Respuesta química y eficacia agronómica de cultivos de girasol (Helianthus agnnuus L.) a fuentes de nitrógeno orgánico y fertilizantes convencionales nitrogenados en suelos áridos

Sunflower (Helianthus annuus L.) is an option for oilseed production, particularly in dry land areas due to good root system development. In this study, two field experiments were performed in the El-Khattara region (Sharkia Governorate, Egypt) during the 2005 season. The objective of this research was to determine the effect of organicnitrogen (ON) sources and their combinations as well as to compare the effect of ON and ammonium sulfate (AS) as a conventional fertilizer added individually or in combination on growth, yield components, oil percentage and the uptake of some macronutrients by sunflowers grown on sandy soil. The treatments of chicken manure (CM) and a mixture of farmyard manure (FYM) with CM were superior to the other treatments and gave the highest yield, dry matter yield, NPK uptake by plants at all growth stages along with seed yield at the mature stage. The effect of the different ON on crop yield and its components may follow the order; CM> palma residues (PR)> FYM. This was more emphasized when the materials were mixed with AS at a ratio of 3:1 and 1:1. The uptake of nitrogen (N), phosphorus (P) and potassium (K) by plants was affected by the addition of different N sources and treatments. The highest nutrient content and uptake by straw were obtained when treated with CM followed by PR at all growth stages, while it was PR followed by CM for seeds. Oil recovery was shown to respond to the N supply and the changes in individual fatty acids were not statistically different. However, it seems that the application of organic fertilizers resulted in an increase in total unsaturated fatty acids compared to the control.El girasol (Helianthus annuus) es una opción para la producción de semillas oleaginosas, en particular en terrenos arenosos debido al buen desarrollo de sus raíces. En este trabajo, dos estudios de campo fueron realizados en la región de El-Ishattara (Sharkia Governorate, Egypt) durante la estación 2005. El efecto de diversas fuentes de nitrógeno orgánico (ON) y el de su combinación, así como el efecto de ON y sulfato amónico (AS) como fertilizante convencional añadido individualmente o en combinación ha sido estudiado en base a su crecimiento, rendimiento de los componentes, porcentaje de aceite y consumo de micronutrientes en girasoles crecidos en suelos arenosos. El tratamiento con estiércol de pollo (CM) y una mezcla de estiércol de corral (FYM) con CM fue superior a otros tratamientos y dio el más alto rendimiento, la mayor cantidad de materia seca, y el mayor consumo de NPK por la planta en todos los estadios de crecimiento, así como en el rendimiento de la semilla en el estado de madurez El efecto promotor de los diferentes ON en el rendimiento del cultivo y sus componentes puede seguir el orden siguiente: CM> residuos de palma (PR)> FYM. Este efecto fue mayor cuando los materiales fueron mezclados con AS en una proporción 3:1 y 1:1. El consumo de nitrógeno (N), fósforo (P) y potasio (K) por la plantas dependió de la adición de diferentes fuentes de nitrógeno y tratamientos. El consumo y contenido de nutrientes más alto del tallo fue obtenido cuando se trató con CM seguido por PR en todos los estadios de crecimiento, mientras que PR fue seguido por CM para semillas. Se ha encontrado que la recuperación del aceite responde a la adición de nitrógeno, pero los cambios en los ácidos grasos no fueron significativamente diferentes. Sin embargo la aplicación de fertilizantes orgánicos resultó en un incremento de los ácidos grasos insaturados

Adjuvant role of corticosteroids in the treatment of community-acquired pneumonia

AbstractBackgroundDespite progress in life-support measures and antimicrobial therapy, the mortality of severe pneumonia has not varied since the mid-1990s, suggesting that other factors are of crucial importance in the evolution of this respiratory infection.ObjectiveTo evaluate the impact of hydrocortisone infusion in community-acquired pneumonia (CAP) in the attenuation of systemic inflammation and reduction of sepsis-related complications.MethodsThe study enrolled 80 patients, clinically and radiolodically diagnosed as community-acquired pneumonia, admitted to Chest department, Respiratory Intensive Care Unit, General Medicine Department and General Medicine Intensive Care Unit of Zagazig University Hospitals. Sixty of them were randomized to receive hydrocortisone as a bolus dose of 200mg intravenously once (only at day 1) then 10mg/h IV infusion for 7days and twenty received placebo, along with antibiotics according to IDSA/ATS 2007 guidelines which were given for both groups. The following parameters were compared in both groups; PaO2 and PaO2/FiO2 ratio, length of hospital stay, duration of IV antibiotic treatment, duration of mechanical ventilation, weaning success from mechanical ventilation, pneumonia complication and hospital outcome.ResultsHydrocortisone treated patients showed a significant improvement in PaO2 and PaO2/FiO2 ratio, a significant reduction in White blood cell count, C-reactive protein levels, Erythrocyte sedimentation rate, a significant reduction in the duration of mechanical ventilation, duration of IV antibiotic treatment, pneumonia complications, and length of hospital stay. Also there was an improvement of hospital outcome, weaning success from mechanical ventilation and radiological resolution compared to the placebo group.ConclusionAdjunctive 7day course of low dose hydrocortisone IV in patients with CAP hastens clinical recovery and prevents the development of sepsis-related complications with a significant reduction in the duration of mechanical ventilation, duration of IV antibiotics and length of hospital stay with the improvement in hospital outcome and weaning success from mechanical ventilation

HEPATOPROTECTIVE AND HEPATOTHERAPUTIC EFFECTS OF PROPOLIS AGAINST D-GALACTOSAMINE/LIPOPOLYSACCHARIDE-INDUCED LIVER DAMAGE IN RATS

Objective: The aim of the present study was to investigate the potential hepatoprotective and hepatotherapeutic activities of propolis against D-galactosamine and lipopolysaccharide (D-GaIN/LPS)-induced hepatotoxicity in rats.Methods: Hepatotoxicity was induced in rats by intra peritoneal injection of GalN (300 mg/kg) and LPS (30 μg/kg). In the hepatoprotection experiment, propolis was administered orally for 10 days before induction of hepatoxicity. In another experiment (hepatotherapy), propolis was dosed immediately after GalN/LPS injection.Results: Injection of GalN/LPS to rats induced hepatic damage that was manifested by a significant increase in the activities of aminotransferases, alkaline phosphatase, lactate dehydrogenase and levels of tumor necrosis factor-alpha (TNF-α) and total bilirubin in serum. Liver homogenate of intoxicated animals had the lower content of reduced glutathione with increased levels of the hepatic malondialdehyde and caspase-3 enzyme. Histological data presented marked damage in liver sections of intoxicated rats. Oral dosing of propolis before or once immediately after intoxication reversed these altered parameters near to normal values.Conclusion: Liver apoptotic events such as DNA fragmentation and increased caspase-3 activity observed during intoxication were prevented by pre and post- propolis treatment. These results suggest that propolis could afford significant protection and therapy in alleviation of hepatotoxicity.Â

Contraception use among Muslim women in Alexandria, Egypt: a descriptive pilot study

Background: This pilot study aimed to create a questionnaire survey directed to understand knowledge gaps related to contraception among Muslim women in Alexandria, Egypt, so potential interventions could be designed to enable more informed decision-making. The project was a mixed-method, cross-sectional study using a questionnaire survey.Methods: Participants were randomly selected at outpatient clinics at Alexandria university hospitals in September and October 2020. The inclusion criteria were to be an 18 year old or older woman and able to give consent. The recruitment goal for this pilot study was 100 participants. The consented participants were interviewed about demographics, socio-structural and contraception use. The questionnaire was tested using a focus group of 11 women. The study data was collected using KoBoToolbox and exported to the SPSS software for descriptive analysis. The primary outcome was to validate the survey questionnaire and the secondary outcome to assess knowledge regarding contraception methods and emergency contraception.Results: The age of study participants ranged from 18-60 with a mean of 34 years. Almost all participants had previously heard of various contraceptive methods and 75% used them before. The majority did not know about emergency contraception. Most respondents had a favorable attitude toward family planning, and their primary sources of information were family and friends.Conclusions: Preliminary findings show that most women knew about contraception methods, though few of them heard of emergency contraception. Because of the patriarchal nature of Egyptian society, family planning education should target the whole population

Intraoperative endomanometric laparoscopic Nissen fundoplication improves postoperative outcomes in large sliding hiatus hernia with severe gastroesophageal reflux disease. A retrospective cohort study

Background: Laparoscopic Nissen Fundoplication (LNF) is the gold standard surgical intervention for gastroesophageal reflux disease (GERD). LNF can be followed by recurrent symptoms or complications affecting patient satisfaction. The aim of this study is to assess the value of the intraoperative endomanometric evaluation of esophagogastric competence and pressure combined with LNF in patients with large sliding hiatus hernia (> 5 cm) with severe GERD (DeMeester score >100). Materials and methods: This is a retrospective, multicenter cohort study. Baseline characteristics, postoperative dysphagia and gas bloat syndrome, recurrent symptoms, and satisfaction were collected from a prospectively maintained database. Outcomes analyzed included recurrent reflux symptoms, postoperative side effects, and satisfaction with surgery. Results: 360 patients were stratified into endomanometric LNF (180 patients, LNF+) and LNF alone (180 patients, LNF). Recurrent heartburn (3.9% vs. 8.3%) and recurrent regurgitation (2.2% vs. 5%) showed a lower incidence in the LNF+ group (P=0.012). Postoperative score III recurrent heartburn and score III regurgitations occurred in 0% vs. 3.3% and 0% vs. 2.8% cases in the LNF+ and LNF groups, respectively (P=0.005). Postoperative persistent dysphagia and gas bloat syndrome occurred in 1.75% vs. 5.6% and 0% vs. 3.9% of patients (P=0.001). Score III postoperative persistent dysphagia was 0% vs. 2.8% in the two groups (P=0.007). There was no redo surgery for dysphagia after LNF+. Patient satisfaction at the end of the study was 93.3% vs. 86.7% in both cohorts, respectively (P=0.05). Conclusions: Intraoperative high-resolution manometry (HRM) and endoscopic were feasible in all patients, and the outcomes were favorable from an effectiveness and safety standpoint

Evaluation of growth and nutritional value of Brassica microgreens grown under red, blue and green LEDs combinations

39 p.-7 fig.-2 tab.-9 tab. supl.Microgreens are rich functional crops with valuable nutritional elements that have health benefits when used as food supplements. Growth characterization,nutritional composition profile of 21 varieties representing five species of the Brassica genus asmicrogreens were assessed under light-emitting diodes(LEDs) conditions. Microgreens were grown under four different LEDs ratios(%); red:blue 80:20 and 20:80 (R80:B20 and R20:B80), or red:green:blue 70:10:20 and 20:10:70 (R70:G10:B20 and R20:G10:B70). Results indicated that supplemental lighting with green LEDs (R70:G10:B20) enhanced vegetative growth and morphology, while blue LEDs (R20:B80) increased the mineral and vitamin contents. Interestingly, by linking the nutritional content with the growth yield to define the optimal LEDs setup, we found that the best lighting to promote the microgreen growth was the green LEDs combination (R70:G10:B20). Remarkably, under the green LEDs combination (R70:G10:B20) conditions,the microgreens of Kohlrabi purple, Cabbage red, Broccoli, Kale Tucsan, Komatsuna red, Tatsoi and Cabbage green, which can benefit human health in conditions with limited food, had the highest growth and nutritional content.This research work is a part of a project received seed funding from the Dubai Future Foundation through the Guaana.com open research platform(grant no. MBR026). Dr. Mortaza is supported from ERDF project “Plants as a tool from sustainable global development” No. CZ.02.1.01/0.0/0.0/16_019/0000827.Peer reviewe

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

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

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

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

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