A one-stop perineal clinic: our eleven-year experience.

INTRODUCTION AND HYPOTHESIS: The perineal clinic is a dedicated setting offering assessment for various childbirth-related presentations including obstetric anal sphincter injuries (OASIs), perineal wound complications, pelvic floor dysfunction and other conditions such as female genital mutilation(FGM). We describe the clinical presentation and outcomes of women from a tertiary perineal clinic based on data collected over an 11-year period. METHODS: This is a retrospective observational study. A one-stop outpatient service was offered to all women who sustained OASIs (postnatally and antenatally in a subsequent pregnancy), perineal complications (within 16 weeks postpartum), FGM and/or peripartum symptoms of urinary/anal incontinence or prolapse. Assessment included history with validated questionnaires, examination and anal manometry and endoanal ultrasound when appropriate. Outcomes were compared among different grades of OASIs. Management of each type of presentation was reported with outcomes. RESULTS: There were 3254 first attendance episodes between 2006 and 2016. The majority (58.1%) were for OASIs, followed by perineal wound complications. Compared to the lower grades, the higher grades of OASI were associated with poorer outcomes in terms of symptoms, investigations and complications. Women with OASIs had unrelated symptoms such as urinary incontinence, perineal pain and wound infections that needed further intervention. A high proportion(42%) of wound complications required further specialist management. CONCLUSION: We describe a dedicated, one-stop perineal clinic model for antenatal and postnatal women for management of perineal and pelvic floor disorders. This comprehensive and novel data will enable clinicians to better counsel women regarding of outcomes after OASI and focus training to minimize risks of morbidities

Orai1 Channel Inhibition Preserves Left Ventricular Systolic Function and Normal Ca2+ Handling After Pressure Overload

Background: Orai1 is a critical ion channel subunit, best recognized as a mediator of storeoperated Ca2+ entry (SOCE) in non-excitable cells. SOCE has recently emerged as a key contributor of cardiac hypertrophy and heart failure but the relevance of Orai1 is still unclear. Methods: To test the role of these Orai1 channels in the cardiac pathophysiology, a transgenic mouse was generated with cardiomyocyte-specific expression of an ion pore-disruptive Orai1R91W mutant (C-dnO1). Synthetic chemistry and channel screening strategies were used to develop JPIII, a small-molecule Orai1 channel inhibitor suitable for in vivo delivery. Results: Adult mice subjected to transverse aortic constriction (TAC) developed cardiac hypertrophy and reduced ventricular function associated with increased Orai1 expression and Orai1-dependent SOCE (assessed by Mn2+ influx). C-dnO1 mice displayed normal cardiac electromechanical function and cellular excitation-contraction coupling despite reduced Orai1-dependent SOCE. 5 weeks after TAC, C-dnO1 mice were protected from systolic dysfunction (assessed by preserved left ventricular fractional shortening and ejection fraction) even if increased cardiac mass and pro-hypertrophic markers induction were observed. This is correlated with a protection from TAC-induced cellular Ca2+ signaling alterations (increased SOCE, decreased [Ca2+]i transients amplitude and decay rate, lower SR Ca2+ load and depressed cellular contractility) and SERCA2a downregulation in ventricular cardiomyocytes from C-dnO1 mice, associated with blunted Pyk2 signaling. There was also less fibrosis in heart sections from CdnO1 mice after TAC. Moreover, 3 weeks treatment with JPIII following 5 weeks of TAC confirmed the translational relevance of an Orai1 inhibition strategy during hypertrophic insult. Conclusions: The findings suggest a key role of cardiac Orai1 channels and the potential for Orai1 channel inhibitors as inotropic therapies for maintaining contractility reserve after hypertrophic stress

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Preparation of Lambda-Cyhalothrin-Loaded Chitosan Nanoparticles and Their Bioactivity against Drosophila suzukii

The encapsulation of pesticides within nanoparticles is a promising approach of advanced technology in sustainable agriculture. Lambda-cyhalothrin (LC) was encapsulated by the ionotropic gelation technique into chitosan (CS)/tripolyphosphate (TPP) and CS/alginate (ALG) matrixes. CS-LC nanoparticles were characterized, and their efficacy was then evaluated against the key pest of soft fruits in Europe and the United States, Drosophila suzukii. The encapsulation efficiency (74%), nanoparticle yield (80%), polydispersity index (0.341), zeta potential (-23.1 mV) and particle size (278 nm) were determined at the optimum conditions. FTIR confirmed the cross-linkage between CS and TPP/ALG in the nanoparticles. The optimum formula recommended by the fractional factorial design was associated with the formulation variables of CS of high or low molecular weight, cross-linking agent (TPP), LC concentration (1.5% w/v) and stirring rate (1500 rpm), showing the highest desirability value (0.5511). CS-LC nanoparticles of the lowest particle size (278 nm) exhibited the highest percent mortality of D. suzukii males (86%) and females (84%), exceeding that caused by the commercial product (Karate-zeon® 10% CS) at 2 HAT. This is the first work to use the ionic gelation technique to make LC nanoparticles, to the best of our knowledge. The encapsulation of chemical pesticides within biodegradable polymeric nanoparticles could be helpful for establishing a sustainable IPM strategy with benefits for human and environmental health and the lifetime of pesticides

