Epidural anaesthesia and myomectomy-associated blood loss: — a prospective randomised controlled study

Objectives: The management of anaesthesia for patients with large myomas is particularly important due to disruption of hemodynamic as a result of massive haemorrhage, the prolonged duration of surgery and requirement for additional interventions. This study evaluated the effect of anaesthetic technique on blood loss in patients undergoing myomectomy due to large fibroid uterus. Material and methods: A total of 156 patients that underwent myomectomy were randomized into two equal groups according to the type of anaesthesia: Epidural anaesthesia group and General anaesthesia group. The volume of blood loss and blood products transfusion was reviewed for each patient. Results: The intraoperative blood loss and need for blood transfusion were significantly higher in general anaesthesia group (p < 0.001). The mean hematocrit change was 2.5 ± 1.5 vs 3.7 ± 2.9 % (p = 0.001) for both groups. Conclusions: In the myomectomy planning of women with a large fibroid uterus, the team of gynecologists and anaesthesiologists should take care to choose the most optimal technique for anaesthesia

Effect of Progesterone Therapy versus Diet Modification on Constipation during Pregnancy

Background: Pregnant women may experience constipation for the first time or their existing constipation symptoms increase in severity during pregnancy.Aim: To compare the effect of progesterone versus diet modification in the treatment of constipation during pregnancy.Subjects and Methods: Women aged ≥18 years with functional constipation according to the Rome III criteria from obstetrics outpatients’ clinic and midwife practices included in this study. Participants divided into two groups; control group managed with diet modifications and study group pregnant women with threatened miscarriage and advised to take vaginal progesterone ≥1 week. Participants completed a nonvalidated questionnaire created by the authors during the whole week before intake of progesterone or diet modifications and after treatment phase. Independent Student’s t‑test and Chi‑square (X2) test were used for statistical analysis to compare between two studied groups. Primary outcome measures; change in defecation frequency.Results: Sensation of anorectal obstruction and sensation of incomplete evacuation were significantly less in Group B (progesterone therapy) compared to Group A (diet modification) (54% [154/281] and 62.98% [177/281] vs. 89.76% [614/684] and 91.08% [623/684], respectively) (P = 0.04 and 0.03, respectively). Straining during defecation and manual maneuvers to facilitate evacuation were significantly less in Group B compared to Group A (63.7% [179/281] and 19.9% [56/281] vs. 94.59% [647/684] and 86.54% [592/684], respectively) (P < 0.01 and 0.02, respectively). Episodes of abdominal pain and presence of reflux episodes were also significantly less in Group B compared to Group A (18.5% [52/281] and 17.43% [49/281] vs. 84.11% [589/684] and 75% [513/684], respectively) (P = 0.01 and 0.03, respectively). Conclusions: Estrogen, rather than progesterone, may be a detrimental factor of constipation during pregnancy via decreased bowel movement. Progesterone therapy seems to be effective in the treatment of functional constipation during pregnancy. A randomized placebo controlled trial is required to confirm the data of this study.KEY WORDS: Constipation, diet modification, pregnancy, progesteron

Early Zinc Supplementation and Enhanced Growth of the Low-Birth Weight Neonate

BACKGROUND: Nutritional deficits are almost universal in Low-Birth Weight babies. Zinc is essential for normal infant growth and its supplementation assists growth probably through insulin-like growth factor-1.AIM: This double-blind randomized-controlled trial aimed at evaluating the role of zinc in catch-up growth of low-birth-weight infants and investigating its proposed mediator.MATERIAL AND METHODS: The study was conducted in Ain Shams University Maternity Hospital. Two hundred low-birth-weight neonates were simply randomized to either oral zinc therapy or placebo. Anthropometric measurements were recorded at birth, 3, 6, and 12 months; including weight, recumbent length, head, waist, chest, and mid-upper arm circumferences, and triceps and sub-scapular skin fold thickness. RESULTS: We found that initial and 3-months measurements, except weight, were comparable in the 2 groups. All measurements at 6- and 12-months, except sub-scapular skin-fold-thickness, were significantly higher in zinc group than placebo. Catch-up growth, at 12-months, was significant in zinc group and was significantly higher in appropriate-for-gestational-age vs. small-for-gestational-age, in preterm vs. term, and in male vs. female infants. The median 6-months insulin-like growth factor-1 levels were significantly higher in zinc group.CONCLUSION: We conclude that early start of oral zinc supplementation in low-birth-weight neonates assists catch-up growth, probably through rise of insulin-like growth factor-1

Acaricidal activity of tea tree and lemon oil nanoemulsions against Rhipicephalus annulatus

Tick infestation is a serious problem in many countries since it has an impact on the health of animals used for food production and pets, and frequently affects humans. Therefore, the present study aimed to investigate the acaricidal effects of nanoemulsions of essential oils o

Machine learning and computational chemistry to improve biochar fertilizers : a review

Traditional fertilizers are highly inefficient, with a major loss of nutrients and associated pollution. Alternatively, biochar loaded with phosphorous is a sustainable fertilizer that improves soil structure, stores carbon in soils, and provides plant nutrients in the long run, yet most biochars are not optimal because mechanisms ruling biochar properties are poorly known. This issue can be solved by recent developments in machine learning and computational chemistry. Here we review phosphorus-loaded biochar with emphasis on computational chemistry, machine learning, organic acids, drawbacks of classical fertilizers, biochar production, phosphorus loading, and mechanisms of phosphorous release. Modeling techniques allow for deciphering the influence of individual variables on biochar, employing various supervised learning models tailored to different biochar types. Computational chemistry provides knowledge on factors that control phosphorus binding, e.g., the type of phosphorus compound, soil constituents, mineral surfaces, binding motifs, water, solution pH, and redox potential. Phosphorus release from biochar is controlled by coexisting anions, pH, adsorbent dosage, initial phosphorus concentration, and temperature. Pyrolysis temperatures below 600 °C enhance functional group retention, while temperatures below 450 °C increase plant-available phosphorus. Lower pH values promote phosphorus release, while higher pH values hinder it. Physical modifications, such as increasing surface area and pore volume, can maximize the adsorption capacity of phosphorus-loaded biochar. Furthermore, the type of organic acid affects phosphorus release, with low molecular weight organic acids being advantageous for soil utilization. Lastly, biochar-based fertilizers release nutrients 2–4 times slower than conventional fertilizers

Left Main Coronary Artery Revascularization in Patients with Impaired Renal Function: Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting

Introduction: The evidence about the optimal revascularization strategy in patients with left main coronary artery (LMCA) disease and impaired renal function is limited. Thus, we aimed to compare the outcomes of LMCA disease revascularization (percutaneous coronary intervention [PCI] vs. coronary artery bypass grafting [CABG]) in patients with and without impaired renal function. Methods: This retrospective cohort study included 2,138 patients recruited from 14 centers between 2015 and 2,019. We compared patients with impaired renal function who had PCI (n= 316) to those who had CABG (n = 121) and compared patients with normal renal function who had PCI (n = 906) to those who had CABG (n = 795). The study outcomes were in-hospital and follow-up major adverse cardiovascular and cerebrovascular events (MACCE). Results: Multivariable logistic regression analysis showed that the risk of in-hospital MACCE was significantly higher in CABG compared to PCI in patients with impaired renal function (odds ratio [OR]: 8.13 [95% CI: 4.19–15.76], p < 0.001) and normal renal function (OR: 2.59 [95% CI: 1.79–3.73]; p < 0.001). There were no differences in follow-up MACCE between CABG and PCI in patients with impaired renal function (HR: 1.14 [95% CI: 0.71–1.81], p = 0.585) and normal renal function (HR: 1.12 [0.90–1.39], p = 0.312). Conclusions: PCI could have an advantage over CABG in revascularization of LMCA disease in patients with impaired renal function regarding in-hospital MACCE. The follow-up MACCE was comparable between PCI and CABG in patients with impaired and normal renal function

Factors Influencing the Willingness of Dairy Farmers to Adopt Biogas Plants: A Case Study in Hokkaido, Japan

Intensification of the livestock industry has become environmentally problematic due to the uncontrolled treatment of large amounts of watery manure. One solution is the adoption of biogas plants (BGPs). Hokkaido, Japan, has significant potential for BGP adoption, however, the large financial investments and lack of grid space for selling electricity are barriers. We investigated the relationship between the willingness of farmers to adopt BGPs and their current farming situations. Using a questionnaire survey and multivariate analyses, the results showed that large-scale farmers, particularly those with more than 100 mature cows, were clearly willing to adopt BGPs and expand their businesses in the future, while farmers who planned to downsize their businesses did not exhibit strong willingness to adopt BGPs. In addition, farmers willing to adopt BGPs thought the plants would help solve problems with manure treatment. BGPs might be more accepted by dairy farmers if there were greater incentives for installation given the role BGPs can play in providing stable energy and revitalizing local economies

Efficiency of silver nanoparticles against bacterial contaminants isolated from surface and ground water in Egypt

The bactericidal efficiency of silver nanoparticles (AgNP) was evaluated against bacteria isolated from surface and ground water samples in Egypt. The AgNP were synthesized by typical one-step synthesis protocol, and were characterized using transmission electron microscopy and atomic absorption spectrophotometer. The bactericidal efficiency of AgNP was evaluated by its application in three concentrations i.e., 0.1, 0.05 and 0.01 ppm to water sample, and allowed to interact with bacteria for different duration e.g., 5 min 15 min, 30 min, 1 h and 2 h. Then, the bactericidal efficiency of AgNPs was determined by comparing the counted bacteria before and after the treatments. Higher mean values of total bacterial count (TBC), total coliform count (TCC), and total streptococcal count (TFS) were detected in surface water than in ground water. Also, the results showed that TBC, TCC and TFS exceeded permissible limits. Application of AgNP at different concentration, the number of bacteria in TBC was significantly reduced in all AgNP-exposed samples as compared to the control group (p<0.05). The highest concentration of AgNP exhibited highest bactericidal efficiency in TBC, where, after two hours, 0.1, 0.05 and 0.01 mg/L AgNP was found to be sufficient to inhibit 91.85, 89.14 and 74.92%, and 92.33, 85.23 and 53.17% in TBC of surface and ground water, respectively. Moreover, the inhibition efficiency of the highest concentration (0.1 ppm) against TCC reached to 98.10 and 99.88% in surface water and 95.54 and 99.20% in ground water after 1 h and 2 h, respectively. Similar results were found against TFS count. The AgNPs were found to be effective against bacteria of water origin

