Comparison of heavy metal content of selected vegetables grown with organic and inorganic fertilizers

Background: Leafy vegetables are good sources of micronutrients but are also bio-accumulators of heavy metals. Objective: The study compared the heavy metal content of selected vegetables grown with organic and inorganic fertilizer in Odeda Local Government Area (LGA), Ogun State, Nigeria.Methods: Celosia argentea, Telfairia occidentalis and Corchorus olitorius leaves were collected from four randomly selected farmlands. Soup recipes from a recipe book were standardized and used to prepare soups the samples. The vegetables and soups were analyzed in duplicate for lead (Pb), arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni) and zinc (Zn) using the atomic absorption spectrophotometer. Data obtained were analyzed using SPSS version 20.Results: Arsenic, Pb and Cd were not detected in both Telfairia occidentalis and Corchorus olitorius samples, Similarly, As, Pb, Cr were not detected in the Celosia argentea and its soup. The Ni and Zn in the Corchorus olitorius samples ranged from 0.03mg - 0.6mg/100g and 0.22mg - 0.44mg/100g, respectively. There was not significantly (P > 0.05) different between the organic and inorganic and between the raw and cooked samples. The Ni in Telfairia occidental, ranged from 0.04mg - 0.06mg/100g, zinc from 0.34mg - 0.47mg/100g in both raw and soup samples. In Celosia argentea, Cd ranged from 0.09mg - 0.65mg/100g and was not significantly (P > 0.05) different between the organic and inorganic and between the raw and the cooked samples. Heavy metal in the samples did not exceed FAO/WHO limit for vegetables.Conclusion: The heavy metal content of the organically grown vegetables was not significantly different from the inorganically grown.Keywords: heavy metals; vegetables; organic, inorganic and fertilizer

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P < 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4\u20137) and 7 (6\u20138) days respectively (P < 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients