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

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Not AvailableHeat stress is one of the major environmental concerns in global warming regime and rising temperature has resulted in mass mortalities of animals including fishes. Therefore, strategies for high temperature stress tolerance and ameliorating the effects of heat stress are being looked for. In an earlier study, we reported that Nrf-2 (nuclear factor E2-related factor 2) mediated upregulation of antioxidative enzymes and heat shock proteins (Hsps) provide survivability to fish under heat stress. In this study, we have evaluated the ameliorative potential of dietary curcumin, a potential Nrf-2 inducer in heat stressed cyprinid Puntius sophore. Fishes were fed with diet supplemented with 0.5, 1.0, and 1.5% curcumin at the rate 2% of body weight daily in three separate groups (n = 40 in each group) for 60 days. Fishes fed with basal diet (without curcumin) served as the control (n = 40). Critical thermal maxima (CTmax) was determined for all the groups (n = 10, in duplicates) after the feeding trial. Significant increase in the CTmax was observed in the group fed with 1.5% curcumin- supplemented fishes whereas it remained similar in groups fed with 0.5%, and 1% curcumin-supplemented diet, as compared to control. To understand the molecular mechanism of elevated thermotolerance in the 1.5% curcumin supplemented group, fishes were given a sub-lethal heat shock treatment (36 °C) for 6 h and expression analysis of nrf-2, keap-1, sod, catalase, gpx, and hsp27, hsp60, hsp70, hsp90, and hsp110 was carried out using RT-PCR. In the gill, expression of nrf-2, sod, catalase, gpx, and hsp60, hsp70, hsp90, and hsp110 was found to be elevated in the 1.5% curcumin-fed heat-shocked group compared to control and the basal diet-fed, heat-shocked fishes. Similarly, in the liver, upregulation in expression of nrf-2, sod, catalase, and hsp70 and hsp110 was observed in 1.5% curcumin supplemented and heat shocked group. Thus, this study showed that supplementation of curcumin augments tolerance to high temperature stress in P. sophore that could be attributed to nrf-2-induced upregulation of antioxidative enzymes sod, catalase, gpx, and the hsps.Not Availabl

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Not AvailableQuantitative real-time polymerase chain reaction is the most advanced method of quantifying gene expression studies; however, the significance of the obtained results strongly depends on the normalization of the data to compensate for differences between the samples. In the present study, expression analysis of six different constitutively expressed genes viz. 18S ribosomal RNA, glyceraldehyde-3-phosphate dehydrogenase (gapdh), beta actin (βactin), ribosomal binding protein L13, tubulin and TATA-box-binding protein (tbp) were carried out to test their efficacy as reference genes in three different tissues, namely liver, gill and muscle of murrel Channa striatus exposed to high temperature for variable time periods. The stability and suitability of the genes were determined by using bioinformatic tools: GeNorm, NormFinder and BestKeeper. Based on the results, tub/βactin could be used as the reference genes for liver and gill tissues and βactin/gapdh could be the reference genes for muscle tissues in Channa striatus under both short- and long-term thermal stress.Not Availabl

Marine and freshwater fishes as storehouse of nutraceuticals

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Advances in Marine Natural Products and Nutraceutical Research

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Not AvailableGC-MS is an important instrument in lipid profiling and lipid biomarker identification. The choice of columns and detectors is important in analysis and identification of the biomolecules. In the present study, GC-MS fingerprinting of fatty acids (FAs) in different tissues of freshwater mollusc Lamellidens marginalis was carried out in GC-MS with two different columns, TR-FAME and TR-WaxMS, to examine if choice of columns and detectors influence the identifications of the lipids. These sentinel organisms are used in aquatic pollution monitoring studies as they accumulate toxic environmental contaminants to levels well above those present in the surrounding environment thus providing information on the spatio-temporal pollution trends. FAs identified in different tissues include the saturated FAs palmitic acid (C16:0), margaric acid (C17:0), stearic acid (C18:0), monounsaturated FAs (MUFAs) oleic acid (C18:1), eicosenoic acid (C20:1) and polyunsaturated fatty acid (PUFAs) linoleic acid (C18:2). More numbers of FAs were detected in TR-FAME column than TR-WaxMS column. Several non-fatty acid compounds like butylated hydroxyl toluene (BHT) and dibutyl phthalate were also identified in the FAME (fatty acid methyl ester) preparation using NIST (MS) library. It was interesting to note that the FA peaks (6/14) were outnumbered by the non-fatty acid peaks (8/14). Such compounds could be taken as unidentified FAs unless powerful detectors like MS are available and can lead to erroneous inferences. The study showed that the choice of columns and detectors influenced the identification of the compounds. The information generated on fatty acid profiles of this bivalve could serve as baseline data for this species in searching for lipid biomarkers for aquatic pollution monitoring studies.Not Availabl

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Not AvailableThe Indian shad hilsa, Tenualosa ilisha (Hamilton, 1822) is an important food fish in South-east Asian countries. The fish is rich in oil and known for its high omega-3 polyunsaturated fatty acid (PUFA) content; however information available on the micronutrient profile of this commercially important food fish is limited. The present study investigated the detailed micronutrient profile (mineral and fat soluble vitamins) of different size groups of hilsa. Proximate composition analysis revealed that besides being rich in crude fat (7.91-14.61%), the protein content of this fish is also very high (19.44-21.86%). The macro-minerals potassium, calcium and micro-minerals iron, zinc and the fat soluble vitamins A and E are the dominant micronutrients in different size groups of hilsa. Comparative nutritional evaluation of different size groups of hilsa showed that medium size fish is nutritionally superior to both small and large size groups.Not Availabl