Rhipicephalus annulatus (Acari: Ixodidae) Control by Nigella sativa, Thyme and Spinosad Preparations

Background: Several compounds obtained from plants have potential insecticidal, growth deterrent or repellent characteristics. The control of hard ticks by non-chemical substances was targeted in this study. Methods: The effect of 36 materials on in-vitro ticks was studied, including 2 absolute controls (water only or ab­solute ethyl alcohol only), 6 conventionally used spinosad preparations (aqueous solutions), 12 Nigella sativa (N. sativa) preparations (aqueous and alcoholic solutions), and 12 Thyme preparations (aqueous and alcoholic solutions). The engorged ticks were tested in-vitro for mortality and oviposition ability using the studied materials. Results: The final mortality after 48 hours of application in N. sativa aqueous preparations began from 10.0% con­centration, 1.0% to 100% by concentration preparations ≥10%. In addition, N. sativa alcoholic preparations began from 50.0% concentration, 2 % to 100% by concentration ≥5%. Meanwhile, Thyme aqueous and alcoholic prepa­rations began from 70.0% concentration, 5% to 90% by concentration 10–20%. Additionally, spinosad aqueous preparations and both of control preparations (Water and Alcohol) resulted in no mortality. All differences were sta­tistically significant. The oviposition was stopped in N. sativa (aqueous ≥10% and alcoholic ≥5%) and in spinosad (aqueous≥25%). The aqoues dilution of the used matters killed B. annulatus larvae beginning from the concentration 5%. Conclusion: Nigella sativa alcohol 20% was the best of studied preparations being the lowest concentration (20%) that could achieve the highest lethal (100%) effect in shortest time (12 hours). Moreover, Thyme oil and spinosad could not kill 100% of adult but did on larvae

Tanta stroke chain performance during era of COVID-19 pandemic: how to minimize the real/expectation gap

Abstract Background During the coronavirus disease of 2019 (COVID-19) pandemic, it would be so difficult to keep the balance between time-saving best stroke care and medical staff safety which obliges healthcare decision-makers to think extraordinarily. The objectives of this study were to evaluate the performance of the Tanta stroke chain (TSC) during the period of the study as well as to identify areas of strength and disparities of the system while dealing with the COVID-19 pandemic measures. The study was conducted on 492 acute ischemic stroke (AIS) patients who were divided into COVID-19 suspected (115 patients) and COVID-19 non-suspected (377 patients). The former group was further COVID-19 confirmed and COVID-19 negative patients. The latter group was subdivided according to the timing of the patient’s arrival at the hospital in the morning, evening, and night shifts group while the fourth group constitute those reached during shifting hours. Patients received early stroke management regarding the 2018 AHA/ASA guideline and its 2019 update. Results Suspected COVID-19 patients represented 23.37% of studied patients. Onset to needle time was significantly prolonged in suspected COVID-19 patients with little chance of utilizing IV thrombolysis (IVT) and consecutive higher morbidity and mortality rates. For COVID-19 non-suspected patients group, a higher rate of IVT utilization was noticed in those reached during the morning shift with a lower chance of utilization in those reached during the shifting hours. Conclusion COVID-19 measures had an inverse effect on TSC logistics which needed upgrading of the service to better cope with the pandemic and to improve AIS patients’ functional outcomes

Systemic Use of Arnica Montana for the Reduction of Postsurgical Sequels following Extraction of Impacted Mandibular 3rd Molars: A Pilot Study

Background. Postsurgical sequels (PSS) are a group of complications commonly encountered following invasive dental surgical procedures such as bone grafting procedures, external sinus grafting, and 3rd molar extractions. These include pain, intraoral and extraoral bruising, and edema. The aim of this study is to evaluate the clinical efficacy of arnica montana (AM) in the management of PSS following extraction of impacted mandibular 3rd molars. The investigators null hypothesis includes no significant role of AM in reducing PSS following dental extraction. Materials and Methods. The investigators implemented a case-control pilot study enrolling twenty-three patients with impacted mandibular 3rd molars. These patients were allocated to AM or control group. Baseline clinical measurements were collected and included: (1) length of the surgical procedure, (2) pain score, (3) maximum mouth opening, and (4) facial measurements to evaluate edema levels. Subjects in active group received systemic AM tablets following the manufacturer instructions. All study subjects were followed up on Days 2, 4, and 7. Data was analyzed for statistical significance. Results. A total of 30 impacted mandibular 3rd molars were extracted, in which 22 completed with AM. There were 16 females, and the average age was 26 years. On Day 2, subjects in the AM group reported significantly lower VAS compared to control group (3.09 ± 2.22 versus 4.75 ± 1.28). In addition, bleeding, extraoral bruising, edema, and decrease in maximum mouth opening were significantly less reported in the AM group. Conclusions. This study describes the potential benefit of AM in reducing PSS following dental extractions

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially