Ameliorative Effects of Adansonia Digitata Leaf Extract on Carbon Tetrachloride (CCL4) Induced Testicular Toxicity in Adult Male Wistar Rats

Adansonia digitata is locally consumed as food in Nigeria. In the present study, the ameliorative effect of the aqueous leaf extract of Adansonia digitata (AeAD) was evaluated in carbon tetrachloride (CCl4) – induced testicular toxicity in Wistar rats. To evaluate the effect of AeAD in CCl4 induced testicular toxicity, 20 adult male Wistar rats were equally divided into 4 groups (n=5). Group A animals received 1 ml olive oil per os (p.o) for two weeks, Group B animals received 2.5 ml/kg CCl4 (50% in olive oil, p.o) for two days, Group C animals received 500 ml/kg AeAD (p.o) for two weeks while Group D animals received 2.5 ml/kg CCl4 (50% in olive oil, p.o) for two days followed by 500 ml/kg AeAD (p.o) for two weeks. The ameliorative effects of AeAD were observed on reproductive hormonal parameters, activity of an antioxidant enzyme and cyto-architecture of the testis. Carbon tetrachloride treatment significantly (P<0.05) reduced levels of testosterone, follicle stimulating hormone, luteinizing hormone and superoxide dismutase levels with distortions in the cyto-architecture of the testes in treated animals. These effects were ameliorated with AeAD treatment. The results demonstrated that the AeAD has the ability to ameliorate against carbontetrachloride-induced testicular toxicity  suggesting it may have a therapeutic role in free radical mediated diseases.Keywords: Antioxidant; SOD; Testes; Histology

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Kuluttajabarometri maakunnittain 2000, 2. neljännes

Suomen virallinen tilasto (SVT

Use of failure-to-rescue to identify international variation in postoperative care in low-, middle- and high-income countries: a 7-day cohort study of elective surgery

This was an investigator-initiated study funded by Nestle Health Sciences through an unrestricted research grant and by a National Institute for Health Research (UK) Professorship held by R.P. The study was sponsored by Queen Mary University of London

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease