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Background: Obesity is a global health concern associated with a range of perioperative challenges, particularly during general anesthesia. Altered respiratory mechanics, pharmacokinetics, and increased comorbidities in obese patients may compromise anesthetic safety and recovery outcomes. Despite rising obesity rates in Libya, local data on anesthesia-related risks in this population remain limited.Objective: This study aimed to evaluate the effects of obesity on anesthetic recovery times and hemodynamic parameters in patients undergoing general anesthesia in a public hospital in Libya.Methods: A prospective observational study was conducted on 20 adult surgical patients from January to May 2023. Patients were divided into obese (BMI ≥ 30 kg/m2)and non-obese groups. Parameters assessed included time to spontaneous ventilation, Laryngeal Mask Airway (LMA) removal time, eye-opening time, and post-anesthesia Care Unit (PACU) discharge time. Intraoperative hemodynamic measures and the prevalence of comorbidities were also recorded. Statistical analysis was performed using SPSS version 20, with p < 0.05 considered statistically significant.Results: Obese patients (n = 12) exhibited significantly longer recovery times compared to non-obese patients (n = 8): spontaneous ventilation (12.8 vs. 9.4 min, p = 0.002), LMA removal (14.1 vs. 10.1 min, p = 0.001), eye opening (13.5 vs. 9.7 min, p < 0.001), and PACU discharge (68.3 vs. 49.5 min, p < 0.001). Obese patients also had lower mean arterial pressure (82.4 vs. 91.5 mmHg, p = 0.026), higher heart rates (95.2 vs. 88.3 bpm, p = 0.041), and reduced oxygen saturation (94.1% vs. 96.7%, p = 0.018). Comorbidities such as hypertension and diabetes were significantly more prevalent among obese patients.Conclusion: Obesity significantly prolongs anesthetic recovery and impairs hemodynamic stability in surgical patients undergoing general anesthesia. These findings support the need for targeted perioperative strategies, preoperative risk stratification, and extended postoperative monitoring for obese individuals, particularly in resource-limited healthcare settings.

Objective: To assess the knowledge, attitudes and practices declared among general practitioners (GPs) concerning the use of antibiotics for the treatment of ARI in children under 5 years in Lubumbashi. Methods: A cross-sectional survey was conducted to assess the level of knowledge, attitude and practices concerning antibiotic prescribing among 67 GPs working in the pediatric setting in various health structures in Lubumbashi city, in the Democratic Republic of Congo. Data were collected from April 1st to June 30th, 2020. Results: GPs had limited knowledge about antibiotic prescriptions (mean of 46% correct answers to 8 questions). Although they are generally concerned about antibiotic resistance (mean ± SD = 0.50 ± 0.68), and are unwilling to submit to pressure to prescribe antibiotics to meet patient demands and expectations (mean ± SD = –1.78 ± 0.31) and the requirements to prescribe antibiotics for fear of losing patients (mean ± SD = –1.67 ± 0.47), there was a lack of motivation to change prescribing practices (mean ± SD = −0.37 ± 0.94) and strong agreement that they themselves should take responsibility for tackling antibiotic resistance (mean ± SD = 1.24 ± 0.74). Multiple linear regression results showed that higher knowledge scores were associated with less avoidance of responsibility when prescribing antibiotics (β = 0.919; p = 0.000). Conclusion: To curb the over-prescription of antibiotics, it is not enough to improve knowledge in itself. The lack of motivation of physicians to change must be addressed through a systematic approach. These data show the need for interventions that support the rational prescribing of antibiotics.

Many studies from the early 20th century on the significance of the pores of Kohn were assessed based on the pathogenesis and pathology of pneumococci pneumonia occurring in man. The pneumococci were carried in the edema fluid directly from alveolus to alveolus through the pores of Kohn and from bronchiole to bronchiole as a result of repeated aspirations, aided by breathing, coughing, and gravity. With the emerging minimally invasive and non-invasive techniques experimentations and the current medications; tackling exacerbations and improving the pulmonary function in various lung diseases remains a dilemma for clinicians and researchers. In this article, we aim to review specifically the pores of Kohn as this is the portal for the spread of infection but also lung recruitment during breathing.

We analyze optomechanically induced Transparency and asymmetric Fano-line shape Profile in a two-mode cavity system, coupling at weak and strong coupling regimes. The model system consists of one mechanical mode and two optical modes. The transmission shows nonreciprocal behavior. Both the forward transmission and backward reflection for the system are analyzed for both optic-optic and mechanical-optic cavities by considering various system parameters. The output spectra lead to sharp asymmetric Fano-resonance and tunable transparency. Double line-shape profile is observed in the output Spectrum. Our proposal provides a new platform for application in quantum telecommunications and a photonic device like optical Switches.

Background and objective: Peroxidase is an oxidoreductase that uses different compounds as substrates and thus can be utilized for different applications. The goal of this work is to isolate peroxidase from lemon peels using Three-Phase Portioning (TPP). Methods: TPP was set by adding varying amounts of salts and alcohol and the enzyme activity recovery was measured for each variable. Different parameters were optimized successively in order to achieve the highest enzyme activity recovery including salt type, salt concentration, pH, alcohol/crude extract ratio and type of alcohol and then, combining all optimized conditions together.Results: Salt that gave maximal recovery was sodium potassium tartrate, optimal salt concentration was 15%, optimal pH was 8, optimal alcohol/crude extract ratio was 1 and t-butanol was preferred to 1-butanol. Efficiently, upon combining all optimized factors, an activity recovery of 175% was obtained.Conclusion: This protocol provides an easy, feasible method to efficiently isolate peroxidase from lemon peels using TPP.

