237 research outputs found

    Pharmacodynamic and Pharmacokinetic Studies on Tetracycline Hydrochloride in Rabbits

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    Tetracycline is one of the most important groups of antibiotics that have harmful effects on the consumers, therefore the public health safety against its residues represents a significant issue. This study aimed to estimate the effect of tetracycline hydrochloride on some hematological parameters, kidneys function tests as well as liver and breast muscle enzymes with special reference to the supposed withdrawal time of this drug in different rabbits’ tissues (kidney, liver and muscles), following oral dose of tetracycline using High Performance Liquid Chromatography. Tetracycline was administrated to eighteen rabbits directly into the stomach at a dose of 35 mg/kg BW once daily for five successive days. Samples were collected on the 1st, 3rd, 7th, 14th, 21st and 28th days after the last oral dose. The results revealed that, tetracycline caused a significant increase in the uric acid, urea, creatinine, alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) activities with no significant changes in the hematological parameters when compared with the control group. The residues remained in the liver and kidney for 7 days, while in muscles for 3 days only after the last oral dose of the drug. In conclusion, the disturbances in the biological parameters occurred by tetracycline administration in rabbits was transient and returned to normal after 7 days of last treatment. The withdrawal time of tetracycline was 14 days from the rabbit's tissues

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

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    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<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

    Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

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    Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

    Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

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    Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

    Pharmacokinetics of cefquinome following multiple doses intramuscular administration in goats using HPLC

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    Pharmacokinetics of cefquinome was investigated in goats following multiple IM doses (2mg/Kg) for 3 successive days using HPLC. The plasma concentration time data was best fitted by two compartment model demonstrating the presence of absorption, distribution and elimination phases. The maximum plasma concentrations (Cmax) following multiple IM administration were 3.66±0.03, 4.46±0.12 and 5.16±0.14 attained at Tmax of 2 hours and declined to (Cmin) 0.5±0.04 , 0.7±0.03 and 0.86±0.04 μg/ml at 24 h post drug administration in the first , second and third days respectively. Cefquinome was eliminated with half-life values (t o.5 el) of 6.13±0.54, 7.26±0.31 and 7.52±0.65 h in the first, second and third days post IM administration respectively. Cefquinome had a slight cumulative effect following repeated intramuscular administration and the repeated intramuscular injection of cefquinome at a dose of 2mg/kg with 24 h interval met pharmacokinetic–pharmacodynamic criteria predicting a successful therapy for susceptible bacteria with MIC ≤ 0.39 μg /mL

    Heavy Metals Residues in Bivalve Mollusks in Fayoum Province and their Potential Health Hazards

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        Bivalves Mollusks have a potential benefit which include protection from anemia due to its content of iron and vit B12 in addition they pose a threat in promoting the ability to be contaminated by different heavy metals residues as a result of mining, industrial production untreated sewage sludge. Hg, Pb, Cd, As and Cr are the main five toxic heavy metals that induce human poisoning. For evaluation of Hg, Pb, Cd, As and Cr residues in Bivalve Mollusks in Fayoum province and their potential hazards, a total of 64 random samples of Bivalve Mollusks (Callista Florida species) were collected from the fish markets of Fayoum City, (Wadi Elrayan), Egypt The results revealed that the mean residues of Hg, Pb, Cd, As and Cr were 0.75, 0.77, 0.089, 7.285 and 0.011 mg/kg/ww, respectively. All samples examined  for Hg and  As exceeded the PML while Pb and Cd lied with the PML The collected samples were subjected to soaking in running water for 30 minutes; soaking in 5% acetic acid solution for 30 minutes and boiling with 5% acetic acid solution for 15 minutes .The heights reduction % of heavy metals residual levels were recorded after treatment in boiling 5% acetic acid treatment with the following reduction %; Hg (80%), Pb (67.6%), Cd (77.5%), As (44.35%) and Cr (75.76%). The assessment of Hazard quotient (HQ) and hazard index (HI) value was exceeded 1 which indicates a potential risk to human health and TR was &gt; 1x10-4 which indicates a carcinogenic risk to the local consumers and will face high chronic risk if they consume Bivalve Mollusks on regular basis in their diet

    An abattoir study of the prevalence of foot lesions and claw measurements in water buffalo in Egypt.

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    BackgroundLameness has been associated with compromised animal welfare and reduced productivity in dairy cattle herds worldwide. However, little is known about the prevalence of claw lesions in the dairy buffalo population in Egypt. Furthermore, the optimum measurements for claw trimming in buffalo are unknown. A cross-sectional cadaver study was conducted where 135 pair buffalo hind feet were collected from 4 slaughterhouses and examined for the presence of claw lesions. The proportion and associated 95% confidence interval (CI) of each type of lesion were calculated. A separate set of healthy claws (n = 26) underwent ultrasonography (US) and computed tomography (CT). The agreement between US and CT measurements was assessed using Passing-Bablok regression and intraclass correlation coefficient. The CT measurements were used to calculate trimming recommendations.ResultsAt least one lesion was identified in 242 claws (89.6%, 95% CI = 85.4-93.0). In healthy claws, poor to moderate agreement was identified between US and CT measurements which could be due a sample size of the study. The average ± standard deviation (SD) minimum recommended external wall length of the lateral and medial claws in heifers was 7.1 ± 0.36 cm and 7.5 ± 0.35 cm, respectively. The average ± SD minimum recommended external wall length in buffaloes over five years of age was 8.2 ± 0.27 cm and 8.4 ± 0.39 cm for the lateral and medial claws, respectively.ConclusionsThe study found a high prevalence of claw lesions in buffalo in Egypt, the clinical significance of which requires further elucidation. Recommended measurements will help guide claw trimming in buffalo to minimise lesions

    Acknowledgement to reviewers of fluids in 2018

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