Extraction, Chemical Composition and Insecticidal Activities of Lantana camara Linn. Leaf Essential Oils against Tribolium castaneum, Lasioderma serricorne and Callosobruchus chinensis

Storage pests and the food spoilage they cause are problems of great concern. Using essential oil obtained from different plants as an insecticide against these storage pests can be considered an environmentally friendly pest management option. Lantana camara Linn. (family Verbenaceae) is a flowering species, and is also a noxious weed that can proliferate well in nearly all geographical habitats. A biopesticide derived from the essential oil extracted from this plant can offer an effective solution for controlling storage pests. The goal of this study is to extract and analyse the chemical composition of essential oil obtained from L. camara leaves, and assess its effectiveness as a bioactive substance against three storage pests: Tribolium castaneum, Lasioderma serricorne, and Callosobruchus chinensis. The yield of essential oil extracted from L. camara leaves was about 0.24 ± 0.014%. By employing the GC-MS technique, the major phytochemicals contained in L. camara leaf essential oil were identified as caryophyllene (69.96%), isoledene (12%), and α-copaene (4.11%). The essential oil exhibited excellent fumigant toxicity (LC50 of 16.70 mg/L air for T. castaneum, 4.141 mg/L air for L. serricorne and 6.245 mg/L air for C. chinensis at 24 h), contact toxicity (LC50 of 8.93 mg/cm2 for T. castaneum, 4.82 mg/cm2 for L. serricorne and 6.24 mg/cm2 for C. chinensis after 24 h) along with effective repellent activity towards the test insects. In addition, the oil showed no significant phytotoxicity on the germination of paddy seeds. This presents the potential to utilize a weed in developing a biopesticide for effectively managing stored product insects because of its strong bioactivity

The effect of dietary sericite on growth performance, digestive enzymes activity, gut microbiota and haematological parameters of Nile tilapia, Oreochromis niloticus (L.) fingerlings

A feeding trial was conducted to assess the effect of dietary supplementation of sericite (silicate clay) on growth performance, digestive enzymes activity, immune parameters and gut microbiota, of Nile tilapia, Oreochromis niloticus (L.) fingerlings. Five isonitrogenous diets were formulated each diet supplemented with different levels of sericite 0 (control), 2.5, 5, 7.5 and 10 g/kg diet. After 70 days of feeding trial, supplemental sericite were quadratically improved the final body weight (FBW) (P = 0.023), weight gain (WG) (P = 0.012), specific growth rate (SGR) (P = 0.023) and feed conversion ratio (FCR) P = 0.023) and protein efficiency ratio (PER) (quadratic, P = 0.045). However, the relationship between FCR and sericite levels was expressed by a broken-line model with an identified optimal breakpoint of 6.3 g/kg of sericite inclusion in the diets. Additionally, significant quadratic increase in alkaline phosphatase (ALP), amylase, trypsin, chymotrypsin and lipase enzymes were detected (P = 0.026; P = 0.023; P = 0.013; P = 0.045; P = 0.023) as the level of sericite increased in the diet. Furthermore, dietary sericite levels exhibited linear decreased in the total count bacteria, E. coli and Enterobacteriaceae of stomach and gut of experimental fish (linear, P = 0.032; P = 0.024; P = 0.035; P = 0.023; P = 0.012; P = 0.039, respectively). There was no effect of dietary sericite levels on hemoglobin (Hb), hematocrit (Htc) and red blood cells (RBCs), but a quadratic trend was observed in white blood cells (WBCs), monocytes and lymphocytes of fish (quadratic, P = 0.036; P = 0.013; P = 0.034), respectively. Increasing dietary sericite levels did not affect alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin and globulin but quadratically increased total protein (quadratic, P = 0.012) and IgM exhibited linear trend (linear, P = 0.045). Results in this study indicate that the addition of sericite as feed additive enhanced the growth, feed utilization, digestive enzyme activities, blood profile and gut biota of Nile tilapia.info:eu-repo/semantics/publishedVersio