Purpose: The purpose of the study is to access the prevalence of accessory right inferior hepatic veins and their relevant significance in liver transplantation. Materials and Methods: A retrospective study was done in which the CT of 82 potential liver transplant candidates between January 2012 and March 2013 were reviewed. The presence of the accessory right inferior hepatic vein was examined; the diameters of the accessory inferior hepatic veins and the distance between the point where they open into the inferior vena cava on the coronal plane and to the right hepatic vein-inferior vena cava junction was measured. Results: Out of 82 patients, 42 (51%) had accessory right inferior hepatic veins. Right accessory inferior hepatic veins larger than 3 mm were detected in 23 (28%) patients. The distance of these veins to the right hepatic vein-inferior vena cava junction was more than 4 cm in 13 (15%) patients. Conclusion: The precise preoperative knowledge of accessory right inferior hepatic veins is essential in living donor liver transplantation.

Objectives: To highlight and determine the maternal and neonatal outcome and associated risks for patients who have undergone their 6th and more caesarean sections. Design: Case control study. Setting: Tertiary Centre (Security Forces Hospital – Riyadh – Saudi Arabia). Patients: 80 patients selected to study group who have undergone their sixth and more caesarean sections in Security Forces Hospital. Between June 2006 and May 2010. This group was compared to 80 patients who have undergone their third to fifth caesarean sections during the same time period and immediately following the studied case. Main outcome measured: Age and parity of women in study and the control group were correlated with the number of previous caesarean sections. Intra operative and post-operative maternal complications including presence and grade of adhesions, intra partum and postpartum hemorrhage, use of measurement and methods (both medical and surgical) to control bleeding such as Bakry balloon, Internal iliac artery ligation, etc., were highlighted. Bowel injury, blood transfusion, admission to surgical intensive care, incidence of placenta previa and accreta, post-operative complications like paralytic ileus, wound infection were also noted. Further, neonatal outcome including birth weight, Apgar score, and need for neonatal intensive care unit admission were reviewed. Results: Patients in the study group had higher incidence of extensive adhesions (41.25%) compared to (12.25%) in the control group. Bowel injury was (2.5%) in study group with none in the control group. The incidence of placenta previa was (8.75%) in the study group as compared to (2.5%) in the control group, with placenta accreta complicating (28.57%) of placenta previa seen only in the study group. Blood transfusion was higher in the study group (20%) as compared to (5%) in the control group. Neonatal admission to NICU was higher in the study group (27.5%) in comparison to the control group (12.5%). Also birth weight was lower in the study group. Conclusion: The more the number of caesarean sections, the more the maternal and neonatal morbidity. Patients should have proper counselling during antenatal follow up about the risks of repeated caesarean sections, and offered bilateral tubal ligation after the third or fourth caesarean sections.

The Injection of autologous Adipose-Derived Stem Cells (ADSCs) and Stromal Vascular Fraction (SVF) into dermal and subdermal layers can improve skin volume and rejuvenation. The SEFFI (Superficial Enhanced Fluid Fat Injection) technique, which involves minimal manipulation of autologous microfragmented adipose tissue, was utilized for harvesting and re-injection, using the SEFFILLER™ disposable medical device. Mechanical fragmentation of adipose tissue is a well-established surgical technique that stimulates tissue regeneration, filler, and biological activity. The study evaluated the biological properties (regenerative and anti-aging) of different harvest and processing fat graft methods among which the fragmented adipose tissue, specifically focusing on the presence of exosomes. Exosomes, nanometer-sized vesicles produced by cells for cellular communication, were found to contain miRNAs with anti-inflammatory, regenerative, and vascular content. The products’ contained exosomes were confirmed in the study through electron microscopy, Western Blotting, gene expression, and sequencing of miRNA content. 

Septic arthritis of the shoulder joint is rare and might affect around 3% of the general population [1]. A delay in diagnosis may increase morbidity and lead to bone and cartilage destruction [2]. Septic arthritis is an unusual complication of pregnancy and can progress to permanent arthropathy and disability [3]. Septic arthropathy in pregnancy requires multidisciplinary team involvement for prompt recognition and treatment to improve both maternal and fetal outcomes. High index of suspicion is vital when clinical and laboratory findings suggest septic arthritis. There are multiple predisposing factors reported previously for septic arthritis of the shoulder in pregnancy such as medical conditions, pyelonephritis and trauma. We report a 37 year old lady who presented at 26 weeks gestation with acute left shoulder pain and high temperature following minor left palm trauma. She also had left mastectomy with axillary clearance ten years earlier. She underwent arthroscopic wash out of her left shoulder joint and was covered with antibiotics with rapid improvement and recovery. We reinforce the importance of early multidisciplinary involvement when septic arthritis of the shoulder in pregnancy is suspected especially in women who have had previous mastectomy and axillary clearance which could be a predisposing factor for such a rare and serious joint condition in pregnancy.

Determination of the detector efficiency using volumetric cylindrical sources is very important in various scientific and industrial fields, especially in the field of quantitative analysis. To calculate the absolute activity of any sample, the full-energy peak efficiency (FEPE) of the detector is needed. By applying the efficiency transfer method, the FEPE of the detector would be determined easily without using the standard sources. This approach depends on two main factors. The first one, is the reference efficiency of the reference source, which is determined experimentally, and the second one, is the calculation of the effective solid angle ratio between the sample and the reference source geometries. This work introduces an empirical formula for calculating the second factor for using two different sizes of NaI(Tl) detectors. The validity of this empirical formula was successfully demonstrated by comparing the calculating values with the experimental values.