Enhanced recovery protocols versus traditional methods after resection and reanastomosis in gastrointestinal surgery in pediatric patients

Background Enhanced recovery after surgery (ERAS) is a group of changes in perioperative care that represent a fundamental shift from the traditional management of the gastrointestinal (GI) surgical patient.Objective To compare the results of applying enhanced recovery after GI resection in children versus the traditional methods.Patients and methods This prospective study included 60 patients who underwent GI resectional surgery between February 2016 and February 2017 at our institution. The patients were divided into two groups: group A (30 patients) was managed with ERAS protocol and group B (30 patients) was managed with traditional methods. All the patients underwent standard hand-sewn technique of GI resection reanastomosis. The protocol of ERAS included no routine nasogastric tube, early diet advancement, minimization of narcotic analgesics, early ambulation, and physical rehabilitation.Results The most frequent cause of GI resection reanastomosis surgery was intussusception (33.3% in group A and 36.7% in group B). Patients in group A had a significant lower frequencies of postoperative fever (33.3 vs. 66.7%, P<0.01) and chest infection (26.7 vs. 60%, P<0.01). Moreover, group A showed a significant shorter postoperative length of hospital stay (4 ± 1.2 days in group A vs. 7.1 ±2.05 days in group B, P<0.001).Conclusion Adopting ERAS protocol for resectional GI surgery in pediatric patients should be encouraged as it is results in lower incidences of postoperative fever and chest infection and is associated with less postoperative length of hospital stay.Keywords: enhanced recovery after surgery, enteral nutrition, gastrointestinal surgery, length of hospital stay, pediatric surger

SUCCESS IN RAT CONTROL IN KUWAIT

The preliminary rat survey prior to the actual attack phase of Rat Control Program in Kuwait revealed an infestation rate with the Norway rat, Rattus norveqicus, in buildings ranging between 32.7% and 70.7%. The comparatively high infestation was observed in 92.5% of Kuwait buildings. Moreover the infestation reached 99% in certain districts of the country. This high infestation was associated with an increase in rat-borne diseases particularly murine typhus, salmonellosis, rat-bite fever and certain parasitic diseases. A programme for rodent control in Kuwait was initiated through a political decision by the cabinet which gave the full responsibility of rodent control to the Ministry of Public Health coordinating with other authorities involved in the problem in addition to an independent budget to fulfill all the program requirements. Financing, administration, guidance, public health information, field work, and research studies were all monitored by the High Committee in addition to Supervising and Following up Committee. The first phase of the program began in the late months of 1979. It included geographical reconnaisance, survey of rodents and their ectoparasites, establishment of the general plan, and a skeletal organization for the program. The second phase was the attack phase. It highlighted biological and epidemiological studies, bioassays of pesticides and training of personnel, which was followed by the actual chemical attack of the incriminated rodents and their ectoparasites for three consecutive years. In addition, sanitation and health education were involved. The third phase, i.e., the maintenance phase, began in August 1982. It is still running to maintain the drastic drop of the Norway rat infestation and to control the house mouse. Kuwait\u27s control program, based on a scientific basis and with a well-organized administration, has successfully realized 99.7% reduction in the infestation rate, with a 99.6% density of infestation Of Norway rats remaining at the end of the attack phase. However, the control of the house mouse produced a reduction of only 71.4% in the infestation rate, and 20% in the density of infestation, possibly indicating intraspecific competition between the two species or less-effective control measures against the mice

Phases smectiques A « bicouche » et « partiellement bicouche »

From microscopic observations, differential scanning calorimetry and X-ray experiments, the partial bilayer SA and the bilayer SA of cyanobenzoyloxy benzoate of heptylphenyl (DB7) are compared to the well-known SA phase of the octyloxycyanobiphenyl (8OCB) This work was initiated from the recent report of a partial bilayer SA → monolayer SA transition [6] and it raises the question again of the identity and number of SA phases. We claim here that the high temperature SA phase of DB7 and the SA phase of 8OCB are isomorphous. In fact, if the bilayer SA(SA2) is readily distinguishable, subsequent studies are necessary in order to clear up the problem of phase transitions between the other kinds of SA arrangements.Par observations microscopiques, analyse enthalpique différentielle et étude structurale aux RX, nous comparons les phases SA partiellement bicouche et bicouche du cyanobenzoyloxy benzoate d'heptylphényle (DB7) à la phase S A bien connue de l'octyloxycyanobiphényle (8OCB). Cette étude qui débouche sur l'isomorphie de la phase SA haute température du DB7 avec la phase SA du 8OCB fait suite à la récente découverte d'une transition SA partiellement bicouche → SA monocouche [6] et pose à nouveau le problème de l'identité et du nombre de phases SA. Nous concluons en faisant remarquer que si la phase SA bicouche notée SA2 est clairement différentiable des autres phases SA, par contre, des études ultérieures seront nécessaires pour dégager des critères de distinction des autres structures SA

Studies on the ontogeny of Streptopelia senegalensis aegyptiaca (latham 1790) 5 – The development of the viscerocranium

The present article shows the following points: The quadrate and Meckel’s cartilages have separate centres of chondrification. A symphsis Meckelii is absent. Meckel’s cartilage has three processes. These are processus mandibularis externus, processus mandibularis internus and retroarticularis. The quadrate cartilage has five processes; orbitalis, medialis, lateralis, oticus and the ventral articular processes. The columella auris has two centres of chondrification, a medial otostapedial centre (the stapes) and a lateral hyostapedial centre

Detection of ancient irrigation canals of Deir El-Hagar playa, Dakhla Oasis, Egypt, using Egyptsat-1 data

Dakhla Oasis is the second provincial oasis in Al-Wadi El-Gedid Governorate in the Western Desert of Egypt. Dakhla contains several springs and wells, the most important of which are Mut Wells. Deir El – Hagar playa, located about 45 km to the northwest of Mut, the capital of the oasis, is the most important playa where the Roman Deir El-Hagar Temple is located. The Mid-Pleistocene to Holocene exposed lacustrine sediments provide evidence for a more humid climate than that present today. The main aim of this work is to use the High Pass Filter (HPF) image processing technique to enhance and extract archaeological remains and ancient irrigation canals from an Egyptsat-1 2010 satellite image in addition to link between the locations of these canals and the source of the water that replenished these canals. The enhanced images as well as the 3D prospective view indicate that the playa is a semicircular basin covered by extensive lake deposits that owed its water to the natural flowing springs, located 2 km to the south, and rainfall over the depression during the Terminal Paleolithic and Neolithic times. The significance of this research is to highlight how our ancestors were brilliant so as to utilize the local resources to allow water to be conveyed from its source to its destination where it will be fully utilized in irrigation

Land surface analysis of salt affected soils using DEM and GIS

The main objective of the current study is to use the Digital Elevation Model (DEM) and Geographic Information System (GIS) to characterize the surfaces of saline soils. To fulfill this objective two pilot areas represents different soil texture were selected. The first area located to the north of the Nile Delta (alluvial plain) where the second is located at North Sinai (aeolian plain. Shuttle Radar Topography Mission (SRTM) images were used for land surface analyses. The spatial analyst function of ARC-GIS software has been used to produce digital maps of water table and soil salinity. The results indicate that the soil salinity exhibits the low-lying elevation, flat or nearly flat areas (slope < 1%) slopping surfaces of north or south directions. The correlation between water table and soil salinity is significant (R2= 0.714) in the Aeolian plain while it is not significant (R2= 0.422) in the alluvial plain. Information on land surface becomes a must for the management of salt affected soils