PREVALENCE OF PARASITIC CONTAMINATION OF LEAFY GREEN VEGETABLES IN MISURATA, LIBYA

This study was undertaken to determine the prevalence of parasitic contamination in leafy green (lettuce and rocket) vegetables, samples of which were taken up from different regions of Misurata, Libya. A total of 112 raw vegetable samples randomly selected from farms and markets were subsequently examined by a concentration method and then assayed by light microscopy. It was found that 56.3% of the green vegetables were contaminated with different intestinal parasites, the parasites included cysts of Giardia spp., Enatmeaba histolytic a, Entameaba coli , Coccidia spp. oocysts, Balantidium coli and eggs of Hymenolepis nana., Ascaris lumbricoides., Toxocara spp., Strongyloides spp., Trichius trichura and Trichostronylus spp. The highest rate of contamination was detected in rocket (64.3%) while contamination was lower in green lettuce (48.2%). Toxocara spp. eggs were the highest prevalent parasite detected in green vegetables (27%) with the highest score density found in the rocket. Toxocara was followed by Entameaba coli cysts (24%), Coccidia spp. Oocysts (22%), Enatmeaba histolytica cysts (19%), Giardia spp. cysts (10%), and Hymenolepis nana eggs (8%). There were lesser rates of contamination from the parasites Strongyloides spp., Trichius trichura and Trichostronylus spp. There was no significant difference between single and mixed contamination of rocket and lettuce P>0.05. However, there was a statistical difference between protozoa and helminths contamination of rocket and lettuce (P≤0.01). We conclude these findings may have important implications for global food safety and confirm that green vegetables are a point of transmission of intestinal parasites to humans and so are a threat to public health in Misurata, Libya

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

PREVALENCE OF PARASITIC CONTAMINATION OF LEAFY GREEN VEGETABLES IN MISURATA, LIBYA

This study was undertaken to determine the prevalence of parasitic contamination in leafy green (lettuce and rocket) vegetables, samples of which were taken up from different regions of Misurata, Libya. A total of 112 raw vegetable samples randomly selected from farms and markets were subsequently examined by a concentration method and then assayed by light microscopy. It was found that 56.3% of the green vegetables were contaminated with different intestinal parasites, the parasites included cysts of Giardia spp., Enatmeaba histolytic a, Entameaba coli , Coccidia spp. oocysts, Balantidium coli and eggs of Hymenolepis nana., Ascaris lumbricoides., Toxocara spp., Strongyloides spp., Trichius trichura and Trichostronylus spp. The highest rate of contamination was detected in rocket (64.3%) while contamination was lower in green lettuce (48.2%). Toxocara spp. eggs were the highest prevalent parasite detected in green vegetables (27%) with the highest score density found in the rocket. Toxocara was followed by Entameaba coli cysts (24%), Coccidia spp. Oocysts (22%), Enatmeaba histolytica cysts (19%), Giardia spp. cysts (10%), and Hymenolepis nana eggs (8%). There were lesser rates of contamination from the parasites Strongyloides spp., Trichius trichura and Trichostronylus spp. There was no significant difference between single and mixed contamination of rocket and lettuce P>0.05. However, there was a statistical difference between protozoa and helminths contamination of rocket and lettuce (P≤0.01). We conclude these findings may have important implications for global food safety and confirm that green vegetables are a point of transmission of intestinal parasites to humans and so are a threat to public health in Misurata, Libya

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic