20 research outputs found

    Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

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    Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

    Liver assessment post laparoscopic mini gastric bypass versus sleeve gastrectomy operation in obese and morbidly obese patients

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    Background: Morbid obesity is a severe disorder associated with major co‐morbidities reduced quality of life (QoL) and reduced life expectancy. Aim and objectives: The purpose of the study was to compare the effect of laparoscopic mini gastric bypass versus sleeve operation on liver function in a prospective randomized study. Subjects and methods: This study was a prospective study conducted on 80 patients who visit the general surgery clinic at Damietta university hospital (Al Azhar University) and National hepatology and tropical medicine research institute (NHTMRI); patients were being divided into 2 groups: Group A (40 patients): Undergoing laparoscopic sleeve gastrectomy surgery. Group B (40 patients):  undergoing laparoscopic mini gastric bypass surgery. Results: There a gradual significant decrease from preoperative to 12 months postoperative regarding ALT and AST in Group A, while there a gradual significant decrease from preoperative to 12 months postoperative regarding AST in Group B, Conclusion: This study demonstrated a low prevalence of abnormal LFT in our morbidly obese patients who underwent bariatric surgery. This may serve as an indirect indication of a lower prevalence of significant liver damage in these subjects

    Application of ZnO-nanoparticles to manage Rhizopus soft rot of sweet potato and prolong shelf-life

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    A reduction in crop spoilage and an increase in shelf-life is the goal of effective disease control methods. This study aimed to assess ZnO-nanoparticles (ZnO-NPs) as a safe, new protectant against Rhizopus soft rot of sweet potato. ZnO-NPs had a fungicidal effect against Rhizopus stolonifer when used at concentrations above 50 ppm. The results showed that tubers treated with ZnO-NPs exhibited fewer fungal populations (1.2 CFU per segment) than those that did not receive the treatment. Tubers infected with Rhizopus stolonifer and treated with ZnO-NPs showed no visible decay for up to 15 days, indicating that ZnO-NPs act as a coating layer on tuber surface. The greatest weight loss after 15 days of storage was reported in infected tubers (8.98%), followed by infected tubers treated with ZnO (6.54%) and infected tubers treated with ZnO-NPs (3.79%). The activity of cell-wall degrading enzymes, α-amylase and cellulase, were significantly increased in both infected tubers and those treated with ZnO, compared to the tubers treated with ZnO-NPs. These results confirm that coating with ZnO-NPs is an effective method of protecting sweet potato tubers from infection, maintaining their quality and increasing their shelf-life for up to 2 months in storage

    Induction of defense mechanisms involved in disease resistance of onion blight disease caused by Botrytis allii

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    Abstract Botrytis umbel blight caused by Botrytis allii is a major disease that attacks onion crop. In vitro, Trichoderma viride, Penicillium chrysogenum, and Saccharomyces cerevisiae and extract of bitter apple fruits (Citrullus colocynthis) showed antagonistic effect and inhibited the mycelial growth of B. allii. Gas chromatography–mass spectrometry (GC-MS) analysis of bitter apple fruits showed the existence of 37 compounds and their derivatives. Among them, 10 compounds constituted 58.66% of the total analyses. Greenhouse experiment approved that the extract of bitter apple fruits was the most effective in reducing disease incidence and severity, followed by P. chrysogenum, when they were applied 2 days pre-inoculation with the pathogen. All treatments significantly increased the total phenolic contents than the untreated control, but the highest increase was obtained when S. cerevisiae and P. chrysogenum were applied. A positive correlation was found between the activity of bioagents and improvement of peroxidase and phenylalanine ammonia-lyase enzymes in onion plants to resist infection with the pathogen. P. chrysogenum caused the highest increase in polyphenoloxidase activity in infected onion plants, while S. cerevisiae showed the lowest level of this enzyme. The study approved that application of the bioagents not only protected the onions against Botrytis disease but also enhanced the content of antioxidant compounds in onions. This encourages the application of such preparations to manage the production of onion crop, especially in the organic farming that bans the application of any chemicals

    Molecular Typing of Virulence and Antimicrobial Resistance Genes with Mutation Tracking of gyrA Gene of Fluoroquinolone-Resistant Strains of Campylobacter Isolated from Broiler Chickens

