Laparoscopic vs open repair for incisional hernia

OBJECTIVES: The aim was to conduct a meta-analysis of RCTs investigating the surgical and postsurgical outcomes of elective incisional hernia by open versus laparoscopic method. MATERIAL AND METHODS: A search of PubMed, Medline, Embase, Science Citation Index, Current Contents, and the Cochrane Central Register of Controlled Trials published between January 1993 and September 2013 identified all the prospective RCTs comparing surgical treatment of only incisional hernia (and not primary ventral hernias) using open and laparoscopic methods were selected. The outcome variables analyzed included (a) hernia diameter; (b) operative time; (c) length of hospital stay; (d) overall complication rate; (e) bowel complications; (f) reoperation; (g) wound infection; (h) wound hematoma or seroma; (i) time to oral intake; (j) back to work; (k) recurrence rate; and (l) post-operative neuralgia. The quality of RCTs was assessed using Jadad's scoring system. Random effects model was used to calculate the effect size of both binary and continuous data. Heterogeneity amongst the outcome variables of these trials was determined by the Cochran Q statistic and I2 index. The meta-analysis was prepared in accordance with PRISMA guidelines. RESULTS: Six RCTs were considered suitable for meta-analysis. A total of 378 patients underwent open mesh repair and 373 had laparoscopic repair. Statistically significant reduction in bowel complications was noted with open surgery compared to the laparoscopic repair in five studies (OR 2.56, 95% CI 1.15, 5.72, p=0.02). Comparable effects were noted for other variables which include hernia diameter (SMD -0.27, 95% CI -0.77, 0.23, p=0.29), operative time (SMD -0.08, 95% CI -4.46, 4.30, p=0.97), overall complications (OR -1.07, 95% CI -0.33, 3.42, p=0.91), wound infection (OR 0.49, 95% CI 0.09, 2.67, p=0.41), wound hematoma or seroma (OR 1.54, 95% CI 0.58, 4.09, p=0.38), reoperation rate (OR -0.32, 95% CI 0.07, 1.43, p=0.14), time to oral intake (SMD -0.16, 95% CI -1.97, 2.28, p=0.89), length of hospital stay (SMD -0.83, 95% CI -2.22, 0.56, p=0.24), back to work (SMD -3.14, 95% CI -8.92, 2.64, p=0.29), recurrence rate (OR 1.41, 95% CI 0.81, 2.46, p=0.23), and postoperative neuralgia (OR 0.48, 95% CI 0.16, 1.46, p=0.20). CONCLUSIONS: On the basis of our meta-analysis, we conclude that laparoscopic and open repair of incisional hernia is comparable. A larger randomized controlled multicenter trial with strict inclusion and exclusion criteria and standardized techniques for both repairs is required to demonstrate the superiority of one technique over the other

A new estimate of carbon for Bangladesh forest ecosystems with their spatial distribution and REDD+ implications

In tropical developing countries, reducing emissions from deforestation and forest degradation (REDD+) is becoming an important mechanism for conserving forests and protecting biodiversity. A key prerequisite for any successful REDD+ project, however, is obtaining baseline estimates of carbon in forest ecosystems. Using available published data, we provide here a new and more reliable estimate of carbon in Bangladesh forest ecosystems, along with their geo-spatial distribution. Our study reveals great variability in carbon density in different forests and higher carbon stock in the mangrove ecosystems, followed by in hill forests and in inland Sal (Shorea robusta) forests in the country. Due to its coverage, degraded nature, and diverse stakeholder engagement, the hill forests of Bangladesh can be used to obtain maximum REDD+ benefits. Further research on carbon and biodiversity in under-represented forest ecosystems using a commonly accepted protocol is essential for the establishment of successful REDD+ projects and for the protection of the country’s degraded forests and for addressing declining levels of biodiversity

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Hematological reference values for healthy fat-tailed sheep (Dhumba) in Bangladesh

Objective: There is scarce literature regarding hematology profile of fat-tailed sheep (Dhumba). The study was conducted to determine reference intervals for their hematology profile in the context of Bangladesh. Materials and methods: Blood samples were collected from 32 healthy fat-tailed sheep from Dhaka, Bangladesh, during SeptemberOctober, 2015. Hemoglobin (Hb), packed cell volume (PCV), erythrocyte sedimentation rate (ESR), total leukocyte count (TLC), total erythrocyte count (TEC), lymphocyte, monocyte, eosinophil, basophil, and neutrophil counts were measured. Results: The levels showed a wide range and variation based on age and sex. Adult sheep had significantly (p = 0.01) higher Hb level than that of juvenile ( [J Adv Vet Anim Res 2018; 5(4.000): 481-484

Isolation, identification and antimicrobial resistance profile of Staphylococcus aureus in Cockroaches (Periplaneta Americana)

Objective: The study was conducted to determine the prevalence of Staphylococcus aureus in cockroaches (Periplaneta americana), and to assess the antimicrobial resistance profiles of the isolated bacteria. Materials and methods: A total of 150 cockroaches (P. americana) were randomly captured from three households and four restaurants in Chittagong City Corporation, Bangladesh during July to December 2014. The cockroaches were transported to the bacteriology laboratory at the Poultry Research and Training Centre (PRTC), Chittagong Veterinary and Animal Sciences University. The isolation and identification of Staphylococcus spp. from the external surface wash and gut homogenates by pooling cockroaches were done by following conventional bacteriological examinations followed by biochemical characterization. The antibiotic susceptibility profiles of the isolates were determined using disc diffusion method. Results: In this study, the overall prevalence of S. aureus was 38% (n=57/150). Higher prevalence of Staphylococcus spp. was observed among the cockroaches from restaurant (49.3%; n=37/75) as compared to those of households (26.7%; n=20/75) having a significant difference (P<0.05). Highest level of resistance by the Staphylococcus spp. was found to Penicillin (68%) followed by Erythromycin (60%), Oxacillin (46%) and Clindamycin (31%). On the other hand, the Staphylococci isolates were highly sensitive to Cephalothin (84%) and Kanamycin (65%). Conclusion: The rational use of antibiotics needs to be adopted in both human and animal medicine practices to prevent the emergence of drug resistant Staphylococcus spp. [J Adv Vet Anim Res 2016; 3(3.000): 221-228

Assessment of Metal Contamination in Water of Freshwater Aquaculture Farms from a South Asian Tropical Coastal Area

Heavy metal accumulation in aquaculture farms has become a major problem due to the widespread use of artificial feed to enhance fish productivity. To estimate the contamination level and identify metal sources, we investigated the amounts of seven heavy metals (Cu, Zn, Pb, Cd, Cr, Ni, and Mn) in the surface water of commercial fresh water aquaculture farms in a south Asian tropical coastal area. Atomic absorption spectrometry (AAS) was used to analyze 36 water samples from 12 commercial fish farms. The results demonstrated that the range of three heavy metals were detected in a decreasing order of Mn (0.0574–0.4100 mg.L−1) > Zn (0.0125–0.3250 mg.L−1) > Cu (0.0275–0.085 mg.L−1). In all samples, the remaining four heavy metals (Pb, Cd, Cr, and Ni) were below the detectable level (BDL). Except for Mn, the amounts of the metals examined were below WHO and USEPA guideline values. According to the findings, the levels were found to be safe for drinking, agriculture production, and aquaculture. There was no significant correlation (p > 0.05) between heavy metal concentrations and water quality parameters, indicating that pollution came from diverse sources and that no single factor was controlling their levels. Furthermore, Analysis of Variance (ANOVA) revealed no significant differences in the mean metal values among the fish farms (p > 0.05). Multivariate analyses (CA and PCA) demonstrated the association and sources of metal in the study area. Although metal levels were not beyond the threshold limit, it is recommended that suitable measures and continuous monitoring should be undertaken to reduce heavy metal pollution in aquaculture farms and prevent water quality degradation

Isolation and identification of associated bacteria and maggots from myiasis affected wounds of cattle and goats in Bangladesh

ABSTRACT The study was carried out to investigate the associated maggots and bacteria in myiasis affected wound in animals. Total 37 myiasis affected cattle (n=25) and goats (n=12) were examined in this study, of which 21 samples were collected from the Veterinary clinics of Bangladesh Agricultural University (BAU), Mymensingh, and the remaining 16 samples were collected from Upazila Veterinary Hospital, Gouripur, Mymensingh. The maggots were collected from the wounds, and were identified under microscope. For microbial identification, samples (n=10) were collected aseptically by using sterile cotton swab. The samples were allowed to grow in media. Colony and staining characteristics were studied. Traumatic, creeping or migratory myiasis wounds were identified in the examined animals. In this study, subcutaneous wound was mostly recorded, of which 43% (n=9/21) was found at the Veterinary Clinics, BAU, and 44% (n=7/16) was found at the Upazila Veterinary Hospital, Gouripur. The maggots were identified as Chrysomya bezziana, commonly known as Old World screwworm. Occurrence of myiasis due to C. bezziana larvae was recorded as 100%. The associated bacteria were identified as Staphylococcus spp. In conclusion, the myiasis wounds are associated with both Staphylococcus spp. and larvae of C. bezziana. Preventive and control measures against the C. bezziana and Staphylococcus spp. can be undertaken to save the livestock from myiasis in Bangladesh

Production performances of Japanese quail parent stock under open housing system

The study was carried out to assess the production performances of Japanese quail parent stock raised under open housing system and the study was conducted in a local farm with 2000 Japanese parent stock quail birds (Coturnix coturnix japonica). Observed body weight gain was recorded in each weekend up to 7 weeks of their age; birds gained weight 15.73, 31.45, 47.20, 90.80, 125.27, 153.14 and 175.20 grams, respectively. There have been observed sharp decline of fertility and hatchability of birds with increase of their age. Optimum fertility was recorded at third week and optimum hatchability at fifth week of their age. Average flock uniformity was found 83.68%. The hen day egg production of the flock was recorded 81, 83, 85, 86, 89, 89, 89, 89 and 88% in each weekend, respectively. It may therefore be concluded that Japanese quail parent stock performs well under open housing system in Bangladesh and future study can be taken to better understand their production performances