Severity of oEsophageal Anastomotic Leak in patients after oesophagectomy: the SEAL score

Background

Anastomotic leak (AL) is a common but severe complication after oesophagectomy. It is unknown how to determine the severity of AL objectively at diagnosis. Determining leak severity may guide treatment decisions and improve future research. This study aimed to identify leak-related prognostic factors for mortality, and to develop a Severity of oEsophageal Anastomotic Leak (SEAL) score.

Methods

This international, retrospective cohort study in 71 centres worldwide included patients with AL after oesophagectomy between 2011 and 2019. The primary endpoint was 90-day mortality. Leak-related prognostic factors were identified after adjusting for confounders and were included in multivariable logistic regression to develop the SEAL score. Four classes of leak severity (mild, moderate, severe, and critical) were defined based on the risk of 90-day mortality, and the score was validated internally.

Results

Some 1509 patients with AL were included and the 90-day mortality rate was 11.7 per cent. Twelve leak-related prognostic factors were included in the SEAL score. The score showed good calibration and discrimination (c-index 0.77, 95 per cent c.i. 0.73 to 0.81). Higher classes of leak severity graded by the SEAL score were associated with a significant increase in duration of ICU stay, healing time, Comprehensive Complication Index score, and Esophagectomy Complications Consensus Group classification.

Conclusion

The SEAL score grades leak severity into four classes by combining 12 leak-related predictors and can be used to the assess severity of AL after oesophagectomy.

Elderberry extract inhibits tumour necrosis factor induced monocyte adhesion to endothelial cells via modulation of the NF-κB pathway

Funding Acknowledgements

Type of funding sources: Other. Main funding source(s): De Montfort PhD funded scholarship scheme

Introduction

During the early stages of atherosclerosis, monocytes attach to endothelial cells (EC) before differentiating into macrophages causing the accumulation of foam cells and plaque growth. NF-κB and vascular cell adhesion molecule 1 (VCAM-1) are some of the main mediators in EC that are involved in the monocyte adhesion process. Elderberry extract (EE) are rich in anthocyanins a subclass polyphenol with vascular-protective properties.

Purpose

The main of aim of this study is to examine if EE can prevent TNF-α induced inflammation and monocyte adherence to EC.

Methods

Primary Human Umbilical Vein Endothelial Cells (HUVEC) were pre-treated for 1-h and stimulated with or without TNF-α 10 ng/ml for western blot. Cell lysates from the treated cells were then subjected to Western blotting and probed for total and phospho-NF-κB. For monocyte adherence cells were pre-treated for 24-h, then stimulated with/or without TNF-α 10 ng/ml for 24-h. Fluorescently labelled THP-1 cells were then added to the HUVECs for an additional 30 minutes, and samples were measured in a fluorescence plate reader. Cells were put through flow cytometry for measuring reactive oxygen species (ROS) using DCFHFDA assay or VCAM-1 levels using Anti-CD106.

Results

An increase in ROS production and NF-κB phosphorylation was found after stimulation TNF-α 10 ng/ml (p = 0.01). However, cells pre-incubated with EE (50 μg/ml) for 1-hour before TNF-α stimulation caused a reduction in ROS as well as inhibition of NF-κB phosphorylation (p < 0.01). TNF-α 10 ng/ml increased the monocyte adherence to the HUVECs by a 2-fold although, EE prevented TNF-α monocyte adherence (mean value, 589.7 vs 408 p = 0.0033). This was associated with suppressed VCAM-1 expression found in the EE pre-treatment with TNF-α (p = 0.02).

Discussion

Our Preliminary data demonstrates that EE, can prevent monocytes binding onto EC potentially by inhibiting TNF-α induced NF-κB and VCAM-1 levels. Our findings postulate that NF-κB and VCAM-1 could be the direct link for targeting the prevention of monocyte adherence to EC, although this would need confirmation by blocking key cellular signalling pathways to confirm its role. This preliminary data suggests that EE and potentially other polyphenols could be a useful strategy for targeting the initial stages of atherosclerosis.

Recent advances and challenges in 2D/2D heterojunction photocatalysts for solar fuels applications

Although photocatalytic technology has emerged as an effective means of alleviating the projected future fuel crisis by converting sunlight directly into chemical energy, no visible-light-driven, low-cost, and highly stable photocatalyst has been developed to date. Due to considerably higher interfacial contact with numerous reactive sites, effective charge transmission and separation ability, and strong redox potentials, the focus has now shifted to 2D/2D heterojunction systems, which have exhibited effective photocatalytic performance. The fundamentals of 2D/2D photocatalysis for different applications and the classification of 2D/2D materials are first explained in this paper, followed by strategies to improve the photocatalytic performance of various 2D/2D heterojunction systems. Following that, current breakthroughs in 2D/2D metal-based and metal-free heterojunction photocatalysts, as well as their applications for H₂ evolution via water splitting, CO₂ reduction, and N₂ fixation, are discussed. Finally, a brief overview of current constraints and predicted results for 2D/2D heterojunction systems is also presented. This paper lays out a strategy for developing efficient 2D/2D heterojunction photocatalysts and sophisticated technology for solar fuel applications in order to address the energy issue.

