EFFECT OF PRE AND POST-HARVEST TREATMENTS ON THE POSTHARVEST KEEPING QUALITY OF SUNFLOWER CV. SUN RICH ORANGE CUT FLOWERS

Two experiments were consummated in a saran’s greenhouse at the Ornamental Nursery and the Ornamental Laboratory of Fac. Agric., Zagazig Univ., Egypt to study the effect of two factors (NPK fertilization at different rates of 0, 1.5, 3.0 and 4.5 g/l (pre-harvest) and some pulsing solutions i.e. distilled water (D.W.) for 16 h, sucrose (S) at 20% for 16 h, S (20%) for 16 h + silver thiosulfate (STS) at 1:4 mM for 18 min and S (20%) + 8-hydroxyquinoline sulfate (8-HQS) at 200 ppm for 16 h) to enhance sunflower (Helianthus annuus L.) cv. Sun Rich Orange growth and keeping quality of cut flowers after harvesting during 2019 and 2020 summer seasons. Also, the interactions between these two factors were assessed. Using any NPK fertilizer rate significantly enhanced plant height, total fresh and dry weights of plant and flower diameter as well as total chlorophyll content in the leaves, total carbohydrates percentage in leaves and anthocyanin content in flower petals of sunflower compared to control. Moreover, the rate of 3 g/l of NPK gave the highest values of water uptake and water balance in comparison with the other rates. The longevity of the cut flower was gradually increased with increasing NPK fertilizer rate up to 3 g/l then it decreased. Using S + STS or S + 8-HQS as a pulsing solution recorded the highest values in water uptake and water balance at 2, 4 and 6 days of shelf life periods of cut flower as well as increased longevity and fresh weight change (%) of cut sunflower compared to the other ones under study. In general, the interaction between S + STS or S + 8-HQS and 3 g/l of NPK gave the highest values of water balance and longevity compared to the other interaction treatments. It could be concluded that S + STS as well as S + 8-HQS, showed a uniform influence in keeping quality of sunflower cut flowers under 3 g/l of NPK fertilizer with increasing longevity and total sugars content in the flower

Evaluation Relativity Variation and Some Minerals Concentration during Lactation Stage of Syrian Mountains Goat Milk under Grazing System, تقدير التغيرات النسبية ومستوى تراكيز بعض المعادن خلال مرحلة إنتاج حليب الماعز الجبلي السوري تحت نظام الرعاية السرحي

The aim of this study was to investigate the effect of lactation stage on chemical composition and some minerals concentration of Syrian mountains Goat milk using grazing system in Al-Quneitera area (Syria) in year 2013. Twenty mountains Syrian goats were used to evaluate milk production and composition (fat, protein, lactose, and non-fat solids) and some minerals concentration (Ca, P, Na, K, Cu, Mg, Mn, Fe, Zn, cl) during lactation. Using SPSS program, data were analyzed by ANOVA with repeated measures. Daily milk yield was 1473.1 ± 297.42 g/head, while the total milk was 342.02 ± 135.6 Kg/head. The results of statistical analysis showed that there are significant differeces in daily milk yield and percent of fat and protein and lactose and concentration of Ca, P, Na, K, Zn, Mg, during different stages of lactation. It concluded that the concentrations of minerals in Syrian mountains Goat milk is into normal limits and basic minerals concentrations in goat milk. تهدف الدراسة إلى معرفة تأثير مرحلة إنتاج الحليب ضمن الموسم في الأداء الإنتاجي، والتركيب الكيميائي، وتراكيز بعض المعادن في حليب الماعز الجبلي تحت النظام السرحي في محافظة القنيطرة (سورية) خلال عام 2013. استخدم لهذا الغرض 20 عنزةً جبليةً منتجةً للحليب في مواسم حلابة مختلفة من الأول وحتى الرابع، لتقدير إنتاج الحليب والتركيب الكيميائي (نسبة الدهن، البروتين، السكر والمادة الجافة اللادهنية)، وتراكيز بعض المعادن (Ca, P, Na, K, Cu, Mg, Mn, Fe, Zn, Cl) خلال مراحل الإنتاج المختلفة ضمن موسم حلابة كامل. حللت البيانات إحصائياً باستخدام برنامج SPSS. بلغ متوسط كمية الحليب اليومية نحو: 1473.1 ± 297.42 غ/رأس، فيما بلغت كمية الحليب الكلية 342.02 ± 135.6 كغ/رأس خلال موسم حلابة بلغ طوله 238 ± 6.4 يوماً. بينت نتائج التحليل الإحصائي وجود فروق معنوية في متوسط كمية الحليب اليومية، ونسب الدهن، والبروتين، والسكر، وتراكيز الكالسيوم، والفوسفور، والصوديوم، والبوتاسيوم، والمنغنيز، والزنك خلال مراحل الإنتاج المختلفة. يستنتج من الدراسة أن تراكيز المعادن في حليب الماعز الجبلي السوري تقع ضمن المدى الطبيعي لتراكيز المعادن في حليب الماعز

von Willebrand factor levels in the diagnosis of von Willebrand disease: a systematic review and meta-analysis

Von Willebrand Disease (VWD) is associated with significant morbidity as a result of excessive mucocutaneous bleeding symptoms. Patients with VWD can experience easy bruising, epistaxis, gastrointestinal and oral cavity bleeding, as well as heavy menstrual bleeding and bleeding after dental work, surgical procedures, and childbirth. Early diagnosis and treatment is important to prevent and treat these symptoms. We systematically reviewed the accuracy of diagnostic tests using different cut-off values of VWF:Ag and platelet-dependent VWF activity assays in the diagnosis of VWD. We searched Cochrane Central, MEDLINE, and EMBASE for eligible studies. Two investigators screened and abstracted data. Risk of bias was assessed using QUADAS-2 and certainty of evidence using the GRADE framework. We pooled estimates of sensitivity and specificity and reported patient important outcomes when relevant. This review included 21 studies that evaluated VWD diagnosis, including the approach to patients with VWF levels that have normalized with age (6 studies), VWF cut-off levels for the diagnosis of Type 1 VWD (9 studies), and platelet-dependent VWF activity/VWF:Ag ratio cut-off levels for the diagnosis of Type 2 VWD (6 studies). The results showed low certainty in the evidence for a net health benefit from reconsidering the diagnosis of VWD versus simply removing the disease in patients with VWF levels that have normalized with age. For the diagnosis of Type 1 VWD, in patients with VWF:A

Effects of Preoperative Sublingual Misoprostol on Uterine Tone during Isoflurane Anesthesia for Cesarean Section

SummaryBackground and objectivesMisoprostol would reduce the uterine bleeding after cesarean delivery without harmful effects on either mother or baby. We aimed to evaluate the effects of preoperative misoprostol on maternal blood loss, uterine tone, and the need for additional oxytocin after cesarean delivery under isoflurane anesthesia.MethodsAfter ethical approval, 366 patients scheduled for elective cesarean delivery were randomly allocated to receive either sublingual misoprostol 400μg (n=179) or placebo tablet (n=187) after intubation. Anesthesia was maintained with 0.5–0.7 MAC isoflurane with nitrous oxide. All patients received intravenous infusion of 10IU of oxytocin after placental delivery. Perioperative estimated blood loss, uterine tone, need for supplementary oxytocin, hematocrit, Apgar scores at 1 and 5 min and adverse effects were recorded.ResultsAfter induction, patients receiving sublingual misoprostol had significant less perioperative estimated blood loss (202±383.1 vs. 708±204.3mL, p<0.001), need for oxytocin (p<0.001), higher hematocrit levels (p<0.001) and uterine tone (p<0.02). The incidence of shivering was higher in the misoprostol group (p=0.04). There were no differences between the two groups as regarding Apgar scores, nausea and vomiting, gastrointestinal disturbances and pyrexia.ConclusionPreoperative administration of sublingual misoprostol 400μg is safe and effective in attenuating the maternal bleeding and uterine atony from isoflurane anesthesia for cesarean delivery

Prevalence of anxiety and depressive symptoms in ulcerative colitis patients in Jordan and its relationship to patient-reported disease activity

