BMI Scores Research Articles

Efficacy and Safety of Setmelanotide, a Melanocortin-4 Receptor Agonist, for Obese Patients: A Systematic Review and Meta-Analysis.

A malfunction in the melanocortin-4 receptor (MC4R) is associated with obesity in rare genetic syndromes; setmelanotide is a new drug that activates this receptor and is being used to treat severe obesity. This meta-analysis evaluated the efficacy and safety of setmelanotide for weight loss in severe obesity linked to human MC4R deficiency. We searched PubMed, Embase, and Cochrane for randomized and nonrandomized clinical trials using setmelanotide. We considered a p-value ≤ 0.05 statistically significant. We included 376 patients, of whom 328 (87.2%) received setmelanotide for a mean follow-up of 52 weeks. The mean age was 32.8 (14.67) years. Weight loss was significant (MD -3.52; 95% CI -3.98, -3.05; p = 0.01; I2 = 92%), with an average proportion of -6.91% weight loss during treatment. Changes in BMI showed an MD of -10.55 kg/m2 in patients > 18 years and -0.61 kg/m2 in patients < 18 years (BMI score). However, the drug was associated with a higher risk of skin hyperpigmentation (OR 0.69; 95% CI 0.55, 0.80; p = 0.08). Our results support the use of setmelanotide in treating severe obesity.

Association of SGLT-2 inhibitors with bacterial urinary tract infection in type 2 diabetes

ObjectiveWe aimed to investigate the factors associated with UTI in patients with T2D whether being treated with SGLT-2i or not.MethodsAdult patients with T2D, whose urine culture results were available, were analyzed retrospectively. Urine culture was obtained from mid-flow urine. Antibacterial treatment was given to the patients with UTI, which was defined by positive urine cultures and/or clinical findings. We grouped the patients as follows: Group A, those treated with SGLT-2i; and Group B, those not treated with SGLT-2i.ResultsA total of 101 patients were included. Median age was 56 (45–67), 56.4% (n = 57) of the patients were female. Urine culture was positive in 54.9% (n = 28) and 16% (n = 8) of Group A (n = 51) and Group B (n = 50), respectively. Of those for whom urine culture was positive, Escherichia coli was isolated in 83.3% (n = 30), and both Escherichia coli and Klebsiella pneumoniae (K.pneumoniae) were isolated in 16.7% (n = 6). Klebsiella pneumoniae was isolated only from Group A. The need for and duration of hospitalization were higher in Group A (p < 0.001). UTI was detected in 60 patients. ROC analysis showed that a HbA1c of > 5.8% was associated with UTI with good accuracy (AUC: 0.835, p < 0.001). In multiple logistic regression analysis, SGLT-2i use and glucosuria were positive predictors for UTI (p = 0.004, Odds Ratio: 1984.013; and p = 0.028, and Odds Ratio: 12.480, respectively).ConclusionBesides the association of HbA1c and BMI with UTI, SGLT-2i use and glucosuria predicted UTI. Urine culture is important with respect to the choice of antibacterial treatment, especially in those patients under SGLT-2i treatment. The effect of SGLT-2i on the development of UTI is independent of baseline BMI score or HbA1c.

Combined associations of a healthy lifestyle and body mass index with colorectal cancer recurrence and survival: a cohort study

PurposeColorectal cancer (CRC) risk is associated with modifiable lifestyle factors including smoking, physical inactivity, Western diet, and excess body weight. The impact of lifestyle factors on survival is less known. A cohort study was conducted to investigate the combined effects of a healthy lifestyle and body mass index on prognosis following CRC diagnosis.MethodsTreatment and follow-up data were collected from the patient files of 1098 participants from the Colorectal cancer low-risk study cohort including stage I-III CRC patients. A healthy lifestyle and BMI (HL) score was computed using self-reported data on smoking status, physical activity, adherence to a Mediterranean diet pattern, and BMI, and divided into four categories ranging from least to most healthy. Survival analyses were performed to assess recurrence-free survival and overall survival across categories of exposure, using the Kaplan–Meier method and Cox proportional hazards models adjusted for age, sex, and educational level.ResultsAmong 1098 participants with stage I-III CRC, 233 (21.2%) had an HL score of 0–1 (least healthy), 354 (32.2%) HL score of 2, 357 (32.5%) HL score of 3 and 154 (14.0) HL score 4 (most healthy). Patients with the healthiest lifestyle (HL score 4) compared to the least healthy (HL score 0–1) had an improved recurrence-free survival (HL 4 vs HL 0–1, HRadj 0.51 (95% CI 0.31–0.83) and overall survival (HL 4 vs HL 0–1, HRadj 0.52 (95% CI 0.38–0.70).ConclusionAdherence to a healthy lifestyle may increase the recurrence-free and overall survival of patients with stage I–III CRC.