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     Campylobacter is the most common bacterial cause of gastroenteritis globally. A total of 182 fully identified strains of Campylobacter species (42 C. coli and 140 C. jejuni) collected from 6 broiler farms were subjected to studying the antimicrobial resistance pattern and molecular typing of virulence (cadF, ctdA, dnaJ waaC,iam, and fla) and antimicrobial resistance genes (blaOXA-61, gyrA, tetA, tetO, and IR) with sequencing of gyrA region of one strain of fluroquinolones resistant C. coli and C. jejuni. The identified isolates were highly resistant to erythromycin and sulfamethoxazole-trimethoprim. Furthermore, both meropenem and imipenem were effective against the recovered isolates. The tested C. jejuni and C. coli strains had 100%, 83.3%, and 83.3% prevalence of cadF, ctdA, and dnaJ virulence genes, respectively, while waaC, iam, and fla genes couldn’t be detected. The blaOXA-61 resistance gene was found in all of the Campylobacter spp. examined. Furthermore, gyrA, tetA, tetO, and IR resistance genes were found in 100%, 83.3%, 83.3%, and 66.7% of the retrieved C. jejuni strains, respectively.  Likewise, resistance genes were found in 83.3%, 83.3%, 83.3%, and 66.7% of the retrieved C. coli strains, respectively. Approximately 58% (7/12) of the Campylobacter spp. recovered were MDR. Furthermore, 50% (3/6) of the C. jejuni strains recovered were MDR, while 66.7% (4/6) of the C. coli isolates recovered were MDR with MARI(0.22-0.55). For detection of mutations of the gyrA gene, the sequence data of two isolates (C. jejuni and C.coli) were analyzed against the reference sequence on the gene bank where the C. jejuni strain had six mutations, while the C. coli strain had twenty-three. The current findings suggest that MDR Campylobacter strains in poultry may be able to transmit highly virulent Campylobacter as a foodborne pathogen

    Molecular Typing of Virulence and Antimicrobial Resistance Genes with Mutation Tracking of gyrA Gene of Fluoroquinolone-Resistant Strains of Campylobacter Isolated from Broiler Chickens

    No full text
     Campylobacter is the most common bacterial cause of gastroenteritis globally. A total of 182 fully identified strains of Campylobacter species (42 C. coli and 140 C. jejuni) collected from 6 broiler farms were subjected to studying the antimicrobial resistance pattern and molecular typing of virulence (cadF, ctdA, dnaJ waaC,iam, and fla) and antimicrobial resistance genes (blaOXA-61, gyrA, tetA, tetO, and IR) with sequencing of gyrA region of one strain of fluroquinolones resistant C. coli and C. jejuni. The identified isolates were highly resistant to erythromycin and sulfamethoxazole-trimethoprim. Furthermore, both meropenem and imipenem were effective against the recovered isolates. The tested C. jejuni and C. coli strains had 100%, 83.3%, and 83.3% prevalence of cadF, ctdA, and dnaJ virulence genes, respectively, while waaC, iam, and fla genes couldn’t be detected. The blaOXA-61 resistance gene was found in all of the Campylobacter spp. examined. Furthermore, gyrA, tetA, tetO, and IR resistance genes were found in 100%, 83.3%, 83.3%, and 66.7% of the retrieved C. jejuni strains, respectively.  Likewise, resistance genes were found in 83.3%, 83.3%, 83.3%, and 66.7% of the retrieved C. coli strains, respectively. Approximately 58% (7/12) of the Campylobacter spp. recovered were MDR. Furthermore, 50% (3/6) of the C. jejuni strains recovered were MDR, while 66.7% (4/6) of the C. coli isolates recovered were MDR with MARI(0.22-0.55). For detection of mutations of the gyrA gene, the sequence data of two isolates (C. jejuni and C.coli) were analyzed against the reference sequence on the gene bank where the C. jejuni strain had six mutations, while the C. coli strain had twenty-three. The current findings suggest that MDR Campylobacter strains in poultry may be able to transmit highly virulent Campylobacter as a foodborne pathogen

    In Vitro Micropropagation of Endangered <i>Achillea fragrantissima</i> Forssk. Combined with Enhancement of Its Antihyperglycemic Activity