Kompleks polimaltozy z wodorotlenkiem żelaza w leczeniu niedoboru żelaza i niedokrwistości z niedoboru żelaza w okresie ciąży

Introduction. Iron deficiency (ID), and iron deficiency anaemia (IDA) are consistently associated with reduced maternal cognitive function and increased depressive disorders. In addition, the preterm delivery, and intra-uterine growth restriction were reported as an adverse neonatal outcome for ID and IDA. This study designed to evaluate the efficacy of ferric hydroxide polymaltose (FPM) in treatment of ID, and IDA during pregnancy. Materials and methods. One hundred and twenty-two women with ID (ferritin &lt; 15 μg/L), and moderate IDA (haemoglobin ≥ 7 and &lt; 10 g/dL) during pregnancy were included in this study. Studied women treated with FPM tablets for ≥ 3 months. The pre-treatment ferritin, haemoglobin, red blood cells (RBCs)-mean corpuscular volume (MCV), and -mean corpuscular haemoglobin (MCH) were compared by post-treatment values. Results. The mean pre-treatment ferritin, and haemoglobin significantly increased from 12.4 ± 5.6 μg/L and 7.8 ± 3.3 g/dL; respectively to 116.5 ± 6.9 μg/L and 11.1 ± 2.8 g/dL; respectively, 3-months’ after FPM treatment (p = 0.02 and 0.0002; respectively). In addition, the mean pretreatment RBCs MCV, and MCH significantly increased from 73.5 ± 4.6 fL and 24.2 ± 7.7 pg; respectively to 94.0 ± 3.8 fL and 31.7 ± 6.3 pg; respectively 3-months’ after FPM treatment (p = 0.02 and 0.01; respectively). Conclusion. The FPM (Ferose®) is an effective therapeutic option for treatment of ID, and IDA during pregnancy with high safety profile, and low side effects. The superior tolerability of FPM is an important advantage because compliance to oral iron is the main obstacle toward effective treatment of ID, and IDA during pregnancy.Wstęp. Niedobór żelaza (ID) i niedokrwistość z niedoboru żelaza (IDA) wiążą się z pogorszeniem funkcji poznawczych i zwiększonym ryzykiem zaburzeń depresyjnych u matki. Ponadto zgłaszano niekorzystne skutki ID i IDA dla noworodków, poród przedwczesny i wewnątrzmaciczne zahamowanie wzrastania płodu. Celem niniejszego badania była ocena skuteczności polimaltozy wodorotlenku żelazowego (FPM) w leczeniu ID i IDA podczas ciąży. Materiały i metody. Do badania włączono 122 kobiety z ID (ferrytyna < 15 μg/l) i umiarkowaną IDA (hemoglobina ≥ 7 i < 10 g/dl) w czasie ciąży. Badane kobiety przyjmowały FPM w tabletkach przez co najmniej 3 miesiące. Stężenia ferrytyny i hemoglobiny, średnią objętość (MCV) krwinek czerwonych (RBC) i średnią masę hemoglobiny (MCH) w RBC przed leczeniem porównano z wartościami po leczeniu. Wyniki. Średnie stężenia ferrytyny i hemoglobiny przed leczeniem istotnie wzrosły z 12,4 ± 5,6 μg/l i 7,8 ± 3,3 g/dl, odpowiednio, do 116,5 ± 6,9 μg/l i 11,1 ± 2,8 g/dl, odpowiednio, 3 miesiące po leczeniu FPM (p = 0,02 i 0,0002 odpowiednio). Ponadto średnie RBC MCV i MCH przed leczeniem istotnie się zwiększyły z 73,5 ± 4,6 fl i 24,2 ± 7,7 pg, odpowiednio, do 94,0 ± 3,8 fl i 31,7 ± 6,3 pg, odpowiednio, 3 miesiące po leczeniu FPM (p = 0,02 i 0,01 odpowiednio). Wniosek. Polimaltoza wodorotlenku żelazowego (Ferose®) jest skuteczną opcją terapeutyczną w leczeniu ID i IDA u kobiet w ciąży, ponieważ lek ten cechują wysoki profil bezpieczeństwa i niewielkie działania niepożądane. Doskonała tolerancja FPM jest ważną zaletą, ponieważ nieprzestrzeganie zaleceń terapeutycznych dotyczących stosowania doustnych soli żelaza jest główną przeszkodą w skutecznym leczeniu ID i IDA w okresie ciąży