Correlation Between Systemic Immune-Inflammation Index and Suicide Attempts in Children and Adolescents with First-Episode, Drug-Naïve Major Depressive Disorder During the COVID-19 Pandemic.

This study aims to investigate the association between the systemic immune-inflammatory index (SII) and suicide attempt (SA) in children and adolescents with first-episode, drug-naïve Major Depressive Disorder (MDD) during the COVID-19 pandemic. A retrospective study was conducted on 263 MDD patients hospitalized at the Third Hospital of Fuyang City between 2020 and 2022. Patients were categorized into two groups based on the presence of previous SA. The study compared the differences in SII and clinical characteristics between the two groups and used the receiver operating characteristic (ROC) curve to determine the optimal critical value of SII and the area under the curve. Binary logistic regression was used to analyze the independent risk factors for SA. Compared with the patients without SA history, the patients with a personal history of SA had a higher mean HDRS scores (Z=-2.369, p=0.018), higher mean neutrophil count (Z=-2.870, p=0.004), higher mean platelet count (Z=-2.155, p=0.031), and higher mean SII (Z=-3.170, p=0.002). The optimal critical SII determined by the ROC curve was 548.15 (sensitivity = 63.2%, specificity = 83.1%), and the area under the curve was 0.661. After adjusting for gender, age, BMI, illness duration and HDRS score, the risk of total SA in patients with high SII was 8.296 times higher than in those with low SII (OR = 8.296, 95% CI: 3.803-18.095, P < 0.001), The risk of recent SA was 13.922 times higher in patients with high SII than in those with low SII (OR = 13.922, 95% CI: 5.587-34.693, p < 0.001). However, high SII was not a risk factor for past SA (OR = 0.547, 95% CI: 0.062-4.842, P=0.587). SII may be an inexpensive, easily accessible strategy that can assist in determining suicide risk in adolescents with MDD.

Polikistik over sendromunda metformin tedavisi alan ve almayanlarda serum asprosin ve trimetilamin oksit düzeyleri

Purpose: The presence of a potential relationship between metabolic diseases and hormones and the intestinal flora has recently gained attention. Levels of asprosin and trimethylamine oxide (TMAO) may be associated with polycystic over syndrome (PCOS), which is a metabolic disease. The present study aims to investigate the potential relationship of PCOS with serum asprosin and TMAO levels.&#x0D; Materials and Methods: This cross-sectional study included 30 PCOS patients on metformin, 30 PCOS patients not receiving treatment, and 30 healthy controls. The demographic, glucose, insulin resistance, lipid, and hormone profiles of the participants were analyzed. Serum asprosin and TMAO levels were investigated with the ELISA method.&#x0D; Results: Patients with PCOS had higher BMI, serum glucose, triglyceride, ALT, insulin levels, and HOMA-IR scores compared with controls. The serum testosterone level was 28.1 ng/dl in the control group, 33.3 ng/dl in the PCOS group receiving metformin and 48.0 ng/dl in the untreated PCOS group, and there was a statistically significant difference. Neither serum asprosin nor TMAO levels were significantly different when compared between the three groups.&#x0D; Conclusion: Serum asprosin and TMAO levels of individuals with PCOS and healthy controls were not significantly different. The receipt of metformin treatment by PCOS patients did not have a significant relationship with serum asprosin and TMAO levels.

Perception and practice of junk food consumption among undergraduate students in a medical university in Chengalpattu District”

IntroductionJunk foods are defined as processed foods with negligible nutrient value and are often high in salt, sugar, and fat. Junk foods with high sugar content deplete energy levels and the ability to concentrate for extended periods, especially for college students who are forced to consume junk food to curb their hunger as it gives them a sense of pleasure. Due to low prices and affordability, they consume junk food as an alternative to home food.&#x0D; MethodologyThis was a cross-sectional study carried out among undergraduate medical college students in the Chengalpattu district by systematic random sampling. A semi-structured questionnaire which was framed after reviewing similar works of literature was used to assess the knowledge, attitude, and practice regarding junk food consumption. The collected data were entered into MS Excel and analyzed using SPSS version 21. P value &lt;0.05 was considered significant.&#x0D; ResultsOf the 260 participants, 51% were males and 49% were females with a mean age of 20±2.0 years. 65% of the respondents had adequate knowledge regarding the harmful effects of junk food consumption and their BMI scores tended to be in the normal range. 45% of participants felt lethargic after consuming junk food. Chi-square revealed a statistically significant association between the student’s year of study (0.004) and their knowledge score, suggesting that the knowledge level was higher for interns.&#x0D; ConclusionThe present study concludes that most participants had adequate knowledge of junk food consumption patterns. Nutrition counseling regarding a balanced diet and the harmful effects of junk foods may help to curb junk food addiction.

Association of blood pressure and heart rate with carotid markers of vascular remodeling in the young: a case for early prevention.

The association of childhood blood pressure (BP) and heart rate (HR) with intermediate markers of cardiovascular disease several decades later has been shown, but studies on more short-term outcomes are scarce. Using population-based data, this study investigates the association of four BP parameters and HR in childhood with three carotid markers for vascular remodeling one decade later. At the 11-year follow-up, 4607 participants of the nationwide KiGGS cohort aged 14 to 28 years had semi-automated sonographic carotid intima media thickness (CIMT) measurements. We investigated associations of baseline (age 3-17 years) and follow-up SBP, DBP, mean arterial pressure (MAP), pulse pressure (PP) and resting heart rate (RHR), with CIMT and lumen diameter at or above the 90th percentile and distensibility coefficient at or below the tenth percentile in logistic regressions. Analyses were further adjusted using a composite cardiovascular risk (CVR) score of BMI, triglycerides, total/HDL-cholesterol-ratio and HbA1c. SBP, DBP, MAP and RHR were significantly and similarly associated with all carotid measures 11 years later, for example an odds ratio (OR) of 1.17 [confidence interval (CI) 1.06-1.29] for one standard deviation SBP increase with elevated CIMT when adjusting for sex, age and CVR score. Cross-sectionally, the strongest association was found for MAP with reduced distensibility coefficient (OR 1.76; CI 1.59-1.94). This population-based cohort study shows robust and consistent associations between childhood BP and RHR and three carotid measures of vascular remodeling only one decade later, clearly underscoring the potential importance of preventing high BP already early in the life course.

Prevalence of post-liver transplant complications and NASH-related cirrhosis in postmenopausal women

Introduction and ObjectivesCompared to premenopausal women, postmenopausal women are at greater risk of developing NAFLD and NASH, two common indications for liver transplantation (LT). We aim to determine the prevalence of NASH-related cirrhosis in postmenopausal women from a cohort of LT patients and investigate their post-LT complications. Materials and MethodsChart review of 1200 LT patients from 2002-2020 was performed. Postmenopausal women were defined as women over 51 and compared to a control group of men over 51. Prevalence of LT indications was determined. Subgroup analysis assessed cardiovascular disease risk. BMI and ASCVD risk scores were calculated at the time of LT and after 1 year. Results510 patients met the inclusion criteria: 189 (37.1%) women and 321 (62.9%) men. The most common indication was NASH for women (26.5%, p<0.001) and alcohol-related cirrhosis for men (23.1%). 53 men and 46 women underwent subgroup analysis. There was no significant difference in BMI or ASCVD 10-year risk post-LT between sexes. MI occurred more in men (n=9.17%) than women (n=1, 2%, p=0.015), with no significant differences in CAD, CHF, or stroke. LT complications occurred less in men (n=5.9%) than women (n=20, 43%, p=0.0001). ConclusionsPostmenopausal women were significantly more likely to have NASH as an indication for LT than men. Postmenopausal women had greater weight gain and more noncardiac complications than men. Women did not have increased cardiovascular outcomes, ASCVD risk, or mortality. Diet education and weight control in postmenopausal women with existing risk factors for NASH should be encouraged to modulate health outcomes.

Exploring the longitudinal associations between census division income inequality and BMI trajectories among Canadian adolescent: Is gender an effect modifier?

BackgroundIncome inequality is a structural determinant of health linked to increased risk of overweight and obesity, although its links to the health of adolescent populations are not well understood. This study investigated the longitudinal associations between census-division-level (CD) income inequality and BMI trajectories among Canadian adolescents, and determine if these associations vary by gender. MethodsStudy data are from the Cannabis use, Obesity, Mental health, Physical Activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) cohort of adolescents attending secondary schools in Canada. Our sample included 14,675 adolescents who were followed up across three waves of the COMPASS study (2016–2017, 2017–2018, and 2018–2019) and linked to 30 CDs. Measures of income inequality and other area-level covariates were derived and linked to COMPASS participants using data from the 2016 Canadian Census. We utilized multilevel mixed-effects linear regression modelling to quantify the associations between income inequality and BMI and test for effect modification by gender. Sensitivity analyses were run excluding those with BMI scores in the range considered overweight or obesity at baseline. ResultsHigher CD income inequality was significantly associated with higher z-transformed BMI scores (β = 0.11, 95% CI = 0.034 to 0.19). The interaction term between income inequality and time was not statistically significant, indicating that this association remained constant over time. Once stratified by gender, the association between inequality and BMI became stronger for males (β = 0.14, 95% CI = 0.060 to 0.022) and attenuated for females (β = 0.063, 95% CI = −0.047 to 0.17). ConclusionAttending schools in CDs with higher income inequality was associated with higher BMI scores among male but not female adolescents. Further work is needed to investigate this discrepancy and identify the structural mechanisms that mediate the relationship between inequality and adolescent health.

Total hip arthroplasty versus hemiarthroplasty in the treatment of active elderly patients over 75 years with displaced femoral neck fractures: a retrospective study

BackgroundFemoral neck fractures are associated with substantial morbidity and mortality for older adults. Total hip arthroplasty (THA) and hemiarthroplasty (HA) are widely used in elderly patients with displaced femoral neck fractures (DFNF), but there is still controversy refering to the optimal chose for the management of DFNF in active elderly patients.MethodsThis is a retrospective cohort study that incorporates medical record review with an outcomes management database. 73 patients who underwent HA and 66 patients who underwent THA were identified from January 2015 to December 2017. Data of age, gender, BMI, comorbidity status, operation time, blood loss, hospitalization time, in-hospital complication were collected and analyzed. Clinical follow-up and radiographic examinations were performed at approximately five years, and hip complications, Harris Hip Score (HHS) and EuroQol-5 Dimensions (EQ-5D) were assessed.ResultsPreoperative general data of sex, age, BMI and charlson comorbidity score of THA group(n=55) has no statistically significant difference with that of HA group. Patients treated by THA had significantly longer operation time (105.5 vs 76.7 minutes; P < 0.001), more blood loss (524.1 vs 350.1 ml; P < 0.001) and longer hospitalization time (15.8 vs 13.8 days; P < 0.001). There was no significant differences between two groups in complications (32.7% vs 25.8%, P=0.432). No patients died during the hospitalization. After five years, only 33 patients in the THA group and 34 patents in the HA group were still alive, and the fraction surviving were not statistically significant between two groups (60.0% vs 54.8%, P> 0.05). The differences in hip function in favor of THA appeared to increase after the five-year follow-up, and the difference was significant in terms of the total Harris hip score (81.3 vs 73.1, P < 0.001) as well as in the dimensions of pain (38.9 vs 35.9, P=0.033), function (33.7 vs 29.2, P=0.001), absence of deformity (4.0 vs 3.9, P=0.023) and range of motion (4.6 vs 4.2, P=0.008). There was no significant differences between groups in hip dislocation rate (6.1% vs 0.0%, P=0.239). The erosion rate of hip joint in the THA group was significantly lower than that of the HA group (0.0% vs 26.5%, P=0.002). The health-related quality of life, according to EQ-5D index score, was found to be higher (0.69 vs 0.63, P= 0.001) in the THA group than the HA group after five years.ConclusionTHA may be a preferred management option for active elderly patients over 75 years. The more extensive surgery of THA is not associated with higher in-hospital complication rate or mortality rate. These patients can benefit from THA in terms of hip function and quality of life.Trial registrationNo.

Risk factors for postpartum urinary incontinence: The impact of early-onset and late-onset Gestational Diabetes Mellitus in a nested case-control study

BackgroundGestational Diabetes Mellitus (GDM) and many other clinical variables have been associated with postpartum urinary incontinence (UI). However, the data are still restricted, and no study explored early- or late-onset GDM as a risk factor for this condition. We aimed to identify independent risk factors for postpartum UI, focusing on GDM and its early or late onset. Methods: A nested case control derived from the Diamater cohort study included 517 pregnant women who submitted to a planned C-section and followed by 6–18 months after delivery according to the timing of GDM diagnosis: early-onset GDM (before 20 weeks) and late-onset GDM(24–28 weeks) and the occurrence of UI. Results: Univariate analysis showed that the risk for 6–18 months postpartum UI was 49% higher in non-Caucasian ethnicity (1.49,1.02–2.18), 3,3 times higher in previous bariatric surgery [3.37,1.36–8.21], 39% higher in GDM women (1.39,1.01–1.93), and 5% higher for each BMI score in prepregnancy (1.05, 1.03–1.08) and at the end of pregnancy (1.05,1.02–1.08). Multivariate logistic regression analysis indicates that prepregnancy BMI was the only independent factor associated with the 6–18 months postpartum UI (adj 1.05, 95 %CI 1.02–1.08, P <.001). After stratifying, a second univariate and multivariate analysis were done according to the prepregnancy BMI cutoff score of 25. Thus, a significant association between GDM and postpartum UI in prepregnancy overweight women (RR: 1.91; 95 %CI 1.25–2.90, P =.003) and no association between GDM and 6–18 months postpartum UI in normal prepregnancy BMI (RR: 0.78, 95 %CI 0.39–1.54, P =.482) were found. After multivariate regression, the early-onset-GDM remained the unique independent adjusted risk factor for 6–18 months postpartum UI analysis (adjRR 2.15, 95 %CI 1.33–3.46, P =.002). Conclusion: After a planned C-section, we observed a 6–18 months postpartum UI higher occurrence after GDM, either in early-onset GDM or late-onset GDM. In addition, being overweight (BMI > 25) among women with early-onset GDM was associated with postpartum UI.

Sex-related differences in the impact of nutritional status on length of hospital stay in atrial fibrillation: a retrospective cohort study.

Nutritional status is related to the length of hospitalization of patients with atrial fibrillation (AF). The aim of this study is to assess the prognostic impact of nutritional status and body mass index on length of hospital stay (LOHS) among patients with AF relative to their sex. A retrospective analysis of the medical records of 1,342 patients admitted urgently with a diagnosis of AF (ICD10: I48) to the Cardiology Department (University Hospital in Wroclaw, Poland) between January 2017 and June 2021. In the study group, women were significantly older than men (72.94 ± 9.56 vs. 65.11 ± 12.68, p < 0.001). In an unadjusted linear regression model, malnutrition risk was a significant independent predictor of prolonged hospitalization in men (B = 1.95, p = 0.003) but not in women. In the age-adjusted linear regression model, malnutrition risk was a significant independent predictor of prolonged hospitalization in men (B = 1.843, p = 0.005) but not in women. In the model adjusted for age and comorbidities, malnutrition risk was a significant independent predictor of prolonged hospitalization in men only (B = 1.285, p = 0.043). In none of the models was BMI score a predictor of LOHS in either sex. The risk of malnutrition directly predicts the length of hospital stays in men but not women. The study did not find a relationship between body mass index and length of hospital stay in both women and men.

The Roles of Hedonistic Life Perception and Self-Control on Eating Behaviors and Obesity

Aims: Two important variables are thought to play important roles in people’s eating habits: self-control and hedonism. The purpose of the study is to understand how and how much individuals’ eating behaviors are affected by their hedonistic lifestyle and their degree of self-control.&#x0D; Study Design: Quantitative Online Survey.&#x0D; Place and Duration of Study: 2021-2022, Turkey.&#x0D; Methodology: There were 138 participants who took the survey, which contained three different scales and a demographic form. The Hedonistic Eating Scale [6], The Mindful Eating Questionnaire [7], and the Brief Self-Control Scale [8] were the scales used.&#x0D; Results: BMI and self-control were found to be significantly correlated (r =.410, p =.05). The relationship between BMI and hedonistic eating was significant (r =.493, p =.05). There was a significant correlation between hedonistic eating and self-control (r =.531, p =.05). When a multiple regression analysis was conducted, hedonistic eating and self-control scores predicted the BMI score significantly, F (2,133) = 30.98, p =.000. The R2 =.318 and the adjusted R2 =.309, a medium-size effect reported by the model. Self-control and hedonistic eating were found to predict BMI significantly (F (2,133) = 30.983, p =.000) and to account for 31.8 percent of the variation. Including gender in the model explained an additional 15.2 percent of the variation in BMI, which was found to be significant (F (1,132) = 37.847, p =.000).&#x0D; Conclusion: All three variables (low self-control, high hedonistic eating, and high body mass index) are significantly and positively correlated. Additionally, it was seen that the strength of these variables differed with gender, even though not drastically.

A Multipronged Intervention to Reduce Readmissions and Readmission Intensity After Radical Cystectomy

To develop a multipronged, evidence-based protocol to reduce readmission risk and readmission intensity, as represented by the duration of the index readmission, after radical cystectomy. A per-protocol study was performed. The protocol included preoperative nutritional supplementation, early stent removal, and a follow-up phone call within 4-5days of discharge. The preprotocol period was from February 1, 2020 to July 31, 2021 and the postprotocol period was from December 1, 2020 to November 31, 2021. Using multivariate regression models, we compared outcomes among patients treated with radical cystectomy before and after protocol initiation. We identified 70 preprotocol patients and 126 postprotocol patients. After adjusting for age, sex, BMI, and frailty score, there was a significant reduction in 90-day readmission intensity (7 vs 5days; P=.048) among postprotocol patients. After implementation of an evidence-based protocol for patients undergoing radical 90-day readmission intensity decreased significantly. This protocol may move the needle forward on reducing readmissions, but a larger randomized trial is needed.

DETERMINING FACTORS AFFECTING OF THE PHYSICAL ACTIVITY LEVEL OF OLDER ADULTS DURING THE COVID-19 PANDEMIC

Objective: Social isolation during the COVID-19 pandemic adversely affected the physical and psychological conditions of the elderly. This study was planned to determine the factors affecting the physical activities of elderly individuals living in Turkey.&#x0D; Method: In this study, frailty level (Fragility Scale), depressive symptoms (Geriatric Depression Scale [GDS]), physical activity level (PASE Questionnaire), kinesiophobia (TAMPA Scale), and anxiety (Beck Anxiety Scale) of elderly individuals were evaluated by a structured Google survey. Regression analysis was used to determine the factors affecting the level of physical activity.&#x0D; Results: While 52% of the participants (28% male; 72% female; mean age: 69.34±15.03 years) stated that they were less physically active, 93% stated that their social participation decreased during the pandemic process. The mean physical activity score was 89.12±55.33 (the highest score was calculated for indoor activities: 32.00±21.34; the lowest score was calculated for work-related activities: 2.10±6.33). Kinesiophobia score was 41.44±7.39. Approximately half of the participants were in the category of “guarantees a comprehensive assessment for depression”, while 18% were in the category of “suggesting depression” and 30% were in the category of “no depression” (GDS mean score: 14.41±6.01). In addition, it was determined that 29% of the elderly had severe anxiety, 25% had moderate anxiety, and 24% had mild anxiety. The mean frailty score was 2.09±1.69 (normal 19%; pre-fragile 53%; frail 28%). According to univariate linear regression analysis and multiple regression analysis, the most factors affecting the level of physical activity were age, BMI score, fear of movement and fragility.&#x0D; Conclusion: The results obtained from this study showed that the physical activity level of the elderly decreased in the first year of the COVID-19 pandemic. In addition, increasing age, BMI score, kinesiophobia and fragility caused a decrease in the physical activity level of the elderly. These findings suggest that health policy makers and health care providers should organize appropriate care plans for the elderly after the pandemic period.

558 Comparison of Length of Post-Operative Hospital Stay Following Robot-Assisted Laparoscopic Nephrectomies with Traditional Laparoscopic Nephrectomies: A Single-Centre Retrospective Study

Abstract Aim The study aims to compare the length of post-operative hospital stay following robot-assisted laparoscopic (RAL) nephrectomies with stays following traditional laparoscopic (LAP) nephrectomies at a district general hospital. Method This study retrospectively compares the post-operative length of hospital stay using information documented on patient’s paper notes scanned onto an online system. Between January 2021 and December 2021, 25 patients underwent LAP nephrectomies in this unit. Following the introduction of RAL at our unit, all patients requiring a nephrectomy had this procedure done using RAL. Between January 2022 to November 2022, 33 patients underwent a RAL, 3 of which required conversion to open and excluded from this study. Additionally, data on age, BMI, tumour size and ASA score was collected to identify any evidence of systemic bias. Results Mean post LAP hospital stay was 3.60 (±3.24) nights, while post RAL was shorter at 2.07 (±1.44) nights to a statistically significant degree (p-value = 0.0357). There was no significant difference in any of the demographic factors between the two groups (LAP and RAL). When including data for partial nephrectomies (n = 20; LAP = 11, RAL = 9) and pyeloplasties (n = 9; LAP = 5, RAL = 4), length of post-operation hospital stay was still significantly shorter for patients who had undergone robot-assisted laparoscopy. Mean post-LAP hospital stay was 3.56 (±2.62) nights, while post-RAL was shorter at 2.21 (±1.68) nights to a statistically significant degree (p-value = 0.00666). Conclusions The use of robot-assistance during laparoscopic nephrectomies was associated with significantly shorter post-operative hospital stays over traditional laparoscopic procedures in this cohort of patients.

An assessment of nutritional status of elderly in Bolangir district of Odisha: a community based study

Background: Ageing is a physiological process that begins at birth, continues throughout life, and culminates in death. Poor nutrition is not a normal by-product of ageing; older persons are vulnerable to malnutrition due to physiological, psychological, social, nutritional, and environmental risk factors. Objective were to assess the nutritional status of elderly residing in rural areas with special reference to anthropometric measurements. Methods: A community based cross-sectional study was conducted in Mursundi Village at Alagpur block of Bolangir district of Odisha, India. A total of sixty elderly of age 60 years or above were selected for the study through random sampling method. Data was assessed using a well-structured and pretested questionnaire. Information was collected from selected elderly people through personal interview by repeatedly visiting the study area. Results: Out of the total 60 participants, the mean height of the male elderly was 149.5±7.23 cm subsequently mean weight was 50.33±8.89 kg and BMI score (22.97±2.25 kg/m²) of the male elderly was within the normal range. Similarly, the mean height and weight of the female elderly participants were 151.4±7.16 cm and 49.33±6.69 kg respectively while the BMI mean score (21.34±2.94 kg/m²) falls into to the underweight category. About 33.3% of the elderly males were normal, 43.3% underweight and 23.33% from overweight category. Similarly, majority females (26.66%) were normal, 50.0% were underweight and 23.33% from overweight category. Conclusions: Nutritional status of elderly subjects especially among females is very poor as detected in this study. There is need and scope for geriatric nutritional interventions mainly through nutrition education in rural population.

Study of Serum Chemerin Level in Chronic Hepatitis C Virus Patients with and without Nonalcoholic Fatty Liver Disease

Abstract Background Chronic hepatitis C (CHC) has a number of features that suggest that it should be recognized not only as a viral disease but also as a metabolic liver disease that encompasses insulin resistance (IR), liver steatosis, impaired glucose tolerance or type 2 diabetes mellitus (T2DM) and disturbances in lipid metabolism. Objective To evaluate the role of serum Chemerin as a biomarker in patients with chronic hepatitis C virus with and without Non Alcoholic Fatty Liver Disease and its correlation to disease progress and activity and to evaluate its relationship with various laboratory parameters of the disease. Patients and Methods Type of study: A case control study. Study setting: outpatient clinics and inpatient wards at King Fahd hospital, Medina, Saudi Arabia &amp; outpatient clinics at Ain Shams university hospitals, Egypt. Study Period: 6 months. Study Population: The study was conducted on normal populations, chronic HCV patients with NAFLD, and chronic HCV patients without NAFLD. Results In the present study the mean chemerin level was found to be statistically higher in chronic hepatitis C virus patients with NAFLD group compared to chronic hepatitis C virus patients without NAFLD group and was found to be statistically higher in both previous groups than in control group (p value &amp;lt;0.05). There was significant positive correlation between serum chemerin with ALT (p value &amp;lt;0.01), AST (p value&amp;lt;0.01), BMI (P value&amp;lt;0.01), INR (p value&amp;lt;0.01), triglyceride (p value&amp;lt;0.01), FIB4 index (p value &amp;lt;0.01) and NAFLD fibrosis score (p value &amp;lt;0.01). There was significant negative correlation between serum chemerin with serum ALBUMIN (p value &amp;lt;0.01). Conclusion The results obtained in the current study demonstrate that the serum chemerin level increased in parallel with the worsening liver functional reserves in CHC patients and serum chemerin level incrased in patients with CHC associated with NAFLD. It could be concluded that chemerin may be considered as additional tools for assessment of prognosis of CHC and monitoring the virally derived metabolic abnormality.

ThTP6.2 Comparison of length of post-operative hospital stay following robot-assisted laparoscopic nephrectomies with traditional laparoscopic nephrectomies: a single-centre retrospective study

Abstract Aim The study aims to compare the length of post-operative hospital stay following robot-assisted laparoscopic (RAL) nephrectomies with stays following traditional laparoscopic (LAP) nephrectomies at a district general hospital. Method This study retrospectively compares the post-operative length of hospital stay using information documented on patient’s paper notes scanned onto an online system. Between January 2021 and December 2021, 25 patients underwent LAP nephrectomies in this unit. Following the introduction of RAL at our unit, all patients requiring a nephrectomy had this procedure done using RAL. Between January 2022 to November 2022, 33 patients underwent a RAL, 3 of which required conversion to open and excluded from this study. Additionally, data on age, BMI, tumour size and ASA score was collected to identify any evidence of systemic bias. Results Mean post LAP hospital stay was 3.60 (±3.24) nights, while post RAL was shorter at 2.07 (±1.44) nights to a statistically significant degree (p-value=0.0357). There was no significant difference in any of the demographic factors between the two groups (LAP and RAL). When including data for partial nephrectomies (n=20; LAP=11, RAL=9) and pyeloplasties (n=9; LAP=5, RAL=4), length of post-operation hospital stay was still significantly shorter for patients who had undergone robot-assisted laparoscopy. Mean post-LAP hospital stay was 3.56 (±2.62) nights, while post-RAL was shorter at 2.21 (±1.68) nights to a statistically significant degree (p-value=0.00666). Conclusions The use of robot-assistance during laparoscopic nephrectomies was associated with significantly shorter post-operative hospital stays over traditional laparoscopic procedures in this cohort of patients.

A comparison of perioperative outcomes of transperitoneal versus retroperitoneal robot-assisted partial nephrectomy: a systematic review.

RAPN can be carried out via a transperitoneal or retroperitoneal approach. The choice between the two approaches is open to debate and usually based on surgeon preference. The perioperative outcomes of transperitoneal robot-assisted partial nephrectomy versus retroperitoneal robot-assisted partial nephrectomy were compared. A systematic review of the literature was performed up to May 2020, using PubMed, Cochrane, Scopus and Ovid databases. Articles were selected according to a search strategy based on PRISMA criteria. Only studies comparing TRAPN with RRAPN were eligible for inclusion.Eleven studies were included in the quantitative synthesis. Baseline demographics (age, BMI, ASA, tumour size, and RENAL nephrometry score), intraoperative data (operative time, estimated blood loss, and warm ischaemia time) and postoperative outcomes (major complications according to Clavien-Dindo, length of hospital stay (LOS) and positive surgical margin rate) were recorded. A total of 3139 patients were included (2052 TRAPN vs. 1087 RRAPN).There was no significant difference in demographic variables (age, BMI), tumour size (p = 0.06) nor the nephrometry score (p = 0.20) between the two groups.Operative time(p = 0.02), estimated blood loss (p < 0.00001) and LOS (p < 0.00001) were significantly lower in the RRAPN group. No differences were found in major postoperative complications (Clavien-Dindo > 3; p = 0.37), warm ischaemia time (p = 0.37) or positive surgical margins (p = 0.13). Future researchers must attempt to achieve adequately powered, expertise based, multi-surgeon and multi-centric studies comparing TRAPN and RRAPN. RRAPN gives similar outcomes to TRAPN. RRAPN is associated with reduced operative time and LOS. Ideally, surgeons should be familiar and competent in both RAPN approaches and adopt a risk-stratified and patient-centred individualised approach, dependent on the tumour and patient characteristics. RAPN is feasible via two approaches. The retroperitoneal approach seems to be associated with a shorter operation time and hospital stay.