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    Achillea fragrantissima Forssk. (Family: Asteraceae) has been used as a natural remedy in the Arabian region for its antihyperglycemic activity. As a result of the intensive demand for this plant in folk medicinal uses, its scarcity has become problematic. This study has explored methods that produce an efficient in vitro culture protocol for the conservation of this plant as well as the enhancement of its hypoglycemic activity. A. fragrantissima cultures on Murashige and Skoog (MS) medium supplemented with 3.6 ”M/L of 6-benzyl aminopurine (BAP) for a two month period resulted in maximum in vitro shoot proliferation (12.33 shoots/explant) while MS medium supplemented with 2.4 ”M/L 1-naphthalene acetic acid (NAA) provided maximum in vitro adventitious root formation (2.46 roots/shoot tip explant). Callus induction was favored by leaf explants cultured on MS medium and supplemented with 3 ”M/L BAP and 3 ”M/L IAA media in dark conditions. Further in vivo study of some selected feedings determined that the best hypoglycemic activity was obtained in either indole-3-butyric acid (IBA)-fed plants (24%) or NAA-fed plants (22%). Both treatments enhanced insulin-like activity in STZ-treated diabetic Sprague-Dawley rats when compared with the wild plant (10%). Moreover, the IBA-fed plants showed significant antioxidant activity while the NAA-fed plants inhibited salivary alpha amylase. The framework of this study provides in vitro culture methods that can sustain the cultivation of this over-exploited A. fragrantissima plant as well as increase its antioxidant and insulin-like activities

    Data on photo-nanofiller models for self-cleaning foul release coating of ship hulls

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    The data presented in this article are related to the research article entitled “Smart photo-induced silicone/TiO2 nanocomposites with dominant [110] exposed surfaces for self-cleaning foul-release coatings of ship hulls” (Selimet al., 2016) [1]. This article reports on successfully designing and controlling TiO2 spherical single crystal photo-nanofillers and indicating evidence of fouling resistance after stimulation through UV radiation exposure. These data also reveal that the influence of well-dispersed spherical TiO2 nanoparticles (NPs) into the polymer matrix surface features on the prepared fouling release (FR) coating. Single crystal TiO2 nanospheres have played a large role in the scenario of photocatalysis due to its cost effectiveness, inert nature and photo stability. The model output and the surface and mechanical behavior data of the fabricated UV-irradiated silicone-based FR nanocoatings are made publicly available through analyzing nanocomposite topology, superhydrophilicity and self-cleaning efficiency in order to enable critical analysis of the tailored model. It also investigates the photo-bactericidal effect confirmed through biofilm coverage data disability. The modeled nanocomposites were subjected to comparable studies with other published models so as to understand how different UV-irradiated nano-scale parameters propagate and affect bulk film response. Keywords: Nanofillers, Fouling release, Self-cleaning, Photo-bactericida

    In Vitro Micropropagation of Endangered Achillea fragrantissima Forssk. Combined with Enhancement of Its Antihyperglycemic Activity

    No full text
    Achillea fragrantissima Forssk. (Family: Asteraceae) has been used as a natural remedy in the Arabian region for its antihyperglycemic activity. As a result of the intensive demand for this plant in folk medicinal uses, its scarcity has become problematic. This study has explored methods that produce an efficient in vitro culture protocol for the conservation of this plant as well as the enhancement of its hypoglycemic activity. A. fragrantissima cultures on Murashige and Skoog (MS) medium supplemented with 3.6 &micro;M/L of 6-benzyl aminopurine (BAP) for a two month period resulted in maximum in vitro shoot proliferation (12.33 shoots/explant) while MS medium supplemented with 2.4 &micro;M/L 1-naphthalene acetic acid (NAA) provided maximum in vitro adventitious root formation (2.46 roots/shoot tip explant). Callus induction was favored by leaf explants cultured on MS medium and supplemented with 3 &micro;M/L BAP and 3 &micro;M/L IAA media in dark conditions. Further in vivo study of some selected feedings determined that the best hypoglycemic activity was obtained in either indole-3-butyric acid (IBA)-fed plants (24%) or NAA-fed plants (22%). Both treatments enhanced insulin-like activity in STZ-treated diabetic Sprague-Dawley rats when compared with the wild plant (10%). Moreover, the IBA-fed plants showed significant antioxidant activity while the NAA-fed plants inhibited salivary alpha amylase. The framework of this study provides in vitro culture methods that can sustain the cultivation of this over-exploited A. fragrantissima plant as well as increase its antioxidant and insulin-like activities
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