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Abstract This study determined the prevalence and the associated factors with meeting the recommended amount of physical activity among type 2 diabetes mellitus (T2DM) patients receiving care in resource-limited settings of the West Bank of Palestine. Physical activity was assessed using the World Health Organization’s Global Physical Activity Questionnaire. Associations were examined using multivariate logistic regression. Of the 302 patients included, 117 (38.7%) met the recommended amount of physical activity. Being younger than 58 years [aOR = 2.1 (95% CI 1.0–4.3], were employed [aOR = 2.3 (95% CI 1.1–4.9)], had high income [aOR = 3.9 (95% CI 1.3–11.9)], had thought that physical activity was crucial for T2DM patients [aOR = 32.7 (95% CI 3.9–275.5)], did not have comorbidities [aOR = 2.2 (95% CI 1.1–4.4)], had normal weight [aOR = 2.8 (95% CI 1.3–6.0)], and those who were overweight [aOR = 2.6 (95% CI 1.1–6.0)] were more likely to meet the recommended amount of physical activity compared to the patients who were 58 years or older, had low income, did not think that physical activity was crucial for T2DM patients, had comorbidities, and were obese, respectively. There is a need to increase physical activity among T2DM patients in resource limited settings.

Abstract This research studies high-density polyethylene (HDPE) behavior that is not easily identifiable in a production setting, but is, nevertheless, necessary for consideration when specifying equipment performance for hot plate [...]

Introduction: Leiomyoma of the bladder is a rare diagnosis and accounts for 0.43% of all bladder tumors. We herein present a case of a thirty-nine-year-old female diagnosed with bladder leiomyoma presenting with urinary retention. Workup of her urinary retention revealed a midline bladder neck mass. Transurethral resection of her tumor revealed pathology consistent with bladder leiomyoma. Surgical resection is generally the recommended management of this lesion to make a histopathological diagnosis despite low potential of malignant transformation. Although these tumors are benign, they can cause severe obstructive or irritative symptoms. Further research is needed to determine the pathophysiology of these tumors

Background Flow diversion (FD: flow diversion, flow diverter) is an endovascular treatment for many intracranial aneurysm types; however, limited reports have explored the use of FDs in bifurcation aneurysm management. We analyzed the safety and efficacy of FD for the management of intracranial bifurcation aneurysms. Methods A systematic review identified original research articles that used FD for treating intracranial bifurcation aneurysms. Articles with >4 patients that reported outcomes on the use of FDs for the management of bifurcation aneurysms along the anterior communicating artery (AComA), internal carotid artery terminus (ICAt), basilar apex (BA), or middle cerebral artery bifurcation (MCAb) were included. Meta-analysis was performed using a random effects model. Results 19 studies were included with 522 patients harboring 534 bifurcation aneurysms (mean size 9 mm, 78% unruptured). Complete aneurysmal occlusion rate was 68% (95% CI 58.7% to 76.1%, I²=67%) at mean angiographic follow-up of 16 months. Subgroup analysis of FD as a standalone treatment estimated a complete occlusion rate of 69% (95% CI 50% to 83%, I²=38%). The total complication rate was 22% (95% CI 16.7% to 28.6%, I²=51%), largely due to an ischemic complication rate of 16% (95% CI 10.8% to 21.9%, I²=55%). The etiologies of ischemic complications were largely due to jailed artery hypoperfusion (47%) and in- stent thrombosis (38%). 7% of patients suffered permanent symptomatic complications (95% CI 4.5% to 9.8%, I²=6%). Conclusion FD treatment of bifurcation aneurysms has a modest efficacy and relatively unfavorable safety profile. Proceduralists may consider reserving FD as a treatment option if no other surgical or endovascular therapy is deemed feasible. [ABSTRACT FROM AUTHOR]

Research is a significant component of academic neurosurgery. This analysis of current American leaders in neurosurgery provides a bibliometric review of research impact and productivity with a focus on m-quotient analysis throughout the stages of career development including medical school, residency and faculty. A random selection of neurosurgeons (n = 82) from the Society of Neurological Surgeons (SNS) was analyzed using Scopus to collect research and publication data including publication count, h-index, and m-quotient during each career phase. The mean number of publications, h-index, and m-quotient for medical school, residency, and faculty career stages are reported. Neurosurgeons with self-reported subspecialties of vascular, skull base, functional, spine, and pediatrics had significantly higher m-quotients than general neurosurgeons (p

Purpose. Urinary tract infections (UTIs) are common in the first 6 months after renal transplantation, and there are only limited data about UTIs after transplantation in Saudi Arabia in general. Methods. A retrospective study from January 2017 to May 2020 with 6-month follow-up. Results. 279 renal transplant recipients were included. Mean age was 43.4 ± 16.0 years, and114 (40.9%) were women. Urinary stents were inserted routinely during transplantation and were removed 35.3 ± 28 days postoperatively. Ninety-seven patients (35%) developed urinary tract infections (UTIs) in the first six months after renal transplantation. Of those who developed the first episode of UTI, the recurrence rates were 57%, 27%, and 14% for having one, two, or three recurrences, respectively. Late urinary stent removals, defined as more than 21 days postoperatively, tended to have more UTIs (OR: 1.43, P: 0.259, CI: 0.76–2.66). Age >40, female gender, history of neurogenic bladder, and transplantation abroad were statistically significant factors associated with UTIs and recurrence. Diabetes, level of immunosuppression, deceased donor renal transplantation, pretransplant residual urine volume, or history of vesicoureteral reflux (VUR) was not associated with a higher incidence of UTIs. UTIs were asymptomatic in 60% but complicated with bacteremia in 6% of the cases. Multidrug resistant organisms (MDROs) were the causative organisms in 42% of cases, and in-hospital treatment was required in about 50% of cases. Norfloxacin + Bactrim DD (160/800 mg) every other day was not associated with the lower risk of developing UTIs compared to the standard prophylaxis daily Bactrim SS (80/400 mg). Conclusion. UTIs and recurrence are common in the first 6 months after renal transplantation. Age >40, female gender, neurogenic bladder, and transplantation abroad are associated with the increased risk of UTIs and recurrence. MDROs are common causative organisms, and hospitalization is frequently required. Dual prophylactic antibiotics did not seem to be advantageous over the standard daily Bactrim.

Purpose. To evaluate the impact of early (3 weeks) urinary stent removal on urinary tract infections (UTIs) post renal transplantation. Methods. A retrospective study was performed including all adult renal transplants who were transplanted between January 2017 and May 2020 with a minimum of 6-month follow-up at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Results. A total of 279 kidney recipients included in the study were stratified into 114 in the early stent removal group (ESR) and 165 in the late stent removal group (LSR). Mean age was 43.4 ± 15.8; women: n: 114, 40.90%; and deceased donor transplant: n: 55, 19.70%. Mean stent removal time was 35.3 ± 28.0 days posttransplant (14.1 ± 4.6 days in the ESR versus 49.9 ± 28.1 days in LSR, p

Introduction: Anterior lumbar interbody fusion is a common and well-utilized approach to treatment of lower lumbosacral spondylolisthesis. The authors aim to assess the impact of perioperative neurological deficits on the in-hospital morbidity and mortality. As such, the clinical risk factors leading to perioperative neurological deficits in patients undergoing anterior lumbar interbody fusion are assessed in a large cohort sample from the national inpatient sample (NIS). Methods: Data was collected from the NIS-HCUP, a stratified sample of 20% of all community hospital discharges from the years 1999–2011 was analyzed. Patients who underwent anterior lumbar interbody fusion (ALIF) as their primary procedure were included. Results: The study cohort consisted of 67,900 patients with a mean age of 49.37 years. Approximately 54.96% of the patients were female, 83.60% were white, and 92.62% of the patients were operated on electively. The incidence of perioperative neurological deficit following ALIF was 1.02%. Perioperative neurological deficits were found to independently predict morbidity following ALIF in our multivariable analysis (OR 2.07; CI 1.688 – 2.541) but were not an independent predictor of mortality. Patients with increasing age (OR 1.034; CI 1.027–1.041) and high vWR 5–14 (OR 1.456; CI 1.065–1.990) had an increased risk of having perioperative neurological deficits. Conclusion: Overall, perioperative neurological deficits following ALIF are rare (1.02%), and mortality is extraordinarily rare (0.15%). Patients with older age and higher comorbidities are at increased risk for of perioperative neurological deficit and consequently in hospital morbidity. As such, these results serve to further illuminate the importance of preoperative screening and proper patient stratification.