Bacterial and Heavy Metals Analyses in Fish at Shawaka Area of Tigris River

This study was conducted from October to December 2012. 35 fish were collected from the Shawaka area of the Tigris river for quality analyses using bacteriological and chemical parameters. Results of bacteriological analysis showed that the total viable bacteria count  in the fish gut, skin and gill were ranged from 35.35×103 - 6×103 cfu/g, 34.9×103 -21×103 cfu/g and 30.1×103 - 1.9×103 cfu/g respectiveluy. 151 bacterial isolates  were obtained and identified into 14 genera (13 Gram negative bacteria + one Gram positive bacteria). The predominant bacteria from different organs were  Staphylococcus spp., E. coli, Proteus spp., Citrobacter spp., Enterobacter spp. respectively. The results of  study indicated that most fish samples were polluted with high levels of  heavy metal Pb, Cd and Hg. Concentration of these heavy metals exceed limits for the fish recommended by the World Health Organization   (WHO) and the Centre for Environment, Fisheries and Aquaculture Science (CEFAS). Key word: Tigris river, Fish, Bacteria, Heavy Metal

PURIFICATION AND CHARACTERIZATION OF PROTEASE FROM Pseudomonas aeruginosa ISOLATED FROM SOME WOUND AND BURN INFECTION.

Twenty Four isolates of Pseudomonas aeruginosa were identified. The isolates were 8(33%) from wound infections, 16(66%) isolates from burn infections. The sensitivity of Pseudomonas aeruginosa isolates was been tested against (10) antibiotics showed isolates version resistance with different percentage against antibiotics. Pseudomonas aeruginosa exhibited (100%) resistance to Ampicillin. While percentages of resistance to Cefixime and Ceftazidime were (95.8%) and (79%) respectively. Resistance percentages to Tobramycin, Piperacillin, Norfloxacillin, Ciprofloxacin were (41.6%), (20.8%), (20.8%) and (4%) respectively. All isolates of Pseudomonas aeruginosa were highly sensitive (100%) to Aztronam, Imipenem, Cefepime. The optimum conditions for protease production were in LB medium with a pH (8) after (48) hrs of incubation at (35) Cº. Purification of the protease was done using ion exchange chromatography DEAE-cellulose and gel filtration with sephadex G-100. Molecular weight of the purified protease was measured by sephadex G-100 and it was found to be around (21379) Dalton. The optimum temperature of enzyme activity was (35) Cº. However, the pH (8) was for activity and stability of this enzyme. Zn++ and Ca++ ions may play a role in the enhancement and stability of the enzyme. Enzyme activity was not inhibited in the presence of reducing agent such as Cysteine, but it was inhibited in the presence of EDT

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research