Comparison of Alveolar Osteitis (AO) occurrence after impacted mandibular third molar removal with and without post-extraction socket irrigation

Objective: We wanted to see whether impacted third mandibular molar extractions resulted in Alveolar Osteitis if post-extraction socket irrigation was used or not. Methodology: A randomized control experiment on 70 patients study was conducted from July 2019 to January 2020 at Islamabad Dental Hospital's OMFS department. Patients presenting with the mandibular third molars fulfilling the inclusion criteria had their teeth extracted with and without socket irrigation using the computer lottery method. In cases of dry socket, clinical diagnosis was made between the 3rd, 5th, and 7th postoperative days. Results: 70 patients/sockets were evaluated with 35 having been irrigated and 35 non-irrigated. The age range was 16-50years with a mean of 29.49 and most patients were between the 16-35 age group. There were 48.6% males and 51.4% females. Dry Socket was evaluated on the 3rd, 5th, and 7th day between groups (A=irrigation, B=Non-irrigation). On the 3rd postop day, 14 (40%) patients in group A and 15(42.9%) patients were diagnosed as dry Sockets. A similar number of patients in both groups (20%) exhibited symptoms of dry socket on the fifth and seventh postoperative days, as did 5 (14.3 %) in group A, 3 (8.6 %) in group B, and 1(2.9 %t) in group A, all on the fifth postoperative day. Conclusion: On the third, fifth, and seventh postoperative days, there was no significant difference in the result of Alveolar Osteitis between the groups

Wood-derived biochar influences nutrient use efficiency of heavy metals in spinach (spinacia oleracea) under groundwater and wastewater irrigation

Present study analysed the influence of slow-pyrolyzed wood-derived biochar on growth performance and heavy metal accumulation in the leaves of spinach grown under groundwater and wastewater irrigation. Biochar was applied in soil as 5% (~30 t·ha−1) and 10% (~60 t·ha−1) amendment. According to results, plant biomass was significantly higher under wastewater than groundwater irrigation. Biochar amendment increased significantly the aboveground plant biomass and root biomass and promoted water use efficiency (WUE). Under groundwater irrigation, biochar amendment at 10% application rate, increased the leaf area index (P < 0.05), while amendment of biochar at all application rates significantly reduced leaf area index under wastewater irrigation (P < 0.05). Application of biochar also reduced accumulation of rhizosphere soil around roots under wastewater irrigation, indicating less exudate production in the rhizosphere of plants. Biochar significantly reduced the concentration of copper (Cu) in under wastewater irrigation. Biochar increased the nutrient use efficiency (NUE) of plants for zinc (Zn) and Cu under wastewater irrigation

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Biochar influences growth performance and heavy metal accumulation in spinach under wastewater irrigation

This pot-based study investigated the influence of cow-manure-derived slow pyrolyzed biochar on the growth performance and accumulation of Nickle (Ni), Zink (Zn), Copper (Cu) and Iron (Fe) in the aboveground plant biomass of spinach (Spinacia oleracea L.) grown under wastewater and groundwater irrigation. Biochar was applied in soil with or without manure (mixture of dung of cow and sheep/goat) at 3, 5 and 10% rates. Biochar application at 5% and when co-applied with manure at all application rates increased aboveground plant biomass under wastewater and groundwater irrigation. Application of biochar at 5 and 10% rates and when co-amended with manure at all application rates, increased the leaf area index under wastewater irrigation but caused no influence under groundwater irrigation. Biochar amendment at 5% rate reduced while at 10% rate and when co-applied with manure at 3 and 5% application rates increased root biomass under wastewater irrigation. Under groundwater irrigation, amendment of biochar at 10% and when co-applied with manure at 3 and 10% increased root biomass. Under wastewater irrigation, application of biochar tended to reduce the concentration of Ni when co-amended with manure while increased the concentration of Cu in aboveground plant tissues at 3 and 5% rates and when co-applied with manure at 10% rate. In conclusion, manure-derived biochar increased crop growth performance and influenced accumulation of heavy metals in aboveground plant tissues under wastewater and groundwater irrigation. Application of manure with biochar reduced concentration of Ni under wastewater irrigation and enhanced crop growth performance under groundwater irrigation

Time trends and age-related etiologies of pediatric hydrocephalus: results of a groupwise analysis in a clinical cohort

Objective: The current study aimed at evaluating experience with pediatric hydrocephalus and reviewing time trends and age-related differences in etiology, management, and outcomes of pediatric hydrocephalus at a tertiary care center in a south Asian country. Methods: We conducted a retrospective cohort study based on case note review of pediatric Patients (age, 1 month to 15 years) with hydrocephalus managed at Aga Khan University Hospital Karachi, over an 18-year period (1988-2005). For analysis, the study period was divided into two epochs (period A, 1988-1996, period B, 1997-2005) and study population was divided into two age groups (0-12 months and 1-15 years). Results: A total of 338 cases of pediatric hydrocephalus were identified. Most common etiology of pediatric hydrocephalus was meningitis (38.1%), followed by congenital hydrocephalus (20.4%) and brain tumors (8.3%). Shunt infection and blockage were seen in 38 (11.2%) and 54 (16.0%) children, respectively, 67 (19.8%) required shunt revision. Highest rates of shunt failure were seen in bacterial meningitis (35.3%) and aqueductal stenosis (29.2%). Neurological and/or cognitive deficits were observed more frequently in children under 1 year of age (P=0.029). Duration of hospital stay in period A was significantly higher than in period B (PConclusion: Despite recent advancements, hydrocephalus is still associated with high rate of shunt failure and mortality. Factors associated with poor outcome include younger age group and etiology of hydrocephalus

Time trends and age-related etiologies of pediatric hydrocephalus: results of a groupwise analysis in a clinical cohort

Objective: The current study aimed at evaluating experience with pediatric hydrocephalus and reviewing time trends and age-related differences in etiology, management, and outcomes of pediatric hydrocephalus at a tertiary care center in a south Asian country. Methods: We conducted a retrospective cohort study based on case note review of pediatric Patients (age, 1 month to 15 years) with hydrocephalus managed at Aga Khan University Hospital Karachi, over an 18-year period (1988-2005). For analysis, the study period was divided into two epochs (period A, 1988-1996, period B, 1997-2005) and study population was divided into two age groups (0-12 months and 1-15 years). Results: A total of 338 cases of pediatric hydrocephalus were identified. Most common etiology of pediatric hydrocephalus was meningitis (38.1%), followed by congenital hydrocephalus (20.4%) and brain tumors (8.3%). Shunt infection and blockage were seen in 38 (11.2%) and 54 (16.0%) children, respectively, 67 (19.8%) required shunt revision. Highest rates of shunt failure were seen in bacterial meningitis (35.3%) and aqueductal stenosis (29.2%). Neurological and/or cognitive deficits were observed more frequently in children under 1 year of age (P=0.029). Duration of hospital stay in period A was significantly higher than in period B (PConclusion: Despite recent advancements, hydrocephalus is still associated with high rate of shunt failure and mortality. Factors associated with poor outcome include younger age group and etiology of hydrocephalus