The impact of strife in the poetry of Nasr bin Sayar

هدفت الورقة إلى دراسة صدى الفتن في خراسان في شعر نصر بن سيّار آخر عامل لخراسان لعهد بني أمية، وطبيعي أن تكون صدى هذه الفتن طاغية على شعره بحكم وجوده باعتباره مركزاً للأحداث في خراسان، اعتمدت الدراسة المنهج الوصفي وذلك بجمع شعر نصر في  الفتن من كتب التراجم والسير، والتاريخ والأدب- لعدم وجود ديوان له- وتحليله، ومطابقته بالأحداث وخلصت الورقة إلى عدة نتائج أهمها: جاء شعر نصر في العصبية القبلية تعصباً للمضرية على اليمانية- كما هو متوقع- خلا أبيات له في إنصاف حيٍّ من اليمانية، وأبيات قليلة أخرى تدعو إلى نبذ الفرقة واتحاد القبائل العربية جميعها ضد عدوها المتربص بها. الفتن التي تناولها شعر نصر بن سيّار كانت فتنا متداخلة سياسية كانت أم دينية أم قبلية أدت في النهاية إلى وضع حدٍّ للحكم الأموي، اتسمت أشعار نصر التي قالها بأخرة بالتحذير من الثورة العباسية، وإنِّها إن لم تحسم سوف تنتشر من خراسان إلى ربوع الخلافة الإسلامية كلها، وهو مليء بالتصاوير الفنية وقد صدقت كل تنبؤاته.            The paper aimed to study the impact of strife in Khorasan in the poetry of Nasr bin Sayar, the last governor of Khorasan in the era of Banu Umayyah. Naturally, the impact of this strife would overwhelm his poems with the notice of his existence as a center around which events revolve in Khorasan. The study adopted the descriptive approach by collecting Nasr's poetry in the strife from books of translation, biographies, history and literature, analyzing and comparing it with events.             The paper concluded with several results, the most important of which is: Nasr's poetry came in tribal extremism as expected. An extremism for Mudhariya against Yamani, except for some verses praising a Yamani District or a few other verses calling for the renunciation of division and the union of all Arab tribes against their lurking enemy. This strife that Nasr addressed through his political, religious, or tribal poetry eventually led to an end to Umayyad rule.             Nasr's poems were characterized by the fear of the Abbasid revolution and that, if not resolved, it would spread from Khorasan to all parts of the Islami caliphate. It is poetry complete after artistic image, and all his predication were true

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms

Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4&nbsp;% presented with RS, while 13.6&nbsp;% had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7&nbsp;% vs RS: 37.5&nbsp;%). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1&nbsp;% vs. RS 32.0&nbsp;%), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83-0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders