Anatomical variations of hepatic artery using the multidetector computed tomography angiography

Background: The frequency of normal and aberrant hepatic arteries differs among ethnicities. The aim of our work was to study the frequency of normal and aberrant hepatic arteries among Egyptians using multidetector computed tomography (MDCT) and to compare our prevalence with the prevalence of other nationalities. In addition, the gender differences of such variations were clarified. Moreover, the arterial feeding of hepatic segment IV was determined. Materials and methods: The present study was carried out on 500 patients (409 males and 91 females). Abdominal CT was performed using two MDCT systems, a 64-row, and a 256-slice system. Results: According to Michel’s classification, the normal anatomy (type I) was observed in 369 (73.8%) cases, while anomalous hepatic arterial pattern was detected in 131 (26.2%) cases. These anomalies were distributed as follows: type II in 36 (7.2%) cases, type III in 60 (12%) cases, types IV and V in 5 cases for each (1% each), type VI in 14 (2.8%) and types VIII and IX in a single case for each (0.2% each). Neither type VII nor type X was detected. Nine (1.8%) unclassified cases were observed. According to Hiaat’s classification, the anomalies were distributed as follows: type II in 41 (8.2%) cases, type III in 74 (14.8%) cases, type IV in 6 (1.2%) cases, type V in a single case (0.2%) and type VI in 2 (0.4%) cases. Finally, 7 (1.4%) unclassified cases were observed. Common hepatic artery (CHA) originated from coeliac trunk in 98% (79.8% males and 18.2% females). It originated from the abdominal aorta in 0.4% and from the superior mesenteric artery (SMA) in 0.4%. It was absent in 1.2%. Right hepatic artery (RHA) originated from the CHA in 86.6% (69.8% males and 16.8% females) and from the SMA in 13.2% (11.8% males and 1.4% females) and from the abdominal aorta in 0.2% (a single male case). Left hepatic artery (LHA) originated from the CHA in 91.2% and from the left gastric artery (LGA) in 8.8%. The most common origin of the segment IV blood supply was the LHA in 60.8%, followed by the RHA in 35%. Less commonly, blood supply derived from the hepatic artery proper (HAP) in 1%. Combined supply derived from RHA and LHA in 0.8%, from the LHA and HAP in 2% and the least encountered was from the RHA and HAP in 0.4%. Conclusions: Hepatic artery variations among Egyptians have a different distribution when compared to such variations among other species. The normal hepatic arterial pattern was observed in 73.8%, while the anomalous was detected in 26.2%. The CHA originated from the coeliac trunk in 98%, the RHA originated from the CHA in 86.6% and the LHA originated from the CHA in 91.2%. The most common arterial supply of the hepatic segment IV is derived from the LHA (60.2%)

Modifying the design of pond production systems can improve the health and welfare of farmed Nile tilapia, Oreochromis niloticus

Infected fish have been known to recover from mild illness when they are able to locate to warmer water. This study aimed to replicate this 'behavioural fever' effect in an aquaculture setting by artificially heating a section of a fish pond (thereby introducing a thermal gradient) and effectively modifying pond design. This was achieved through the construction of a 'greenhouse' type structure above a section of the pond. Over the length of the production cycle at three typical Nile tilapia (Oreochromis niloticus) farms, the study collected data on water quality and fish growth and at the end of the cycle, blood samples were taken and total production was recorded. At each farm, fish were divided into two identical ponds, one with a greenhouse covering 3% of the pond surface area and one without. Results showed that greenhouse was effective in warming the surface of the water immediately below it. Oxygen levels were also higher under the greenhouse than outside of it and higher than in the control pond. Fish reared in the greenhouse ponds tended to be larger than the control ponds and had improved physiological and immune status (i.e., better liver and kidney function, higher antioxidant activity and lysozyme count; p < 0.05). The results of this study suggest that low-cost interventions that introduce thermal gradients in aquaculture systems may hold promise for improving health and welfare status of farmed fish in developing countries.Article Information Received 26 September 2022 Revised 05 November 2022 Accepted 28 November 2022; O n l i n e F i r s t A r t i c l

Modifying the design of pond production systems can improve the health and welfare of farmed Nile tilapia, Oreochromis niloticus

Infected fish have been known to recover from mild illness when they are able to locate to warmer water. This study aimed to replicate this 'behavioural fever' effect in an aquaculture setting by artificially heating a section of a fish pond (thereby introducing a thermal gradient) and effectively modifying pond design. This was achieved through the construction of a 'greenhouse' type structure above a section of the pond. Over the length of the production cycle at three typical Nile tilapia (Oreochromis niloticus) farms, the study collected data on water quality and fish growth and at the end of the cycle, blood samples were taken and total production was recorded. At each farm, fish were divided into two identical ponds, one with a greenhouse covering 3% of the pond surface area and one without. Results showed that greenhouse was effective in warming the surface of the water immediately below it. Oxygen levels were also higher under the greenhouse than outside of it and higher than in the control pond. Fish reared in the greenhouse ponds tended to be larger than the control ponds and had improved physiological and immune status (i.e., better liver and kidney function, higher antioxidant activity and lysozyme count; p < 0.05). The results of this study suggest that low-cost interventions that introduce thermal gradients in aquaculture systems may hold promise for improving health and welfare status of farmed fish in developing countries

COMPARATIVE PROFILING OF BIOMARKER PSORALEN IN ANTIOXIDANT ACTIVE EXTRACTS OF DIFFERENT SPECIES OF GENUS FICUS BY VALIDATED HPTLC METHOD

Background: A simple but sensitive HPTLC method was developed for the comparative evaluation of psoralen in antioxidant active extracts of leaves of five different species of genus Ficus (Ficus carica, Ficus nitida, Ficus ingens, Ficus palmata and Ficus vasta). Materials and Methods: HPTLC studies were carried out using CAMAG HPTLC system on Glass-backed silica gel 60F254 HPTLC pre-coated plates using selected mobile phase toluene: methanol (9:1). The antioxidant activity was carried out, using DPPH free radical method. Results: Among all the five species of genus Ficus, F. palmata and F. carica exhibited comparatively good antioxidant activity in DPPH assay. The developed HPTLC method was found to give a compact spot for psoralen (Rf = 0.55±0.001) at 305 nm. The regression equation and r2 for psoralen was found to be Y= 4.516X+35.894 and 0.998. The quantification result revealed the presence of psoralen in only two species, F. carica (0.24%, w/w) and F. palmata (1.88%, w/w) which supported their supremacy for anti-oxidant potential over other species. The statistical analysis proved that the developed method was reproducible and selective. Conclusion: The developed method can be used as an important tool to assure the therapeutic dose of active ingredients in herbal formulations as well as for standardization and quality control of bulk drugs and in-process formulations. This method can also be employed for the further study of degradation kinetics and determination of psoralen in plasma and other biological fluids

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Management control systems in innovation companies: A literature based framework

Past research has traditionally argued that management control systems (MCSs) may present a hindrance to the creativity of innovation companies. This theoretical paper surveys the literature to focus an investigation on the MCSs of innovation companies. Within the object of control paradigm the paper develops and presents a theoretical model of the impact of eleven external, organisational and innovation related contingency factors on the MCSs in companies that engage in innovation activities. We also suggest measures for further empirical research. By formulating hypotheses on 43 potential interactions the model predicts contradictory influences on two direct control categories, results and action control, but stresses the importance of two indirect categories, personnel and cultural control. More specifically, the high levels of technological complexity and innovation capability in this type of company are expected to be negatively associated with the application of results and action control, whereas personnel and cultural seem to be more appropriate. Furthermore, important sources of finance, venture capital and public funding, are both hypothesised to be positively associated with the application of results, action and personnel control; whereas only public funding is predicted to be positively related to the application of cultural control. The principal contribution of this paper lies in synthesising the literature to provide a model of the impact of a unique set of eleven contingency factors for innovation companies on a broad scope of controls. In addition, the contingency model, if empirically validated, would add value by inferring the particular forms of management control which would be beneficial in innovative company settings. © 2014 Springer-Verlag Berlin Heidelberg

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe