Drug potency effects of three anthelmintics against natural fascioliasis with hematological values in goat

The purpose of the study was to compare the effectiveness of three anthelmintics against naturally occurring fascioliasis in goats as well as how they affected various hematological values over the course of 28 days. For this investigation, out of 417 goats, 60 were selected who were suffering from liver fluke infection. After being randomly divided into four groups of 15 animals each, the first three groups got treatment with triclabendazole, oxyclozanide, and nitroxynil while the fourth group was kept as a control group and received no medication. The results of the study showed that the egg per gram (EPG) count of the treatment groups significantly decreased successively (P < 0.01) on days 3rd, 7th, 14th, and 28th, whereas the control group produced significantly from day 3rd through the experimental period. Results revealed that the mean EPG was reduced by 78.40 %, 73.33 %, and 83.11 %, respectively, following treatment with triclabendazole, oxyclozanide, and nitroxynil, while the mean EPG production was 22.66 % in the control group. Hematological parameters including Hb, PCV, and TEC values, were lower before the treatment but turned to increase significantly (P < 0.01) on study day 28th, however, the mean TLC values were decreased substantially (P < 0.01) compared to the untreated control group. This result may indicate that all three anthelmintics were efficient, but nitroxynil had a relatively higher efficacy against goat fascioliasis regarding on the EPG and hematological indices

Detergent Maceration: A Convenient Skeleton Preparation Technique for Teaching and Demonstration of Veterinary Anatomy

The current study investigates to develop a convenient technique for preparation of a dog skeleton without any unpleasant smell, cracking, crumbling or discoloration of bones by using a combination of commercially available detergent and Hydrogen peroxide (H2O2). Specimens were skinned and immersed in a pre-heated 10-liter detergent solution at 50°C to 60°C for 2-3 hours then left for 12 hours. Maceration was deemed completed when any remaining soft tissue was easily removed under running tap water or by soft brush. Then the bones were kept for bleaching with 3% H2O2 for 24-48 hours and allowed to dry properly in the sun. It is shown that the detergent maceration was remarkably faster compared to the traditional burial, insect, hot or cool-water methods, which requires up to several days. In this entire process, skeletons were prepared and installed in correct conformation in only about 92 hours (less than four days). In contrast, the whole maceration was completed in 15 hours (boiling and cooling). On the other hand, the longest time was taken for bleaching and drying purposes, which were 2 days, respectively. The method investigated here for the preparation of skeletal materials in an essentially odorless way, which has shown to be more convenient (faster, easier, safer, and cheaper) compare to previous models in the fields of veterinary anatomy. We believe this project's result will help improve the preparation and preservation technique of skeletons for gross anatomical studies in veterinary institutions

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Dietary Effects of Garlic (Allium sativum) Powder on Growth Performance of Commercial Broiler

The study was conducted during summer (April-May) to investigate the growth performance of 120-day-old mixed-sex commercial broiler chicks (Cobb-400) by examining the dietary effects of different levels of garlic (Allium sativum) powder supplementation. In a 28-day experiment, four distinct diets (T1, T2, T3, and T4) were utilized, each containing varying amounts of dried garlic powder (0%, 0.5%, 1%, and 2%). The effectiveness of garlic powder on feeding was evaluated by measuring weight gain, feed consumption, feed efficiency, dressing yield, and survivability. The results showed that there were no significant differences in body weight gain among the treatment groups in the first seven days. However, significant differences were observed in broiler diets containing 0.5%, 1%, and 2% garlic powder during the 8-14, 15-21, and 22-28 day periods, with the highest body weight gain observed in birds fed a diet containing 1% garlic powder. Furthermore, significant enhancements (P&lt;0.05) in the feed conversion ratio (FCR) were observed by increasing the inclusion of garlic powder compared to the control group during specific age periods (1-7, 15-21, and 22-28 days), with the treatment group fed with 1% garlic powder exhibiting the most favorable FCR at the trial’s conclusion. Regarding feed intake and survivability, the study showed no significant differences (P&gt;0.05) in broilers with different dietary treatments. The inclusion of garlic powder in broiler feed led to a notable decrease in fat content and an increase in dressing yield, with the highest yield achieved at a 1% supplementation level. Therefore, the study suggests that 1% garlic powder could be a potential feed additive to enhance the overall performance of the broiler

Pig raising practices by unprivileged, ethnic people in Bangladesh

We interviewed 207 pig raisers from seven different districts of Bangladesh to explore their practices related to their pig farming. We used structured questionnaires to interview the pig raisers and used descriptive statistics for analysis. Most of the pig raisers (54%) were illiterate. 50% (104) of them had a monthly income of less than 10000 BDT and 60% (124) were landless. Most of the pig raisers (92%, 191) were rearing local breed and 67% of them were practicing semi-scavenging system. As feed source 55% (114) pig owners used kitchen waste and 54% (111) used rice husk. The pig raisers mentioned different types of challenges such as social problem (16%), disease (50%), less profitable (20%) and unavailability of feed (19%). In our study, we found that 31% respondents visited veterinarians, 28% visited quack and 21% do not take any action when their pigs were sick. Only 16% pig raisers used vaccines against different infectious diseases and 36% used anthelmintics against parasitic diseases. Awareness buildup of the pig raisers may help them raising pigs in a better way which will improve the farming system and reduce the probability of disease transmission

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes

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