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What ' s known on the subject? and What does the study add? A number of SIMS have been introduced into clinical practice in 2006 and has been so far shown to be inferior to standard mid urethral-slings. Adjustable SIMS (Ajust) have been recently introduced into clinical practice however with little evidence on its safety and effi cacy in surgical treatment of female SUI.SIMS-Ajust ® is associated with low rates of postoperative pain and peri-operative morbidity and is both feasible and acceptable under local anaesthesia. The patient reported success rate at 1-year is 80%. OBJECTIVES• To determine whether an adjustable single-incision mini-sling (SIMS, Ajust ® ) is safe and effective in the management of female stress urinary incontinence (SUI) at 12 months follow-up.• To determine whether it is feasible to be performed under local anesthesia (LA). MATERIALS AND METHODS• The present study is a multicentre prospective cohort study in which 90 female patients underwent SIMS-Ajust ® using a standardized insertion technique.• The last 45 women were offered the procedure under LA.• All patients completed their 12-month follow-up. RESULTS• The patient-reported success rate, using Patient Global Impression of Improvement (PGI-I), was 80% at 12 months follow-up and a further 6% ( n = 5) reported themselves to be ' improved ' .• In all, 32/45 (71%) patients agreed to undergo the procedure under LA while one patient required conversion to general anaesthetic.• There was no organ damage or requirement for blood transfusion.• Signifi cantly lower rates of blood loss ( P = 0.025) and postoperative voiding diffi culties ( P = 0.026) were seen in the LA group.• The re-operation rate for SUI was 6% at 12 months. CONCLUSIONS• SIMS (Ajust) appears to be a safe procedure, which is feasible under LA.• SIMS (Ajust) have an 80% patientreported success rate at 12 months follow-up. Fig. 1 ) and, unlike previous SIMS, it provides a robust insertion into the obturator internus muscle/membrane and allows post-insertion adjustment of the tape [ 11 ] . The aim of the present study was to establish the safety profi le of this procedure, the acceptability/feasibility of performing it under LA and the patient-reported success rates at 12 months follow-up. KEYWORDS MATERIAL AND METHODSThe present study is a multi-centre prospective cohort study. All patients admitted for MUS in six centres in Scotland in the period between May and December 2009, and who met the inclusion criteria, were invited to participate in the study; we anticipated recruiting 100 women. The participating surgeons -three urogynaecologists and three gynaecologists, all experienced in standard MUS, having done more than 100 procedures each -attended a formal training day and performed at least fi ve procedures under GA before offering the LA option. The inclusion criteria were urodynamic SUI or urodynamic mixed urinary incontinence (MUI). All patients failed or declined supervised pelvic fl oor muscle training (PFMT). Patients with urodynamic MUI must have reported predomin...

Objective:To examine the validity of central venous oxygen saturation (ScvO2) as a numerical substitution of mixed venous oxygen saturation (SvO2) in adult patients undergoing normothermic on pump beating coronary artery bypass grafting (CABG).Materials and Methods:Prospective clinical observational study was done at King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. Thirty four adult patients scheduled for coronary artery surgery were included. Patients were monitored by a pulmonary artery catheter (PAC) as a part of our routine intraoperative monitoring. SvO2 and ScvO2 were simultaneously measured 15 minutes (T1) and 30 minutes (T2) after induction of anesthesia, 15 and 30 minutes after initiation of cardiopulmonary bypass (T3 and T4), and 15 and 30 minutes after admission to intensive care unit (T5 and T6).Results:ScvO2 showed higher reading than SvO2 all through our study. Our results showed perfect positive statistically significant correlation between SvO2 and ScvO2 at all data points. Individual mean of difference (MOD) between both the readings at study time showed MOD of 1.34 and 1.44 at T1 and T2 simultaneously. This MOD was statistically insignificant, but after on pump beating normothermic bypass was initiated; MOD was 5.2 and 4.4 at T3 and T4 with high statistical significance. In ICU, MOD continues to have high statistical significance, MOD was 6.3 at T5 and at T6 it was 4.6.Conclusions:In on pump beating CABG patients; ScvO2 and SvO2 are not interchangeable numerically. ScvO2 is useful in the meaning of trend; our data suggest that ScvO2 is equivalent to SvO2 , only in the course of clinical decisions as long as absolute values are not required.

Background Endostatin is a protein linked to the C-terminal of collagen in the basement membrane of endothelial cells. It functions as an antiangiogenic protein. It inhibits endothelial proliferation, migration, and tube formation. Studies have observed that it downregulates endothelial-signaling pathways of proangiogenic activity as well as upregulates the angiogenic gene. Aim This work was designated to explore the levels of endostatin in coronavirus disease 2019, trying to investigate its role as a prognostic marker. Patients and methods Patients with positive PCR for SARS-CoV-2 were divided into two groups (survivors and nonsurvivors). Computed tomography chest was for each patient. The nonsurvivor group comprised 19 patients and the survivor group had 31 patients. In addition, 50 normal volunteers participated in this study and served as a control group. Serum endostatin was measured by ELISA and was compared with other measured laboratory parameters. Results Endostatin was statically increased in nonsurvivors than both survivors and normal volunteers (P 1=0.007, P 2=<0.001). However, this significant increase was still observed in survivors on comparing with normal individuals. There was a correlation between endostatin and different parameters in coronavirus disease 2019 patients. Conclusion The high level of endostatin in this prospective study and its correlation with laboratory makers and clinical manifestations leads us to consider it as a valuable prognostic factor. Moreover, it can predict mortality and severity of patients. It was important to conduct a study on large scale to confirm this value.