery in elderly patients undergoing lower limb major arthroplasty: a randomized controlled substudy.

Previous studies have demonstrated improvements in motor, behavioral, and emotional areas following transcranial direct current stimulation (tDCS), but no published studies have reported the efficacy of tDCS on postoperative recovery quality in patients undergoing lower limb major arthroplasty. We hypothesized that tDCS might improve postoperative recovery quality in elderly patients undergoing lower limb major arthroplasty. Ninety-six patients (≥65 years) undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) were randomized to receive 2 mA tDCS for 20 min active-tDCS or sham-tDCS. The primary outcome was the 15-item quality of recovery (QoR-15) score on postoperative day one (Т2). Secondary outcomes included the QoR-15 scores at the 2nd hour (T1), the 1st month (Т3), and the 3rd month (Т4) postoperatively, numeric rating scale scores, and fatigue severity scale scores. Ninety-six elderly patients (mean age, 71 years; 68.7% woman) were analyzed. Higher QoR-15 scores were found in the active-tDCS group at T2 (123.0 [114.3, 127.0] vs. 109.0 [99.3, 115.3]; median difference, 13.0; 95% CI, 8.0 to 17.0; p < 0.001). QoR-15 scores in the active-tDCS group were higher at T1 (p < 0.001), T3 (p = 0.001), and T4 (p = 0.001). The pain scores in the active-tDCS group were lower (p < 0.001 at motion; p < 0.001 at rest). The fatigue degree scores were lower in the active-tDCS group at T1 and T2 (p < 0.001 for each). tDCS may help improve the quality of early recovery in elderly patients undergoing lower limb major arthroplasty. The trial was registered at the China Clinical Trial Center (ChiCTR2200057777, https://www.chictr.org.cn/showproj.html?proj=162744).

The Effect of Additional Tomato Extract in Diluting Sodium Citrate and Egg Yellow in Kampung Chicken on The Quality of Semen Cow Limousine

Undiluted sperm will reduce fertility, therefore dilution is performed to maintain the quality of spermatozoa during storage. Tomatoes contain carbohydrates, vitamin A, vitamin C, protein, and lycopene as antioxidants. Carbohydrates and antioxidants act as a source of energy to potentially prevent free radicals that can damage cells. This study aims to determine the effect of adding tomato juice in sodium citrate diluent and free-range chicken egg yolks to the semen quality of limousin cattle. This study used a completely randomized design (CRD) with 4 treatments and 5 replications. The treatment consisted of a solution of sodium citrate and egg yolk (P0), sodium citrate and egg yolk + 10% tomato extract (P1), sodium citrate and egg yolk + 20% tomato extract (P2), and egg yolk sodium citrate + 30% tomato extract. % (P3). Parameters observed were motility, viability and abnormalities of semen spermatozoa of Limousin cattle. Observations were made at 0, 24, 48, and 72 hours after cooling. The results showed that the addition of 10% tomato extract (P1) had a significant effect on the highest percentage of motility, namely 42.00 ± 2.73c for the 48th hour, the highest viability 62.10 ± 4.51c for the 72nd hour, and lowest abnormality 16.60 ± 1.81a until the 72nd hour. The addition of 10% tomato extract (P1) in sodium citrate diluent and egg yolk resulted in the best motility, viability, and abnormality percentage of Limousin cattle spermatozoa.

NANOPARTICLE PREPARATION OF SIAM CITRUS PEEL EXTRACT (CITRUS NOBILIS L. VAR. MICROCARPA) USING SHORT-CHAIN CHITOSAN AND TRIPOLYPHOSPHATE AS CROSS LINKER AND CELLULAR UPTAKE STUDY ON MCF-7 CELL LINE BY IN VITRO

Objective: High consumption of oranges causes a lot of orange peel waste. Orange peel contains the compound naringenin, which has a cytotoxic effect on various cancer cells. This research aims to develop a preparation of Siamese orange peel extract nanoparticles with short-chain chitosan and tripolyphosphate carriers as an oral drug delivery system and determine its cytotoxic activity against the Michigan Cancer Foundation-7 (MCF-7) cell line. Methods: This research uses the micro tetrazolium (MTT) method to see the cytotoxic activity extract of methanol obtained from maceration extraction. The extract was then formulated into nanoparticles using chitosan and tripolyphosphate. Characterization and evaluation of nanoparticles were carried out, including particle size, zeta potential, entrapment efficiency, and stability in the stomach using 0.1 N HCl and in the intestine using Artificial Intestinal Fluid (AIF) in vitro. This research was also conducted to assess the ability of nanoparticles to enter MCF-7 cells (cellular uptake). Results: Nanoparticles were successfully developed from Siamese orange peel extract. The results of the day 0 nanoparticle characterization were spherical, with average particle size 284.3 nm, zeta potential 0.713 mV, entrapment efficiency 96.73%, and stability in 0.1 N HCl at the 0th hours, respectively. 1st, 2nd, and 3rd. 99.16%, 98.70%, 98.47%, 98.31%, stability on AIF at hours 0, 1, 2, 3 and 4 respectively 99.52%, 99.30%, 99.40%, 98.99%, 99.29%. Characterization of nanoparticles on day 25 showed that the average particle size was 196.2 nm, zeta potential 0.476 mV, entrapment efficiency 96.92%, stability in 0.1 N HCl at 0, 1, 2 and 3 h respectively 99.51%, 98.67%, 98.51%, 98.27%, stability in AIF at 0th, 1st, 2nd, 3rd, and 4th hours 99.24 respectively %, 98.76%, 98.46%, 97.93%, 97.58%. Cytotoxic activity of extract Siamese citrus peel against MCF-7 cells with IC50 of 290.58 µg/ml. The result shows that cellular uptake of Siamese citrus peel nanoparticles can penetrate MCF-7 cells. Conclusion: Stable nanoparticles were successfully developed from Siamese orange peel extract, and their stability was maintained throughout a 30-day storage period. This extract displayed cytotoxic effects and showcased the ability for cellular uptake in MCF-7 cell cultures in vitro.

Efficacy of memantine premedication in alleviating postoperative pain- A systematic review and meta-analysis.

Many premedication agents with opioid-sparing properties have been used in patients undergoing various elective surgeries. Memantine is an N-methyl-D-aspartate (NMDA) receptor antagonist that has been used by many researchers as an opioid-sparing strategy. Various databases like PubMed, Scopus, Cochrane Library, and clinicaltrials.gov were searched after registering the review protocol in PROSPERO for randomized-controlled trials (RCTs) that investigated the efficacy and safety of memantine premedication in adult patients undergoing various elective surgeries. The risk of bias (RoB-2) scale was used to assess the quality of evidence. From the 225 articles that were identified after a database search, 3 studies were included for a qualitative systematic review and a quantitative meta-analysis. The pooled analysis revealed that the use of memantine provided better pain scores at 2nd (mean difference: -0.82, 95% CI: -1.60, -0.05, P = 0.04) with significant heterogeneity (P = 0.06; I² =71%), and 6 hours postoperatively (mean difference: -1.80, 95% CI: -2.23, -1.37, P < 0.00001), but not at 1 hour. The sedation scores at 1 hour were higher in the memantine group but comparable in the 2nd hour. The number of doses of rescue analgesia and nausea/vomiting in the postoperative period was comparable in both groups. The results of this review suggest that memantine premedication could provide better pain scores in the immediate postoperative period with acceptable adverse effects. However, the current evidence is insufficient to suggest the routine use of memantine as a premedication before elective surgeries.

Early Prediction of Bloodstream Infection with Complete Blood Count Parameters: an Ex-Vivo Human Whole Blood Model.

Despite the advanced laboratory technologies available today, blood culture is the gold standard method in the diagnosis of bloodstream infections. Automated blood culture devices give blood culture results for laboratories approximately in 2 - 3 days up to 7 days. Moreover, some microorganisms like nonreproducible bacteria, fungi or viruses cannot be produced in culture. Among all samples taken for blood culture on suspicion of infection approximately 10% are determined as positive whereas the false positive rate due to contamination is 5%. Especially in life-threatening severe conditions such as sepsis early diagnosis and prompt treatment are crucial. Based on this the aim of this study is to investigate complete blood count parameters as potential early markers in Escherichia coli, Staphylococcus aureus and Candida albicans bloodstream infections using an ex vivo whole blood model. Blood samples collected from healthy donors (n = 10) were treated with suspensions containing a certain concentration of microorganisms (107 CFU/mL for both E. coli ATCC 25922 and S. aureus ATCC 29213, 106 CFU/mL for C. albicans ATCC 14053). After bacteremia and candidemia were induced, complete blood count parameters were analyzed hourly in the samples until the end of the 4th hour with a Mindray BC-6800 hematology analyzer. Statistical analysis was performed by Tukey-Kramer post-hoc multiple comparison test and statistical significance was accepted as p < 0.05. When platelet derived parameter baseline values were compared to hourly values in E. coli and S. aureus induced whole blood samples, it was found that the decrease in PLT, P-LCC and the increase in IPF% was significant from the first hour whereas the increase in IMG% was found to be significant only from the 3rd hour onward. In the experiments with C. albicans, it was observed that the increase in IPF% and IMG% was significant from the 2nd and 3rd hour onward, respectively. There was no relationship between MPV, P-LCR, and NLR baseline and hourly results in any microorganism induced model. IPF% can guide clinicians in the early diagnosis and management of treatment of infections caused by S. aureus, E. coli, and C. albicans.

Pre-emptive analgesia with preoperative oral gabapentin and pregabalin in lumbar narrow canal surgery

The success of pre-emption depends on the strategy pertaining to the choice of agent and when and how, to use. This study was aimed to evaluate the efficacy of pre-emptive analgesia regarding the postoperative pain management in lumbar spinal stenosis surgery. The oral gabapentin 800 mg or pregabalin 225 mg or placebo were administered 1 h before surgery. The pain and sedation scores were measured through Visual Analogue Scale (VAS) and Ramsay Sedation Scale (RSS). Three groups of 30 patients each were included in the study. Group 1 was administered with gabapentin 800 mg, Group 2 with pregabalin 225 mg, and Group 3 with placebo 1 hour before the surgery. VAS scores at the 1st, 2nd, 4th, 6th, 8th, 10th, 12th, 14th, 16th, 18th, 20th, 22nd and 24th hours of surgery, and RSS scores and analgesic drug usage in the 1st to 24 hours of surgery were recorded. There were statistically significant differences between the 1st, 2nd and 4th hour VAS score averages. RSS scores changed among the three groups in postoperative period. The total analgesics employed in gabapentin and pregabalin groups were lower than those in placebo group. Pre-emptive analgesia of oral pregabalin or gabapentin minimized the postoperative pain in patients undergoing lumbar stenosis surgery.

The Effects of Early Mobilization on Pain and Quality of Recovery in Patients Undergoing Laparoscopic Cholecystectomy Surgery:

Objective: This study was conducted to determine the effects of early mobilization on pain and quality of recovery in patients undergoing laparoscopic cholecystectomy.&#x0D; Materials and methods: Pretest-posttest experimental design with control group. This study was carried out at the General Surgery Inpatient Clinic of a state hospital between April 2021 and January 2022. A total of 90 patients were included in the study. Starting with two hours after surgery, the patients in the experimental group were mobilized at least 6 times in 24 hours. A “Patient Description Form”, the “Visual Analog Scale for Pain”, and the “Quality of Recovery-40 Questionnaire” were used to collect data. &#x0D; Results: The introductory and medical characteristics of the patients in the intervention and control groups were similar. There was no significant difference between the pain and recovery quality mean scores of the patients in the two groups at the 2nd postoperative hour. The mean pain scores of the patients in the intervention group at the 24th hour and on the 15th day after surgery were found to be significantly lower than the scores of those in the control group. It was found that the mean recovery quality scores of the patients in the intervention group at the 24th hour and on the 15th day after surgery were also higher than those of the patients in the control group.&#x0D; Conclusions: It was determined that early mobilization reduced the level of pain and increased the quality of recovery in laparoscopic cholecystectomy patients.

PREEMPTIVE INTRAVENOUS IBUPROFEN AND LOCAL KETAMINE IMPROVE POSTOPERATIVE ANALGESIA FOLLOWING THIRD MOLAR SURGERY: A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED CLINICAL STUDY

ObjectiveTo compare the efficacy of preemptive ibuprofen, local ketamine, and their combination in managing postoperative pain and trismus following third molar surgery. Materials and MethodsOne hundred patients were randomly divided into four groups. The Intrafen Group had their impacted third molars surgically removed under local anesthesia after receiving intravenous (IV) ibuprofen for preemptive effect. The Ketamine Group received an IV placebo before the surgery, and the extraction process was completed with a local anesthetic-ketamine combination. The Combined Group received preemptive IV ibuprofen before the procedure, and the surgery was performed with a local anesthetic-ketamine combination. The Control Group received an IV placebo before the procedure and then had their impacted third molars removed under local anesthesia. The Visual Analogue Scale (VAS) values, corresponding to the patients' pain levels at the 2nd and 12th postoperative hours and the total amount of analgesic dose used in the first 24 hours, were recorded, and evaluated. The maximum mouth opening of the patients was measured immediately before the procedure, and on the second and seventh postoperative days. The level of patient satisfaction in all groups was assessed during the procedure. ResultsThe mean VAS value corresponding to the 2nd-hour pain level of the combined group was statistically significantly lower than the other groups (p=0.003). A statistically significant difference was found in the mean VAS values corresponding to the pain levels of the groups, favoring the combined group compared to the other groups (p≤ 0.001). A significant difference was observed between the VAS difference values corresponding to the pain levels of the Intrafen group and the Ketamine group, favoring the Intrafen group (p=0.038). The Ketamine group consumed the most analgesic on average over the first 24 hours, whereas the Combined group consumed the least. No statistically significant difference was found between the mean trismus levels of the groups on days 0–2 (p=0.528) and days 0–7 (p=0.129). The intraoperative patient satisfaction level of the combined group was significantly higher than that of the other groups (p=0.030). ConclusionPreemptive Intrafen is an effective regimen for postoperative pain management and is superior to the local anesthetic-ketamine regimen. The most effective method to reduce postoperative pain following third molar surgery is to use a combination of these two regimens. However, none of the treatment methods used in the study had a positive effect on postoperative trismus.

Perbandingan jumlah total bakteri, kadar lemak, dan protein susu segar pada penyimpanan suhu rendah (4 – 6° C) dan suhu ruang

The method and duration of storage are crucial factors determining quality of fresh milk, as assessed by total bacterial, fat content, and protein content of fresh milk. This research aims to determine the comparison of the total bacterial count, fat content, and protein content of fresh milk stored at a low temperature and at room temperature. The research subjects used were fresh milk obtained from a single cow in a single milking process, stored at a low temperature of 4 – 6 ℃ and at room temperature, and then tested and compared for the total bacterial count, fat content, and protein content after storage for the 2nd, 4th, and 6th hours. The data obtained was statistically analyzed using the student’s t-test at a confidence level of α = 95%. The result showed that there a significant difference (p&lt;0,05) in total bacterial and fat content. Within 6 hours, at a low temperature, total bacterial increased from the initial 3,07 × 105 cfu/ml to 5,95 × 105 cfu/ml, while at room temperature, it rose to 21.02 × 105 cfu/ml. The initial fat content was 4,14%, and after 6 hours of storage, at a low temperature, fat content decreased to 3,35%, whereas at room temperature, it dropped below the SNI standard of 3 to 2,91%. As for the protein content of the milk, both at low and room temperatures, the protein did not decrease and did not show a significant difference (p&lt;0,05). It can be concluded that up to two hours of storage, the quality of milk is not affected by temperature. However, after being stored for more than two hours, the storage temperature does impact the total bacterial count and the fat content of the milk.

To Compare the Effects of Post-tonsillectomy Intra-operative Infiltration of Ropivacaine Versus Bupivacaine in Tonsillar Fossa.

Tonsillectomy is one of the most common surgical procedures practiced in Otorhinolaryngology. A significant obstacle for the speedy and smooth recovery is early post- operative pain. Pain leads to negative outcomes such as poor intake, tachycardia, anxiety, delayed wound healing and insomnia. Aim to assess and compare the effect of post-incisional infiltration of 0.75% Ropivacaine v/s 0.5% Bupivacaine on post tonsillectomy pain, the on start of oral intake and stay in hospital and to investigate any complications that can arise due to infiltration of the said drugs. 60 Patients above the age of 5years were posted for tonsillectomy or adenotonsillectomy under general anesthesia. Patients were blinded about the group in which they will be enrolled. Group A received Inj. ropivacaine (0.75%) 2ml and Group B: received Inj. Bupivacaine (0.50%) 2ml in each fossa. After surgery, no analgesics were given & patients were observed for the intensity of post-operative pain in the immediate post-operative period, at 2, 4, 6, 12, 24, 48h and further if not discharged using VISUAL ANALOGUE SCORE (VAS) and VERBAL RATING SCALE(VRS). Post-operative pain assessment was done using VAS and VRS at 2nd, 4th, 6th, 12th, 24th and 48th hour which was found to be lower in Group 'A'. Patients in Group 'A' also started their oral intake sooner, had lesser hospitalization days than group 'B' patients. Longer time for Rescue analgesic and reduced total dose of analgesic required was seen in Group A compared to Group B. This comparative study on Post-incisional infiltration of 2ml 0.75% Ropivacaine v/s 2ml 0.5% Bupivacaine has shown that Ropivacaine is a more effective drug in reducing post-operative pain in comparison to Bupivacaine, proven statistically.

Efficacy of intravenous magnesium sulfate infusion on postoperative pain and quality of recovery for septorhinoplasty: a randomized controlled study

Background The pain that occurs after septorhinoplasty is an important factor affecting the comfort of the patient. Objectives To investigate the effect of perioperative intravenous magnesium sulfate infusion on postoperative pain and quality of recovery in patients underwent septorhinoplasty surgery. Material and methods One hundred twenty patients who underwent septorhinoplasty were randomly divided into two groups. Magnesium group received intravenous magnesium after induction of anesthesia (30 mg/kg), then infused until the end of the surgical procedure (9 mg/kg). The placebo group received the same volume of saline infusion. The VAS score was used for postoperative pain assessment, and the Quality of Recovery-40 (QoR-40) score was used for the assessment of recovery status. Results The postoperative 30 min, 1st, 2nd, 4th (p < .001) and 24th hour (p < .05) VAS scores of the patients in the magnesium infusion group were significantly lower compared to the placebo group. Also; in terms of physical comfort (p < .001), emotional state (p < .05), psychological support, pain and total score values (p < .001), patients in magnesium group had significantly higher QoR-40 scores than those in placebo group. Conclusion Intraoperative magnesium infusion, which is widely used in many surgeries to provide controlled hypotension, also contributes significantly to patient comfort with its positive effect on postoperative pain and recovery scores.

Comparison of Pain Levels on Patients Undergoing Fixed Orthodontic Treatment with 2 Different Self-Ligating Bracket Systems.

Comparison of pain levels of patients treated with 2 different passive self-ligating bracket systems right after initial archwire placement. A total of 34 patients with mild crowding were allocated randomly to 2 groups to be treated using 2 different self-ligating brackets. 0.014 inch copper nitinol and 0.014 inch superelastic nitinol archwires were selected as the initial archwire for Damon Q and SmartClip SL3 systems respectively. Seven page questionnaires that consisted of 3 visual analogue scales were handled to patients to mark their pain levels while chewing, biting with anterior teeth, and biting with posterior teeth at 2nd hour, 6th hour, 2nd day, 3rd day, and 7th day time intervals. Pain scores were measured manually using a ruler and noted. The SmartClip group reported less pain at the 2nd and the 6th hours while chewing. Pain levels were the highest at the 6th h and the 2nd day for the Damon Q and SmartClip SL3 groups respectively. The SmartClip group reported more pain for the first two days, and after the 2nd day, pain scores were very similar to the Damon group. No statistically significant differences were reported between the groups. The highest pain sensation was reported for the 2nd day and decreased toward the 7th day. The SmartClip SL3 group reported lower pain scores in the first two days, but the levels were equaled on the 2nd day and after.

Citrate-coated silver nanoparticles loaded with agomelatine provide neuronal therapy in acute cerebral ischemia/reperfusion of rats by inhibiting the oxidative stress, endoplasmic reticulum stress, and P2X7 receptor-mediated inflammasome.

Cerebral ischemia and reperfusion are related to various situations like injuries after various traumas, oxidative stress, increased calcium ion, capillary hypoperfusion, microvascular hyperpermeability, leukocyte infiltration, and blood-brain barrier disruption. An antidepressant Agomelatine which is a melatonin receptor (MT1/MT2) agonist and serotonin receptor (5-HT2C) antagonist has been reported by studies to have antioxidant and anti-inflammatory effects. In our study, we aimed to detect the effects of citrate-coated silver nanoparticle-loaded agomelatine application on neurodegeneration, endoplasmic reticulum stress, autophagic and apoptotic cell death, inflammation, and P2X7R expression in the cerebral ischemia-reperfusion model to facilitate the passage of blood-brain barrier. Forty two Sprague-Dawley rats in total were divided into six equal groups (n:7) and applications were performed. Acute cerebral injury in the ischemia-reperfusion model was created 2 h after internal carotid artery ligation in rats and then at the 2nd hour of reperfusion citrate-coated silver nanoparticles loaded with Agomelatine were applied. Twenty four hours later, neurologic analysis on animals in experimental groups was performed, animals were decapitated and GSH, GPx, SOD, CAT, MDA, IL-1β, and TNF-α parameters were examined after taking blood and the cerebral tissue samples. As a result, it was determined that ischemia-reperfusion caused endoplasmic reticulum stress in the cerebral tissues and thus caused cellular injury.

Comparison of transoral endoscopic thyroidectomy vestibular approach and open conventional thyroidectomy regardıng inflammatory responses, pain, and patient satisfaction: a prospective study.

The application of transoral endoscopic thyroidectomy vestibular approach (TOETVA) is becoming widespread throughout the world. We primarily aimed to evaluate the severity of surgical trauma in TOETVA and conventional open thyroidectomy (COT) regarding the inflammatory response including the comparison of surgical stress markers [interleukin-6 (IL-6), C-reactive protein (CRP), white blood cell (WBC)]. This non-randomized prospective study enrolled two groups with 20 patients each: COT group and TOETVA group. Patients aged 18-65 years with benign thyroid disease; with fine needle aspiration biopsy results of Bethesda III, IV or Bethesda V, VI (<1 cm nodule); thyroid volume <50 cm3; nodule diameter <4 cm; female gender without a previous neck, chin, and/or oral surgery; without vocal cord paralysis preoperatively; and patients in euthyroid state were enrolled to the study. Preoperative, postoperative second hour, first day, and second day CRP, WBC, and IL-6 levels were evaluated. Pain intensity was evaluated with the visual analog scale (VAS) score on the 2nd and 12th hour, 1st and 2nd days postoperatively. All the patients were female and mean age was significantly higher in the COT group. The operative time was significantly longer in the TOETVA group. No significant difference was found between the two groups regarding IL-6 levels. In the TOETVA group, postoperative second hour WBC value (p = 0.044) and first (p = 0.002) and second day (p = 0.005) CRP values were significantly higher. In the TOETVA group, the lower lip and lower chin VAS scores were significantly higher at 2nd and 12th hour, on the first and second days. The anterior neck VAS score was significantly higher in the TOETVA group at the second hour (p = 0.025). General and cosmetic satisfactions were similar at the 15th and 30th days in both groups. The longer operative time and higher postoperative CRP level and VAS score in the chin and lower lip in the TOETVA group suggested that the method is not a minimally invasive technique compared to COT. However, the presence of similar total complication rates and early postoperative general and esthetic satisfaction that improves over time in both groups suggests that the clinical effect of increased magnitude of systemic inflammatory response in TOETVA might be temporary and acceptable.

Congenital hyperinsulinism and surgical outcome in a single tertiary center in Brazil

ObjectiveCongenital hyperinsulinism (CHI) is a heterogeneous genetic disease characterized by increased insulin secretion and causes persistent hypoglycemia in neonates and infants due to dysregulation of insulin secretion by pancreatic β cells. Babies with severe hypoglycemia and for whom medical treatment has been ineffective usually require surgical treatment with near-total pancreatectomy. To evaluate the clinical and surgical aspects affecting survival outcomes in babies diagnosed with CHI in a single tertiary care center. MethodsRetrospective Cohort study involving a single university tertiary center for the treatment of CHI. The authors study the demographics, clinical, laboratory, and surgical outcomes of this casuistic. Results61 % were female, 39 % male, Birth weight: 3576 g (±313); Age of onset of symptoms: from the 2nd hour of life to 28 days; Time between diagnosis and surgery ranged between 10 and 60 days; Medical clinical treatment, all patients received glucose solution with a continuous glucose infusion and diazoxide. 81 % of the patients used corticosteroids, 77 %. thiazide, 72 % octreotide, 27 % nifedipine; Neurological sequelae during development and growth: 54 % had some degree of delay in neuropsychomotor development, 27 % obesity. Surgery was performed open in 6 and 12 minimally invasive surgery (MIS). Histopathology: 2 focal and 16 diffuse, Length of stay (days) was lower in MIS (p < 0.05). Survival was 100 %. ConclusionsCHI is a rare and difficult-to-manage tumor that must be performed in a multidisciplinary and tertiary center. Most surgical results are good and the laparoscopic approach to disease has been the best choice for patients.

SAT160 Alcoholic Ketoacidosis : An Endocrine Emergency

Abstract Disclosure: L.E. Tiu: None. T.D. Crisostomo: None. Background: Alcoholic Ketoacidosis is a complex metabolic condition frequently confused with Diabetic Ketoacidosis. Currently, there remains an undefined consensus guideline in the diagnosis and management of this disorder that leads to unreported cases. Clinical Case: A 47-year-old male presented with 2-day history of poor dietary intake due to abdominal pain and vomiting after an alcoholic binge drinking. He is a chronic alcoholic beverage drinker (2 liters of beer per day for 10 years). He has family history of Type 2 Diabetes Mellitus but has no known co-morbidities. Upon admission, vital signs were normal, but he was drowsy and incoherent with signs of dehydration and epigastric tenderness. Initial capillary blood glucose was 52 mg/dL. D50W 50ml intravenously was given with repeat CBG of 222 mg/dL. Arterial blood gas (ABG) showed high anion gap metabolic acidosis (pH 7.0 and anion gap of 42) with undetectable bicarbonate and elevated lactate at 17mmol/L. Serum ketones were elevated at 6mmol/L but Hba1c was normal at 4.6 %. Thus, Alcoholic Ketoacidosis was highly considered. Intravenous hydration with saline solution was instituted then shifted to D10W 125mL/hour to allow insulin infusion therapy at initial rate of 2units/hour. Sodium bicarbonate 100 mEqs was given intravenously with recovery of sensorium thereafter. Oral Vitamin B supplement was started, and two doses of Thiamine 100 mg/IV were given. Other tests showed hyperkalemia (5.28meq/L), hypochloridemia (89.7meq/L), hyperuricemia (12.74mg/dL), and hyperphosphatemia (5.8mg/dL). Serial monitoring and correction of electrolytes were done. Moreover, management integrated simultaneous referrals to other subspecialties to rule out other causes of encephalopathy, to evaluate and manage Hypertriglyceridemic Pancreatitis and Alcoholic Liver Disease, and to facilitate nutritional, psychosocial support and rehabilitation. On 2nd hour, repeat ABG showed improvement of pH to 7.3 and HCO3 to 9.80mmol/L. Lactate decreased to 12.70mmol/L. On the 17th hour, ABG showed metabolic alkalosis with resolution of ketosis hence insulin was discontinued. CBG levels for the next 24-48 hours were within normal limits. Oral feeding was supplemented with parenteral nutrition due to decreased appetite. On 48th hour, he displayed combative behavior with visual hallucinations, but there was no consent for psychiatric referral. On 72nd hour, there was spontaneous marked improvement in his behavior. He was discharged clinically stable. Conclusion: Early recognition of Alcoholic Ketoacidosis is imperative. This is an unrecognized endocrine emergency that portends good outcome with timely diagnosis and management. Treatment includes 1. adequate fluid resuscitation 2. thiamine 3. judicious use of insulin and bicarbonate 4. correction of electrolytes 5. multidisciplinary team management. Presentation: Saturday, June 17, 2023

The Relationship Between the Presence of Distal Collateral Lymphatic Flows and Obesity in Patients with Bilateral Lower Extremity Edema

Objective: This study aimed to comprehensively assess radionuclide imaging findings to aid in the clinical diagnosis of early-stage lower extremity lymphedema. Methods: Our retrospective study included 135 patients who underwent lymphoscintigraphy for bilateral lower extremity edema (BLEE) between 2017 and 2022. Of these patients, 117 (86.7%) were female. Lymphoscintigraphic images were acquired at the 10th, 40th, and 2nd hours post-injection of radiopharmaceuticals. Bilateral lower extremity lymphatic congestion (MLC) was observed in the 2nd-hour images of radionuclide imaging (RI), with an associated accumulation of activity in the inguinal lymph nodes. All patients presented with lower extremity edema. Results: Among our patients, 55 (40.7%) were classified as obese. Bilateral distal collateral flows (BDCF) were identified in 60 (44.4%) of our patients, all of whom were female. Within this group, 13 (21.7%) were obese, and 11 (18.3%) exhibited distal and direct muscle lymphatic congestion (DDMLC). DDMLC was present in 63 (46.7%) patients. Unilateral distal collateral flow (UDCF) was detected in 75 (55.6%) of the patients with BLEE, with 67 (89.3%) of them being obese. Obese patients exhibited a significantly higher prevalence of both UDCF and DDMLC (p: 0.0005). Detailed results can be found in Table 1-4 and Figures 3 and 4. Conclusion: Functional bilateral radionuclide imaging methods provide valuable data for physicians, enabling bilateral and comparative assessments. However, particular attention should be paid to the interpretation of asymmetric images, especially in specific patient groups.