Assessment of placental thickness as a predictor of gestational age and fetal weight in second and third trimester of pregnancy

Background: Estimation of precise gestational age as well as fetal weight is important and is usually done by ultrasound assessment of fetal biometry. Recently estimation of placental thickness as a marker of fetal maturity as well as fetal weight has become a topic interest amongst obstetricians because of the accuracy with which placental thickness can be used for estimation of gestational age. We undertook this observational study to find out whether placental thickness can be used for estimation of gestational age and fetal weight in healthy singleton pregnancies. Methods: This was a prospective observational study in which 210 patients in second and third trimester of pregnancy who has undergone antenatal ultrasound examination were included on the basis of a predefined inclusion and exclusion criteria. First gestational age estimation was done using fetal biometry (head circumference, biparietal diameter, abdominal circumference and femur length). Placental thickness was measured at the level of cord insertion. Correlation between placental thickness and gestational age as well as fetal weight as determined by biometry was analyzed by pearsons coefficient. P value less than 0.05 was taken as statistically significant. Results: Mean age of studied cases found to be 24.62±4.12 years. Mean gestational age of the studied cases was found to be 28.19±6.90 weeks. The most common location of placenta was anterior which was seen in 99 (47.14%) patients followed by posterior (32.38%) and fundal (10.95%). Analysis of mean placental thickness in studied cases showed that at 12 weeks of gestation the mean placental thickness was 12.96 mm. Mean placental thickness at 37 weeks found to be 36.82 mm and this value was determined to be cut-off value for differentiating between full term and preterm gestation. There was strong positive correlation between placental thickness and gestational age between 12-38 weeks. Similarly positive correlation also existed between placental thickness and gestational age between 14-37 weeks. Conclusions: Placental thickness can be used for estimation of gestational age as well as fetal weight in cases where fetal biometry can not be entirely relied upon

Preparedness Assessment of Physicians during Coronavirus Disease-19 Pandemic: A Cross-sectional Study

BACKGROUND: Since first confirmed case of coronavirus disease (COVID)-19 in December 2019 by Chinese health authorities and subsequent World Health Organization (WHO) declaration that COVID-19 is a global public health crisis, radical changes have occurred all over the world associating massive lockdown with increased numbers of infected cases and related mortalities. As health care workers (HCWs) are at a great risk to get COVID-19 infection and hence can be a dangerous source of spreading it to the community, it was important to assess HCWs knowledge, attitude, and practice toward COVID-19 infection prevention and control (IPC) to help limit the outcomes of COVID-19. AIM: The objectives of the study were to assess the knowledge, attitudes, and practices of physicians regarding COVID-19 IPC. METHODS: Research setting is “Kasr Al-Ainy” Faculty of Medicine, Cairo University Hospital. Design: A cross-sectional analytical observational hospital-based research in June 2020. Population: A convenient sample of 50 physicians working at Cairo University Hospital was included. Data collection: Self-administered questionnaires derived from the WHO IPC guide during health care when COVID-19 is suspected were used. RESULTS: Mean age of studied group was 30.5 ± 3.97, while their mean years of practice were 4.7 ± 3.55. Mean knowledge score among physicians was 5.6 (± 0.56), two-thirds of them had sufficient knowledge regarding COVID-19 IPC as their mean attitude score among 24.9 (± 2.8). While mean practice scores 5.6 (± 1.05), yet only 68% of the participating physicians use a new set of personal protective equipment when care is given to a different patient. CONCLUSION: Physician’s moderate knowledge, poor attitude, and modest practice toward COVID-19 IPC were found to be not sufficient, not favorable nor safe enough to expected standards

The incidence of Iron Deficiency Anemia in Allergic Rhinitis patients in Qena University Hospital

Background: Allergic rhinitis is a common disease of immune origin. It affects the quality of life of patients negatively. Objectives: To evaluate the changes in iron profile in allergic rhinitis patients. Patients and methods: This study was conducted on thirty patients with allergic rhinitis. All of the participants were subjected to clinical evaluation and the following investigations: Complete blood picture, Serum ferritin, Serum iron and total iron binding capacity (TIBC) and IgE. Visual analogue scale (VAS) score was used to measure the severity of allergic rhinitis. Results: Among the studied patients, there were 18 males (60%) and 12 females (40%), the mean age of studied patients was 11.3 ± 4.2 (SD) years with mean onset age of 4.6 ± 3.01(SD) years and mean duration of disease of 6.7 ± 2.9 years. There were 8 patients (26.7%) with positive family history in the studied patients. The incidence of iron deficiency and iron deficiency anemia was significantly higher in children with severe allergic rhinitis compared with mild cases. Also we found statistically significant difference (p-value = 0.037) between mild, moderate & severe cases of allergic rhinitis as regard Hb, MCH, HCT, ferritin, serum iron and TIBC. A statistically significant difference (p-value = 0.015) was noted between mild, moderate & severe cases as regard IgE. Serum IgE is correlated with the severity of allergic rhinitis in children. Conclusion: Prevalence of iron deficiency anemia in pediatric patients with allergic rhinitis is higher than in patients without atopic disease. Iron deficiency anemia increases markedly with severity of allergic rhinitis. Serum IgE is correlated with the severity of allergic rhinitis in children

Synthesis of biscoumarin bifunctional reactive fluorescent whitening agents and their application on nylon-6 fabric

361-368Two new bifunctional reactive fluorescent whiting agents based on joining two coumarin moieties together through triazinyle-stilbene fluorescent moiety have been successfully synthesized, applied on nylon-6 fabrics and then characterized by NMR and elemental analysis. Spectral properties, such as absorption and emission spectra in solution and on fabrics are investigated. The application of all the prepared compounds as fluorescence [fluorescence whiting agents (FWAs)] and their whiteness as well as light fastness properties on nylon-6 fabric have been compared with monofunctional agent. Despite the fact that the FWAs, containing either mono or bis methyl coumarin derivatives, show better whiteness properties than the FWA containing phenyl coumarin derivative, the later compound shows higher light fastness (excellent)

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

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

Optimization of Polyaluminum Chloride-Chitosan Flocculant for Treating Pig Biogas Slurry Using the Box–Behnken Response Surface Method

Flocculation can remove large amounts of nitrogen and phosphorus from wastewater, and the resulting nitrogen- and phosphorus-rich floc can be used to produce organic fertilizer. For biogas slurries containing high levels of nitrogen and phosphorus, ordinary flocculants can no longer meet the flocculation requirements. In this study, to fully utilize the advantages of the two flocculants and achieve efficient removal rates of nitrogen and phosphorus from a biogas slurry, chitosan (CTS) and polyaluminum chloride (PAC) were used as a composite flocculation agent to flocculate pig biogas slurries. The response surface method was used to study the effect of PAC added (PACadded) to the composite flocculant (CF), composite flocculant added (CFadded) to the biogas slurry and the pH on flocculation performance, and optimize these three parameters. In the tests, when the PACadded was 6.79 g&middot;100 mL&minus;1CF, the CFadded was 20.05 mL&middot;L&minus;1 biogas slurry and the pH was 7.50, the flocculation performance was the best, with an absorbance of 0.132 at a wavelength of 420 nm. The total phosphorus (TP) concentration was reduced from 214.10 mg&middot;L&minus;1 to 1.38 mg&middot;L&minus;1 for a removal rate of 99.4%. The total ammonia nitrogen (TAN) concentration was reduced from 1568.25 mg&middot;L&minus;1 to 150.27 mg&middot;L&minus;1 for a removal rate of 90.4%. The results showed that the CF could form larger flocs, and had greater adsorption capacity and more stable flocculation performance than ordinary flocculants. Furthermore, the CF could exhibit better chelation, electrical neutralization and bridge adsorption

Peritonsillar infiltration of lidocaine Hcl versus intravenous pre-incisional lornoxicam in reducing post-tonsillectomy pain: this is a prospective, randomized, double-blinded, placebo-controlled study

Abstract Background Tonsillectomy is one of the most common procedures in otorhinolaryngology practice where analgesics are required for pain-relief especially in children. To compare the efficacy of using peritonsillar infiltration of lidocaine Hcl versus intravenous preincisional lornoxicam in reducing post tonsillectomy pain. Results Prospective, randomized, double-blinded, placebo-controlled study. Ninety-nine patients from age 12 to 18 years old, prepared for tonsillectomy. Patients were randomly subdivided into three groups as 33 patient in each group to receive either lidocaine (group 1), lornoxicam (group 2), or saline as a placebo (group 3). Anesthesia was induced using intravenous fentanyl and propofol, while endotracheal intubation was facilitated with rocuronium and maintenance by halothan. Intraoperative bleeding, pain scores, interval until first order for analgesic. The postoperative complications including bleeding, hypoxia, nausea, and vomiting also were observed. Pain scores at rest were significantly lower in group 2 than groups 1 and 3 at all observation times. Similarly, pain scores were lower in group 2 during the first 5 postoperative hours. The mean time for rescue analgesic was 276 min in group 2, 91 min in group 1, and about 60 min in group 3. No significant differences were noted for intraoperative bleeding. Conclusion The use of lornoxicam 16 mg at preoperative phase gave good control of immediate post tonsillectomy pain. Level of evidence 3

Synthesis of biscoumarin bifunctional reactive fluorescent whitening agents and their application on nylon-6 fabric

Two new bifunctional reactive fluorescent whiting agents based on joining two coumarin moieties together through triazinyle-stilbene fluorescent moiety have been successfully synthesized, applied on nylon-6 fabrics and then characterized by NMR and elemental analysis. Spectral properties, such as absorption and emission spectra in solution and on fabrics are investigated. The application of all the prepared compounds as fluorescence [fluorescence whiting agents (FWAs)] and their whiteness as well as light fastness properties on nylon-6 fabric have been compared with monofunctional agent. Despite the fact that the FWAs, containing either mono or bis methyl coumarin derivatives, show better whiteness properties than the FWA containing phenyl coumarin derivative, the later compound shows higher light fastness (excellent).

Organoclay-assisted disperse dyeing of polypropylene nanocomposite fabrics in supercritical carbon dioxide

Abstract Dyeing using supercritical carbon dioxide (SC-CO2) is carried out on the polypropylene (PP) nanocomposite fabrics with model disperse dye compared with their regular fabric at various dyeing temperatures and pressures. The results are compared with those obtained in aqueous dyeing method. The PP nanocompsite fabrics dyed in SC-CO2 medium exhibited higher colour strength (K/S) values compared with their PP regular fabric. The PP nanocompsite fabrics and their regular fabric dyed in SC-CO2 medium have higher K/S values than those dyed in aqueous medium. The color coordinates of all PP fabrics dyed in SC-CO2 and aqueous medium were positive with respect to a* and b* coordinates depending on the disperse red dye uptake. The PP nanocomposite fabrics dyed in SC-CO2 and aqueous medium exhibited higher antibacterial properties than their regular fabrics. All PP fabrics dyed in SC-CO2 and aqueous medium present very good washing, perspiration and light fastness