Inflammatory bowel disease is associated with higher rates of anxiety and depression compared to the general population. We aimed to determine the prevalence of anxiety and depressive symptoms among patients with ulcerative colitis and correlation to disease activity. In this cross-sectional study, we collected data from 70 consecutive ulcerative colitis patients over one year at our inflammatory bowel disease outpatient clinic through an interview and a questionnaire containing patient demographics and disease characteristics. Anxiety and depressive symptoms were characterized using the Generalized Anxiety Disorder-7 questionnaire and Patient Health Questionnaire-9, respectively, with ulcerative colitis disease severity assessed by the Partial Mayo scoring system. The majority of our patients were females (68.6%) and the mean age was 39.3 years. Rates of anxiety and depressive symptoms among ulcerative colitis patients were 65.7% and 58.6%, respectively. Depressive symptoms were significantly associated with patient-reported disease activity (r = 0.361; p = 0.010). Significant percentages of ulcerative colitis patients were appreciated to have anxiety and depressive symptoms, and there was a correlation between patient-reported disease activity and depressive symptoms. At this high rate of prevalence, it is justified to screen patients for the presence of psychiatric comorbidities

Suitability of the Openly Accessible 3D Printed Prosthetic Hands for War-Wounded Children

The field of rehabilitation and assistive devices is being disrupted by innovations in desktop 3D printers and open-source designs. For upper limb prosthetics, those technologies have demonstrated a strong potential to aid those with missing hands. However, there are basic interfacing issues that need to be addressed for long term usage. The functionality, durability, and the price need to be considered especially for those in difficult living conditions. We evaluated the most popular designs of body-powered, 3D printed prosthetic hands. We selected a representative sample and evaluated its suitability for its grasping postures, durability, and cost. The prosthetic hand can perform three grasping postures out of the 33 grasps that a human hand can do. This corresponds to grasping objects similar to a coin, a golf ball, and a credit card. Results showed that the material used in the hand and the cables can withstand a 22 N normal grasping force, which is acceptable based on standards for accessibility design. The cost model showed that a 3D printed hand could be produced for as low as $19. For the benefit of children with congenital missing limbs and for the war-wounded, the results can serve as a baseline study to advance the development of prosthetic hands that are functional yet low-cost

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

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

Background 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&lt;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&lt;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

Epidemiology of Chlamydia trachomatis in the Middle East and north Africa: a systematic review, meta-analysis, and meta-regression.

BACKGROUND: The epidemiology of Chlamydia trachomatis in the Middle East and north Africa is poorly understood. We aimed to provide a comprehensive epidemiological assessment of C trachomatis infection in the Middle East and north Africa. METHODS: We did a systematic review of C trachomatis infection as well as a meta-analysis and meta-regression of C trachomatis prevalence. We searched PubMed and Embase, as well as regional and national databases up to March 13, 2019, using broad search terms with no language or year restrictions. Any document or report including biological measures for C trachomatis prevalence or incidence was eligible for inclusion. We extracted all measures of current (genital or rectal), recent, and ever infection with C trachomatis. We estimated pooled average prevalence in different populations using random-effects meta-analysis. Factors associated with prevalence and sources of between-study heterogeneity were determined using meta-regression. FINDINGS: We identified a total of 1531 citations, of which 255 reports contributed to 552 C trachomatis prevalence measures from 20 countries. No incidence measures were identified. Pooled prevalence of current genital infection was 3·0% (95% CI 2·3-3·8) in general populations, 2·8% (1·0-5·2) in intermediate-risk populations, 13·2% (7·2-20·7) in female sex workers, 11·3% (9·0-13·7) in infertility clinic attendees, 12·4% (7·9-17·7) in women with miscarriage, 12·4% (9·4-15·7) in symptomatic women, and 17·4% (12·5-22·8) in symptomatic men. Pooled prevalence of current rectal infection was 7·7% (4·2-12·0) in men who have sex with men. Substantial between-study heterogeneity was found. Multivariable meta-regression explained 29·0% of variation. Population type was most strongly associated with prevalence. Additional associations were found with assay type, sample size, country, and sex, but not with sampling methodology or response rate (about 90% of studies used convenience sampling and >75% had unclear response rate). There was no evidence for temporal variation in prevalence between 1982 and 2018. INTERPRETATION: C trachomatis prevalence in the Middle East and north Africa is similar to other regions, but higher than expected given its sexually conservative norms. High prevalence in infertility clinic attendees and in women with miscarriage suggests a potential role for C trachomatis in poor reproductive health outcomes in this region. FUNDING: National Priorities Research Program from the Qatar National Research Fund (a member of Qatar Foundation)