Early oral feeding and its impact on postoperative outcomes in head and neck cancer surgery: a meta-analysis.

BACKGROUND: Early oral feeding has been previously postulated to contribute to developing postoperative complications following head and neck reconstructive surgeries using free flaps. This study assessed the association between the timing of oral feeding (early vs. late) and postoperative complications and length of hospital stay among these patients. METHOD: PubMed, Scopus, Cochrane, and Web of Science were searched using terms such as "oral feeding" and "head or neck cancer." We utilized RevMan software version 5.4 for the analysis. The study defined early oral feeding as feeding within 5-day post-operation, while late oral feeding was defined as feeding after the fifth postoperative day. Five papers that met the inclusion criteria were included in the analysis, with 1097 patients. RESULTS: The results showed that early feeding was not significantly associated with postoperative fistulas (RR 0.49, 95% CI 0.23 to 1.05, p-value = 0.07), hematoma/seroma (RR 0.71, 95% CI 0.33 to 1.51, p-value = 0.38), or flap failure (RR 0.84, 95% CI = 0.38 to 1.87, p-value = 0.67). However, early oral feeding was significantly associated with shorter hospital stays than late oral feeding (MD -3.18, 95% CI -4.90 to -1.46, p-value = 0.0003). CONCLUSION: No significant difference exists between early and late oral feeding regarding the risk of postoperative complications in head and neck cancer (HNC) patients who underwent free flap reconstruction surgery. However, early oral feeding is significantly associated with a shorter hospital stay than late oral feeding. Thus, surgeons should consider implementing early oral feeding after free flap reconstruction in HNC patients.

Physical activity patterns among obese adults attending rural primary health care units, Ismailia Governorate, Egypt: A case-control study.

Obesity is an ignored health problem in all countries; there are a lot of health problems related directly or indirectly to overweight and obesity. The incidence of COVID-19 with social isolation and technological development in recent years strongly contributed to a progressive increase in obesity. . Assess the pattern of the 3 divisions of physical activity and sedentary behaviors in obese patients. Physical inactivity is a significant concern, especially among individuals with obesity and certain demographic characteristics. Addressing these factors and promoting physical activity interventions tailored to specific populations is essential in combating sedentary behavior and its associated health implications.This case-control study included 350 adult obese patients (BMI ≥ 30) and 75 people with normal BMI (18.5-24.9). Their sociodemographic data were analyzed and their pattern of physical activity related to work, movement to and from places for 10 minutes, and pattern of recreational activity were assessed, in addition to the assessment of the sedentary behaviors. The mean age of the study group was 34 years, the majority were females, educated, and working. Forty five percent of the total sample were physically inactive; the pattern of activity during travel to and from places (10 min) was lower in obese patients. Recreational activities were low in the studied population, in the present study the time spent sitting or reclining (except sleeping) was significantly higher among obese participants than controls (P ≤ .001). Obesity, urban residence, unemployment and illiteracy were independent risk factors for physical inactivity.

Serum trimethylamine N-oxide levels among coronary artery disease and acute coronary syndrome patients: a systematic review and meta-analysis.

Background and Aim: Recent studies have linked trimethylamine N-oxide (TMAO) to cardiovascular diseases; our study aimed to analyze the association between coronary artery disease (CAD), acute coronary syndrome (ACS), and TMAO. Methods: PubMed, Scopus, Embase, and Web of Science were searched using terms such as 'CAD' and 'TMAO'. Only observational controlled studies were included. RevMan software version 5.4 was used for the analysis. Results: A significant association was found between the CAD group and increased serum TMAO levels compared with the control group (MD=1.16, 95% CI=0.54-1.78, P=0.0003). This association remained significant among acute coronary syndrome patients (MD=0.98, 95% CI=0.73-1.23, P<0.00001) and was also detected among young and old CAD patients (MD=0.35, 95% CI=0.06-0.64, P=0.02 and MD=1.36, 95% CI=0.71-2.01, P<0.0001, respectively). On further analysis of intestinal metabolites, the authors detected an insignificant association between choline, betaine, carnitine, and CAD. According to our sensitivity analysis, TMAO is an acceptable diagnostic marker for CAD (0.721, SE was 0.0816, 95% CI: 0.561-0.881). Conclusion: TMAO is an acceptable diagnostic marker for CAD, with significantly higher levels among these patients regardless of their age. Other metabolites did not show such an association. The role of serum level TMAO in the early diagnosis of CAD should be further explored.