Significant Decrement Research Articles

Timing of Decremental Response During Repetitive Nerve Stimulation in Myasthenia Gravis

Background: A decrement >10% detected during repetitive nerve stimulation (RNS) is supportive of considering a diagnosis of myasthenia gravis (MG). Several studies have found that most of this decrement is seen between 4 to 6 min post-exercise. However, there are not available studies analyzing if shorter timing would be sufficient. 
 Objective: The objective of this study was to evaluate if RNS up to 2 min post-exercise is sufficient to detect a decrement response >10%.
 Methods: We performed a retrospective chart review study of patients referred to our neuromuscular clinic at The University of Kansas Medical Center with symptoms suggestive of MG from 2013 to 2017.
 Results: A total of 76 patients with MG and 100 controls were identified. A significant decrement was detected in 95% of MG patients with abnormal RNS within 2 minutes post-exercise.
 Conclusion: RNS up to 2 min post-exercise might be sufficient to detect a significant decrement in MG patients.

Evaluation of Alternative Sources of Supplementary Cementitious Materials for Concrete Materials

This study characterized and evaluated the use of reclaimed fly ash (RFA) and reclaimed ground bottom ash (GBA) as alternative sources of supplementary cementitious materials (SCMs) for the production of concrete mixtures. Conventional Class F fly ash (FA) was also evaluated for comparison. The effects of SCM content on fresh and hardened properties of concrete were investigated by replacing 10%, 20%, and 30% of cement by mass. Characterization results showed that all three ashes met ASTM C618 chemical requirements (i.e., sum of SiO2 + Al2O3 + Fe2O3, CaO, SO3, moisture content, and loss of ignition) and 7- and 28-days strength activity index (SAI) requirements for Class F FA. In addition, RFA exhibited slightly higher SAI at 28 days of curing, followed by GBA and FA. In relation to fresh concrete properties, FA increased the concrete slump compared with the control mixture, whereas RFA and GBA decreased the concrete slump. However, GBA produced more significant slump decrements than RFA, which was attributed to the irregular angular particles of GBA. Generally, all the coal ashes produced decrements in air content compared with the control mixture. Comparatively, among the three ashes, GBA exhibited the highest 28- and 90-days compressive strength and surface resistivity (SR) at all cement replacement levels. Furthermore, at 90 days of curing, RFA and GBA concrete mixtures outperformed the FA concrete mixtures in relation to compressive strength and SR. Consequently, both RFA and GBA are promising SCMs for concrete materials.

Thermodynamic and economic analysis of a directly solar-driven power-to-methane system by detailed distributed parameter method

The transformation of solar energy into easily transportable and storable fuel brings a prospective solution to the issue caused by its intermittency and non-dispatching. Relying on well-established infrastructures and mature technologies for application, methane can be an attractive energy carrier for improving the penetration of solar energy in the future energy structure. To evaluate the feasibility of solar-to-methane from technical and economic views, this paper proposes a directly solar-driven power-to-methane system integrating photovoltaic plant, solid oxide electrolysis cell, methanation reactor, and membrane module. The detailed distributed parameter method is employed for thermodynamically modeling the core components of the system to consider the profiles of current density, temperatures, and composition concentrations. A comprehensive thermodynamic and economic analysis is further conducted for the system, and the results indicate that the power-to-methane efficiency, total energy efficiency, and total exergy efficiency of the system can reach 68.41%, 9.88%, and 11.08%, respectively. With the annual average solar radiation of 557.43 W/m2, the system achieves an annual synthetic natural gas yield of 914.51 MWh/y. A high total product unit cost of 186.57 $/MWh is obtained in 2020, whereas it is predicted to decrease to 91.51 $/MWh (about 51% reduction) in a future scenario with a payback period of 4.66 years due to the significant decrement of the photovoltaic investment cost. The present work reveals the engineering realizability and economic viability of solar-to-methane and provides a competitive option for the development of solar energy.

The influence of immersion order of low concentration ammonium polyphosphate on the interphase, mechanical and combustion properties of Moso bamboo scrimber

As a high-strength biomass composite material, the development of bamboo scrimber (BS) was limited by its flammable characteristics. In this study, different immersion orders of ammonium polyphosphate (10 wt%, APP solution) for bamboo bundles were selected in order to evaluate its influence on the interphase behavior, mechanical and combustion properties of BS. The flattened bamboo bundles, phenol-formaldehyde (PF) and APP solution were utilized to fabricate the BSs. The interphase behavior of the treated bamboo bundles was characterized by the contact angle measurement, Fourier transform infrared spectroscopy (FTIR) analysis, fluorescence microscope and SEM-EDS measurement. Thermogravimetric analysis, limiting oxygen index (LOI), mechanical properties before and after combustion test were assessed for various BSs. The results showed that significantly increased equilibrium contact angle of PF droplet on the surface of bamboo after immersed in APP solution while the decrement was for APP solution droplet on the surface of bamboo after immersed in PF. Varied intensities of chemical bonds and distribution forms of APP and PF were observed for the treated BSs depending on the immersion orders. These variations have a great effect on the mechanical and combustion properties. No significant decrement of compressive strength and bending strength was observed for APP-treated BSs with different immersion orders compared with the control sample. Higher compressive strength, bending strength, and modulus of elasticity (MOE) were found for the APP-PF-BS with increments of 31.60%, 21.70%, and 29.01%, respectively. Significantly increased thermal stability was observed for bamboo bundles after immersed in APP and PF especially for the temperature over 300 °C. After the combustion test (duration of 40 min), a higher LOI of 35.4, retention rates of mechanical properties of 39.96–78.97%, and lower mass loss of 15.93% were obtained for the PF-APP-BS. Finally, the immersion order of low concentration of APP solution has a great effect on the interphase behavior, mechanical and combustion properties of BSs, which plays a significant role in the optimized fabrication of fire-resistant BSs.

A 3D Modulation Scheme for High-speed Baseband Digital Communication System

To improve the transmission rate of wireless communications, the communication frequency band will gradually go higher, and the use of millimeter wave and terahertz will become mainstream in the future. However, the signal attenuation in high bands is considerable, which prevents the achievement of long-distance transmissions. In this paper, we propose a 3D modulation scheme that is especially suitable for high-speed baseband digital communication systems. The proposed scheme is simulated and tested in an experiment. With the same order of modulation, the 3D modulation shows a significant decrement in bit error rate and enables a longer transmission distance.

Exercise capacity remains supernormal, though mildly reduced in middle-aged military personnel with Moderate to Severe Obstructive Sleep Apnea.

The relationship between moderate to severe OSA and exercise capacity remains unclear. Prior studies showing a reduction in VO2 max in this population have mostly involved middle-aged, overweight patients. We aimed to study this relationship in a similarly aged population of military personnel with previously undiagnosed moderate to severe OSA. We studied late-career male military personnel who underwent CPET and polysomnography (PSG). Patients were categorized either into an OSA group (apnea-hypopnea index (AHI) ≥ 15 events/h) ora control group (AHI < 15 events/h). VO2 max was compared between groups. 170 male military personnel met criteria for the study. Mean AHI was 29.0/h in the OSA group (n = 58) versus 7.4/h in the controls (n = 112) while SpO2 nadir was slightly lower (86.0% vs. 89.0%). Patients were of similar age (53.1 vs. 53.7years), and BMI was slightly higher in the OSA group (27.5kg/m2 vs. 26.3kg/m2). Percent-predicted VO2 max was supernormal in both groups, though itwas comparatively lower in the OSA group (117% vs. 125%; p < 0.001). Military personnel with moderate to severe OSA were able to achieve supernormal VO2 max values, yet had an 8% decrement in exercise capacity compared to controls. These findings suggest that OSA without significant hypoxemia may not significantly influence exercise capacity. It remains likely that the effects of untreated OSA on exercise capacity are complex and are affected by several variables including BMI, degree of associated hypoxemia, and regularity of exercise. Statistically lowerVO2 max noted in this study may suggest that untreated OSA in less fit populations may lead to significant decrements in exercise capacity.

