Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Evaluation of Eucalyptus Clones Under Seasonal Waterlogging Conditions in South-Western Punjab

Eucalyptus is widely planted genus in many continents due to its rapid growth, several uses and good adaptability to climates and soil types. This study was based on nine Eucalyptus clones/progenies (C-413, C-3020, C-2135, C-7, C-2045, C-411, C-526, C-316 and seedlings) planted at farmers field experiencing seasonal waterlogging. The experiment was planted following randomized block design with plot size of 12 trees replicated four times. The survival of Seedlings, C-7, C-413, C-526 and C-316 was better and varied from 78.3 to 88.3 percent. Significant differences were found for tree height and diameter at age of 2 and 4 year, and volume index at age of 4 year. The tree height and diameter at breast height at 4 year age varied from 5.93 to 6.76 m and 56.4 to 87.6 mm, respectively. The relative ranking on basis of volume index was C-413&gt;C-316&gt;C-411&gt;C-7&gt;C-526. Clones C-413, C-316, C-7 and C-526 were promising based on adaptability and growth traits.</jats:p

Variation Among Poplar (Populus Deltoides Bartr.) Clones for Growth, Wood Traits and Tolerance to Leaf Spot Diseases

Poplar is economically important and fast growing tree species which is widely adopted by farmers of northwest India. The nursery study was conducted for two years to find out clonal variation for plant height, collar diameter, biomass, wood traits and incidence of leaf spot disease. Results found significant differences among the clones for all growth traits, specific gravity and fiber length. Clones L-290/84, 22-N and L-50/88 were promising for tree height and collar diameter during 1st year study. In 2nd year the tree height was highest in L-7/87 but was at par with L-34/82. L-7/87, L-247/84 and L-48/89 were promising for diameter. Clones L-48/89, L-7/87, 22-N, L-247/84, S7C8, and WSL-22 recorded superiority for both above ground and root biomass. The maximum fiber length was recorded in clone WSL-29 (0.936 mm) which was at par with those of WSL-22, L-17/92 and L-50/88. The wood specific gravity ranged from 0.383 to 0.498. Clone L-290/84 was at top rank but statistically par with 40-N, G-48, L-50/88 and T-90. The relative resistance for leaf spot was the higher in L-290/84, 40-N and WSL-29 in 1st year, and WSL-29, L-17/92, L-290/84, 22-N, 40-N, S7C8, and L-48/89 were found to be resistant during 2nd year. On the basis of all the traits clones L-48/89, 22-N, L-290/84, 40-N, and WSL-22 have shown promise and need to be tested at multiple sites before commercial cultivation.</jats:p

Extended BBCH scale of Moringa oleifera Lam. and its implications for growing in Urban Food Forests

The phenological studies of tree species is a potential tool to develop a keen observation for monitoring the gradual impact of climate change on biology of trees, manifested through variation in timing and duration of different phenological events in their life cycle. The documentation of these phenological growth stages reflect upon the implications for their responsiveness to seasonal variation in climate and potential utilization for the benefit of mankind. Pertaining to the immense significance of phenology, a study was conducted to document different growth and developmental stages in Moringa oleifera Lam. referencing to the BBCH scale (Biologische Bundesantalt, Bundessortenamt und Chemische Industrie), supplementing with significant Landmark stages (developed by the authors) under the subtropical conditions of Punjab state, India. The observation and the analysis of the growth stages in M. oleifera depicted asynchronous growth patterns exhibiting juvenile, vegetative and reproductive developmental stages within an individual tree canopy. These phenophases appeared simultaneously and were designated numerical values corresponding to principle growth stages (0–9) and secondary sub-stages (0–9) reflecting their relative intensity of occurrence. The novel landmark scale proposed for M. oleifera, defines the optimum stage(s) for its utilization such as tender leaves for culinary purpose; mature leaves for processing for manufacturing of fortified food products and herbal medicines; and immature pods for utilization in culinary preparations. The landmark stages proposed in M. oleifera reflect its immense significance for introducing as an edible tree species in Urban Food Forests as a source of nutrition besides offering other multi-functionalities of ecological, landscaping, esthetic and spiritual aspects