Evaluation of the Effect of Left Nostril Breathing on Cardiorespiratory Parameters and Reaction Time in Young Healthy Individuals

Background: Pranayama, a yogic breathing practice, produces several physiological responses in healthy individuals. Hypertension is a critical and booming public health challenge all over the world. Yoga is one of the effective methods to reduce blood pressure (BP) and pulse rate (PR).Objective: To evaluate the effect of left nostril breathing (LNB) exercise on cardiorespiratory parameters and reaction time (RT) in young healthy individuals.Materials and methods: In this study, 106 young healthy individuals between 18 and 25 years of age were included. The systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), respiratory rate (RR), vital capacity (VC), peak expiratory flow rate (PEFR), and reaction time (RT) of volunteers were recorded at baseline (before exercise) and after two weeks of left nostril breathing exercise performed 45 minutes daily.Results: There was a significant reduction in SBP (126.64 ± 15.51 mmHg versus 116.29 ± 11.91 mmHg; Cohen’s d (effect size): 0.87; p < 0.0001)), DBP (76.57 ± 14.87 mmHg versus 71.07 ± 11.39 mmHg; Cohen’s d: 0.48; p < 0.0001), PR (85.32 ± 15.44/minute versus 81.77 ± 13.02/minute; Cohen’s d: 0.27; p < 0.0001), and RR (14.26 ± 2.15/minute to 13.17 ± 2.03/minute; Cohen’s d: 0.54; p < 0.0001). A significant increase was observed in VC (3.42 ± 0.62 versus 3.67 ± 0.65; Cohen’s d: 0.39; p < 0.0001) and PEFR (467.81 ± 46.66 versus 498.29 ± 51.50; Cohen’s d: 0.59; p < 0.0001). There was a significant decrement in auditory reaction time (ART) (164.36 ± 27.20 ms versus 143.84 ± 20.32 ms; Cohen’s d: 0.85; p < 0.0001) and visual reaction time (VRT) (190.25 ± 31.48 ms versus 163.75 ± 21.72 ms; Cohen’s d: 0.98; p < 0.0001). There was no significant change in maximum heart rate (MHR) after cardiorespiratory activity (CRA) (p > 0.434).Conclusion: Left nostril breathing is associated with a decrease in cardiovascular parameters and an increase in VC and PEFR. This technique may be useful for putting up a fight against the stress and strain of daily life. This simple exercise may also be a beneficial adjuvant to pharmacological therapy in hypertensive patients.

Effects of partial sleep deprivation: A comparative assessment of young non-professional and professional taxi drivers

AimThis study aims to determine the effects of partial sleep deprivation (PSD) on driving performance of professional and young non-professional drivers. MethodsThe study included fifty participants (20 professional taxi drivers and 30 young non-professional drivers) driving the simulator-cab in three conditions. The first test session (TS1) was conducted after one night of PSD followed by the second test (TS2) after two consecutive nights of PSD. The driving performance metrics in two conditions of PSD (i.e., sleep duration = 4.25 ± 0.5 h) were compared with the baseline drive with no sleep loss. Sleep restriction was monitored using Actiwatch. Drivers subjectively self-reported their alertness using Karolinska Sleepiness Scale (KSS). Driving performance metrics and reaction time to emergency events were collected during each drive. ResultsA preliminary mixed-design ANOVA showed deterioration in driving performance of all drivers in terms of speed (p < 0.1), speed variability (p = 0.06), standard deviation in lateral positions (SDLP) (p < 0.001) and delayed reaction time (p < 0.05). Separate Mixed-Effects Generalized Linear Models for professional and non-professional drivers showed that speed variability, SDLP and reaction time increased from baseline during both the PSD tests, among both the driving groups. The speed variability, SDLP and reaction time of professional drivers differed significantly from other drivers under PSD conditions. Contrary to the existing belief, the professional drivers had significant decrements in driving performance due to PSD. ConclusionA critical and comparative analysis revealed that driving experience/skill of professional drivers does not improve their resistance to deteriorating effects of sleep loss.

Evaluation of the Effect of Hydromethanolic Seed Extract of Lepidium sativum L. (Fetto) on Deep-fried Palm Oil Diet Induced Nonalcoholic Fatty Liver Disease on Male Swiss Albino Mice.

IntroductionNonalcoholic fatty liver disease (NAFLD) is the most prevalent disease due to a dramatic change in dietary habits, especially an increase in consumption of fat and carbohydrates in deep-fried foods.ObjectiveThe objective was to evaluate the effect of hydromethanolic seed extract of Lepidium sativum on deep-fried palm oil diet induced NAFLDon male mice.MethodsAn experimental study design was conducted. Twenty-four male mice aged 8 to 10 weeks, weighing 32–42 g were divided into four groups. The four groups were divided into two controls and two treatments. Mice in normal control (C0) were administered only with the basal diet whereas negative control (C1) provided only with the deep-fried palm oil diet. The treatment groups T1, and T2 were administered with deep-fried palm oil diet and HMSELS at dose of 200 and 400 mg/kg/day, respectively for 28 days. Then on day 29, the mice were fasted overnight, anaesthetized and sacrificed by cervical dislocation after blood was taken by cardiac puncture for liver function tests while liver tissues were taken for histopathology investigation.ResultsThe serum ALT and total bilirubin showed significant decrement whereas the serum albumin levels showed significant increment in T2 group. However, serum AST and ALP levels were decreased significantly in both T1 and T2 groups. Besides, the T2 group liver sections of mice were showed better effect of HMSELS on restoring the damaged liver histopathology almost toward normal.ConclusionThe HMSELS at a dose of 400 mg/kg/day (T2) was more effective on the liver function tests and liver histopathology that altered by feeding deep-fried palm oil diet. The good protective effect of HMSELS against deep-fried palm oil diet-induced NAFLD might be due to its antioxidant content.

A Field Study on Safety Performance of Apron Controllers at a Large-Scale Airport Based on Digital Tower.

The innovative concept of digital tower provides a new solution for reducing the construction and operation costs of airports with adverse natural environments, poor intervisibility conditions, or sparse traffic. However, it leads to changes in the situational awareness of air traffic controllers and to challenges in safety performance. To research the safety performance of apron controllers at a large-scale airport applying a digital tower, a field study was conducted at Baiyun International Airport in Guangzhou, China. In this study, we established a comprehensive index system from the perspective of situational awareness, which provided measurements on the areas of interests, gaze and physiological features, and vigilance of controllers. Three modules were compared: a physical tower module, a digital tower module with a large panoramic screen, and a digital tower module with a small panoramic screen. The differences in the safety performances of apron controllers are discussed in two aspects: adaptability and reliability. The results indicated that the apron controllers at the three modules performed different cognition patterns, but similar cognition effort was paid toward maintaining performance. Furthermore, the significant vigilance decrement of controllers exists between after-duty and before-duty, but with no significant difference among the three modules. In conclusion, apron controllers at a large-scale airport could obtain effective safety performances based on a digital tower that were no less than those from a physical tower.

The Effects of Helicobacter Pylori Eradication on Liver Function and Metabolic Profile in Non-diabetic Non-alcoholic Steatohepatitis: A 5-year Randomized Clinical Trial.

BACKGROUND: To evaluate the effects of Helicobacter pylori (HP) eradication on liver function tests (LFT) and fat content (LFC) in non-diabetic non-alcoholic steatohepatitis (NASH). METHODS: This randomized clinical trial included dyspeptic HP infected non-diabetic NASH participants. The intervention arm received HP eradication treatment, while the control arm did not get any HP treatment. In the meantime, the standard management of NASH was performed in both trial arms. Mean alterations in LFT were the primary outcome and the secondary outcomes included the mean changes in LFC and serum metabolic profile. The trial follow-up period was 5 years. RESULTS: 40 participants (female: 20), with a mean age of 41.58 (±12.31) years, were enrolled in the study. The HP eradication arm included 20 participants (female: 11) with a mean age of 40.25 (±10.59) years, and the control arm consisted of 20 individuals (female: 9) with a mean age of 42.90 (±13.97) years. The tests of within-subjects effects showed a significant decrease in mean serum alanine aminotransferase (ALT; P=0.007), triglyceride (TG; P=0.04), cholesterol (P=0.004), and fasting blood sugar (FBS; P<0.001), and an increase in high-density lipoprotein (HDL; P=0.04) in both research groups during the study period. The tests of between-subjects effects demonstrated a more significant decrement of FBS in HP eradicated patients than the controls (P=0.02). The reduction in waist circumference, aspartate aminotransferase (AST), ALT, alkaline phosphatase, triglyceride, cholesterol, low-density lipoprotein, insulin, and LFC were more prominent in the intervention group than the controls; however, these differences were not statistically significant. CONCLUSION: Adding HP eradication treatment to standard NASH treatment showed more therapeutic effect thanthe standard NASH treatment protocol alone regarding the decrement of FBS in participants with dyspeptic non-diabetic NASH. Considering the non-statistically significant improvement in other metabolic indices and LFT in this trial, further studies are recommended.

Drilling study on CFRP/Ti-6Al-4V stacks using chip breaker grooved drill

ABSTRACT Carbon fiber reinforced plastic/Ti-6Al-4V stacks are most commonly utilized in aircraft structures as they have a higher strength-to-weight ratio. Usually, these materials are stacked together and riveted by drilling holes. The holes produced during the operation require more precision and high quality. In general, the chips produced during the drilling of Ti-6Al-4V alloy stacked underneath the surface of CFRP material increase the damage and thrust force during drilling CFRP/Ti stacks. In this experimental investigation, a chip breaker in the form of a groove was machined on the rack face of the drill tool. Sixteen drilling experimental runs were conducted on CFRP/Ti-6Al-4V stacks along with standard and grooved tungsten carbide drills. Two input parameters such as cutting speed and feed with four levels were considered during drilling under a dry machining environment. The response attributes measured were thrust force, chip formation and delamination. Based on the study, a decrease in cutting force with an increase in the chip breakability was found at maximum speeds. Furthermore, a significant decrement was noticed in the delamination and formation of burrs with the grooved drill tool compared to the standard tool.

Impact of Prolonged Absence of Organized Training on Body Composition, Neuromuscular Performance, and Aerobic Capacity: A Study in Youth Male Soccer Players Exposed to COVID-19 Lockdown.

The aim of this study is to examine how physical performance has changed after 15 weeks (109 days) long-term absence of organized training in youth soccer players imposed by the stay at home orders. A total of sixty-eight young male soccer players from different age categories (U15, U16, U17 and U19) voluntarily participated in the prospective cohort study. Body fat percentage (BF%), counter-movement jump (CMJ), 30 m sprint, change-of-direction (COD) and yo-yo intermittent recovery test level-1 (YYIRTL-1) were evaluated twice (before and after the detraining period). Subsequently, 2 × 2 repeated measures ANOVA was used to investigate group and time differences in repeated measurements. A significance level of p < 0.05 was implemented. CV and SWC values were calculated to test the reliability of the tests performed at different times. Statistical analysis was performed using the IBM SPSS statistics software (v.25, IBM, New York, NY, USA). Significant increments in BF%, 30 m sprint, and COD (left and right), and also significant decrements in CMJ and YYIRTL-1, were found after the detraining period. A long-term detraining period due to the stay at home orders has a detrimental effect on body composition, neuromuscular performances, and aerobic capacity in youth soccer players.

To Observe and study the adverse Effects of Lithium Carbonate on Rat Ovaries

Background: The female reproductive organs include uterus, fallopian tubes and ovaries, these organs when exposed to drugs and metals lead to anatomical damage resulting in infertility. Researchers have documented the harmful effects of the favorable antidepressant Lithium Carbonate on many human viscera’s but even today the medicinal world has scarce knowledge of the ablation of ovarian anatomy by lithium carbonate. Aim: To study and document the results of the detrimental effects of Lithium on the ovaries. Methods: We selected Twenty four adult female rats for this observational and experimental study. The female albinos were divided into two groups. Twelve animals were present in Group A and Group B consisted of twelve female rats. The hygienically prepared laboratory diet which consisted of flour pellets and green vegetables was given to Group A animals and Group B rodents received Lithium carbonate in powder form for eight weeks. After completion of the study time animals were sacrificed and weight of ovaries were recorded and compared in both groups. Results: The results in Group B documented that animals had a highly significantly decline in ovarian weight after chronic Lithium carbonate than in Group A. Conclusion: Our prospective study concluded that chronic administration of Lithium Carbonate causes distortion of its tissue and highly significant decrement of weight of the ovary. Keywords: Ovary, decrement, infertility

Encapsulation Material for Retinal Prosthesis With Photodetectors or Photovoltaics

Retinal prosthesis is one of the key strategies for tackling retinitis pigmentosa – a group of genetic disorders that can cause blindness. However, further advancement of retinal implant is hindered by some technical limitations. Current state-of-the-art retinal implants failed within two-three years after implant and showed a significant decrement in their visual acuity. The purpose of this investigation is to search for a material that is better suited for the packaging of retinal implants. Specifically, the study was conducted under the assumption that image acquisition is done internally, i.e. without the use of an external camera. Polydimethylsiloxane (PDMS) and polyimide (PI) are some of the most commonly used materials in implantable devices. In addition, colorless transparent polyimide (CPI) was studied to overcome the optical limitations of PI. Finally, liquid crystal polymer (LCP) and cyclic olefin copolymer (COC) were added in the comparison due to their promising results regarding their expected longevity. In this experiment, PDMS, CPI, and COC outperformed the other materials in optical transparency. Considering the excellent encapsulation properties due to thermoplasticity while being able to be fabricated into a micro-lens array, we believe COC is worth further in-depth investigation for further advancement in the field of a retinal prosthesis.

KCNQ1 rs2237895 polymorphism is associated with the therapeutic response to sulfonylureas in Iranian type 2 diabetes mellitus patients.

Sulfonylureas are the most secondary prescribed oral anti-diabetic drug. Understanding its genetic role in pharmacodynamics can elucidate a considerable knowledge about personalized treatment in type 2 diabetes patients. This study aimed to assess the impact of KCNQ1 variants on sulfonylureas response among type 2 diabetes Iranian patients. 100 patients were recruited who were under sulfonylureas therapy for six months. 50 responder and 50 non-responder patients were selected. KCNQ1 variants were determined by the RFLP method, and their role in treatment response was assessed retrospectively. Patients with rs2237895 CC and AC genotypes demonstrated a significant decrement in FBS and HbA1c after treatment over patients with AA genotypes (All P < 0.001). Compared to the A allele, the odds ratio for treatment success between carriers with rs2237895 C allele was 4.22-fold (P < 0.001). Patients with rs2237892 CT heterozygous genotype exhibit a higher reduction rate in HbA1c and FBS than CC homozygotes (P=0.064 and P=0.079, respectively). The rs2237892 T allele carriers showed an odds ratio equals to 2.83-fold over C allele carriers in the responder group compared to the non-responder group (p=0.081). Findings suggest that the KCNQ1 rs2237895 polymorphism is associated with the sulfonylureas response on Iranian type 2 diabetes patients.

Compression and morphological properties of a bio-based polyurethane foam with aluminum hydroxide

Compression and morphological evaluation of a new bio-based polyurethane foam (PUF) with aluminum hydroxide (ATH) added as flame retardant were carried out. The PUF was obtained from a blend of vegetable oils. Compression behavior of the polyurethane with different mass fractions of flame retardant (ATH) was investigated according to ASTM D1621–16. The ATH addition highly increased the compression yield strength of the specimens, going from 0.85 MPa (no ATH) to 2.34 MPa ( + 50%wt ATH). The compression yield strain did not show a noteworthy difference up to 40% ATH, presenting a significant decrement in the PUF + 50%ATH. The compression elasticity modulus increased from 15.40 MPa (no ATH) up to 139.77 MPa ( + 50%wt ATH). SEM images were used in order to evaluate the morphological structure of the foam. Regarding the cell sizes, there was no pattern observed, therefore, the cell sizes were adopted as random. The shapes of the cells were detected as elliptical in two different directions in the same cross-sectional area. The digital image correlation (DIC) technique showed higher strain values where the transverse ellipsoid-shaped cells were located, therefore, the load-oriented ellipsoids presented higher stiffness. Thus, the results for PUF with addition of ATH show that the bio-based material presented an important improvement in the compression properties, which allows this material to become more useful for different applications, such as furniture, building and automobile industries, as well as sandwich structures.

Pasireotide treatment in Cushing's disease: A single tertiary center's experience.

Patients who were followed up for CD and treated with pasireotide between 2014-2020 at Cerrahpaşa Medical Faculty, were evaluated retrospectively. The efficacy and adverse effects of pasireotide were evaluated in this study. Thirty-two patients were evaluated. The mean duration of treatment was 26.5 [range, 12.0-37.0] months. The 24-h urinary free cortisol (UFC) decreased 46% during the treatment and normalized in 37.5% of patients. A significant decrement was found between pretreatment and last follow-up UFC (p = 0.001). Plasma ACTH decreased by 21%. A significant decrement was found between pre-treatment and the 3rd month, 6th month, and last follow-up ACTH levels (p = 0.014, p = 0.017, and p = 0.017, respectively). Serum cortisol levels decreased by 18% and a significant decrement was found between pretreatment and the 3rd month, and between pretreatment and the last follow-up (p = 0.034 and p = 0.013, respectively). While fasting blood glucose at the 3rd month was significantly higher than pretreatment fasting blood glucose, no significant difference was found between pretreatment fasting blood glucose and 6th month and last follow-up fasting blood glucose. Although there was a significant difference between pretreatment HbA1c levels and the HbA1c levels at the 3rd month (5.9% vs. 6.6% p = 0.007), 6th month (5.9% vs. 6.7% p = 0.003), and the last follow-up (5.9% vs. 7.1% p = 0.001), in the last follow-up, the majority (77%) of patients had adequate glycemic control (HbA1c ≤ 7.0 %).</AbstractText> <AbstractText Label="RESULTS">The authors declare that there is no conflict of interest. Pasireotide treatment is an alternative treatment in CD, remission is obtained in the first months of treatment, and continues for an extended period. Although hyperglycemia is the most common adverse effect, it can be successfully controlled.

EFFECT OF PIGEON MANURE TEA AND Spirulina plantensis ALGAE ON NUTRITIONAL STATUS AND FRUIT QUALITY OF SUCCKARY MANGO TREES

Nutritional status and fruit physical and chemical properties of Succkart mango trees grown in clay soil under Aswan Governorate conditions, Egypt in response partial replacement of mineral nitrogen by using pigeon manure tea + Spirulina plantensis algae were investigated during 2018 and 2019 seasons. Replacement of mineral N by using pigeon manure tea + Spirulina plantensis were very effective in improving all leaves mineral contents (macro elements; N%, P%, K% and Mg % and micro nutrients; Fe, Zn, and Mn ppm). However, nonsignificant differences were observed in leaves Cu contents. Furthermore, fruit physical properties (in terms of fruit length, fruit diameter &amp; pulp/fruit ratio) and chemical properties (in terms of increasing TSS%, reducing, total sugars % &amp; vitamin C contents and decreasing total acidity%) were improved. This positive effect continually until replaced 40% of mineral N fertilizer by using 20% pigeon manure tea + 20% Spirulina plantensis. However, gradual increasing of mineral N replaced ratio from 40% to 100% caused a gradual and significant decrement in all leaves mineral elements, fruit physical and chemical properties. However, the trees received 60% mineral N + 20% pigeon manure tea + 20% Spirulina plantensis present the best results. Contrary, the trees received 0.0% mineral N + 50% 50% pigeon manure tea + 50% Spirulina plantensis present the lowest contents of macro and micro elements as well as fruit physical and chemical properties.

A comparative study of dexmedetomidine–propofol and fentanyl-propofol on perioperative haemodynamics, propofol requirement and post-operative recovery profile in patients undergoing elective abdominal surgeries - A prospective randomised double-blind study

Background: Dexmedetomidine is gaining popularity for its sympatholytic, sedative and haemodynamic stabilising properties, without significant respiratory depression.Methods: A prospective randomised double-blind study was conducted on 60 patients belonging to American Society of Anesthesiologists (ASA) Grade I and II undergoing elective abdominal surgeries who were randomised to receive either dexmedetomidine (Group D-P) or fentanyl (Group F-P) 10 Min prior to induction. Induction was done with midazolam along with propofol in 20 mg aliquots until bispectral index (BIS) value drops below 60. Infusion of one of the study drugs was continued along with propofol infusion which was titrated to maintain BIS around 40–60. Vecuronium to provide muscle relaxation and bolus doses of fentanyl were given whenever additional analgesia was needed. Intra-operative propofol, vecuronium and additional fentanyl requirement, time from discontinuation of anaesthetic drugs to extubation, time from the end of surgery to achieve a Ramsay sedation score of 2 and to the first post-operative analgesic request were recorded. Post-operatively, patients were monitored till 24 h for any adverse events.Results: A significant decrement in heart rate was observed in the D-P group in comparison to the fentanyl group. The D-P group was found to have required less propofol for induction, limited additional fentanyl requirement, less time required for extubation and a delay in request for first post-operative analgesia which was statistically significant.Conclusions: Propofol–dexmedetomidine provides better haemodynamic stability with lesser intraoperative propofol and fentanyl requirement, early cognitive recovery and longer postoperative analgesia when compared to propofol–fentanyl.