POS1413 INTERSTITIAL LUNG DISEASE(ILD) PREVALENCE AND TRENDS IN SYSTEMIC LUPUS ERYTHEMATOSUS(SLE), RHEUMATOID ARTHRITIS(RA), SCLERODERMA(SCL), MYOSITIS AND MIXED CONNECTIVE TISSUE DISEASES(MCTD) ALONG WITH COMPARISON OF LENGTH OF HOSPITALIZATION STAY(LOS), COST AND RACIAL PREDISPOSITION AMONG THESE PATIENTS

Background

ILD includes a category of lung disorders seen in a variety of autoimmune conditions. Prevalence of ILD in autoimmune diseases is variable and poorly studied. ILD is more commonly seen in systemic sclerosis, with 90% of patients showing some interstitial changes on High resolution CT scan. ILD is less common in SLE compared to SCL, with ILD not only a complication but also a poor prognostic factor in these patients. Prior studies have shown increased prevalence of ILD in RA patients over the years. For myositis, ILD can develop during the course of disease or can precede the diagnosis in a small subset of patients.

Objectives

Our study aims to determine the prevalence of ILD in diseases like SLE, Scleroderma, RA, MCTD, and Myositis over the years as well as identify racial predisposition, LOS, Cost of hospitalization in these patients

Methods

We used the Nationwide Inpatient Sample database (years 2003-2018) and extracted patients with ILD using validated International Classification of Disease (ICD) codes. Data from 2015 was excluded from the study in light of the transition of the coding system from version 9 to 10. We identified cases having the diagnosis of SLE, RA, Scleroderma, MCTD or Myositis. Prevalence as well as demographics, cost of hospitalization, and length of stay (LOS) was analyzed and charted. Data was analyzed using statistical analysis system 9.4 software.

Results

We identified a total of 149,691 cases of ILD over 15 years. Patients with RA had the highest prevalence of ILD amongst the 5 studied autoimmune diseases. The prevalence rate of RA in ILD patients in 2003 was 3.3% which significantly reduced to 0.93% in 2018, with a peak of 6.42% seen in 2010 (p <0.0001). Prevalence rate of ILD with myositis decreased from 0.72% in 2003 to 0.46% in 2018 (p 0.0001). The prevalence rates of SLE, Scleroderma, and MCTD in cases with ILD significantly increased from 1.38% to 1.63%, 1.38% to 1.76%, and 0.14% to 0.54% from 2003 to 2018 respectively.

The average age of ILD cases with SLE was significantly younger compared to ILD without autoimmune disease (59.28 vs 72.32 years, p <0.0001), RA (69.72 vs 72.17 years, p <0.0001), Scleroderma (62.01 vs 72.28 years, p < 0.0001), Myositis (59.56 vs 72.19 years, p <0.0001) and MCTD (59.6 vs 72.18 years, p <0.0001). On examining the racial distribution, the African American population with ILD when compared to other races were more likely to have underlying SLE, MCTD, Myositis or Scleroderma. In ILD with RA, Native Americans were the most affected racial demographic followed by African Americans.

Average cost of hospitalization was higher in ILD with MCTD ($104,631 vs $71,264.6, p<0.0001), Myositis ($105,623 vs $71,232.9, p<0.0001) and Scleroderma ($88,736.2 vs $71,135.5, p<0.0001). Average LOS was significantly longer in RA (7.17 vs 6.66 days, p value 0.0006), MCTD (7.71 vs 6.67 days, p value 0.0008), Myositis (8.33 vs 6.66 days, p value <0.0001) and Scleroderma (7.07 vs 6.67 days, p value 0.0176). Though not significant, average LOS was longer in SLE (6.79 vs 6.67 days, p value 0.4999).

Conclusion

Our study shows that the prevalence of RA in ILD cases has significantly reduced through the years. This can be attributed to the better understanding of the disease and its risk factors as well as the availability and use of newer biologic agents to obtain better control. However, the prevalence of SLE, Scleroderma, and MCTD in ILD cases has increased over the years. This points to the need for better therapies as well as highlights the fact that the overall recognition and diagnosis of these diseases have increased over the years. Racial predilection also comes to light, suggesting the need for special attention to certain races to diagnose the autoimmune disease earlier. Average LOS and cost of hospitalization were also higher in ILD cases with autoimmune disease, reflecting the higher socioeconomic burden.

Disclosure of Interests

None declared

Fungal conversion of chicken-feather waste into biofortified compost

Poultry industry is amongst highly developed industries of Pakistan, fulfilling the protein demand of rapidly increasing population. On the other hand, the untreated poultry waste is causing several health and environmental problems. The current study was designed to check the potential of keratinolytic fungal species for the conversion of chicken-feather waste into biofortified compost. For the purpose, three fungal species were isolated from soil samples. These strains were pure cultured and then characterized phenotypically and genotypically. BLAST searches of 18S rDNA nucleotide sequence of the fungal isolates revealed that the two fungal isolates belonged to genus Aspergillus and one belonged to genus Chrysosporium. Optimum temperature for Aspergillus flavus, Aspergillus niger and Chrysosporium queenslandicum was 29, 26 and 25 oC, respectively. A. flavus showed maximum (53%) feather degradation, A. niger degraded feather waste up to 37%, while C. queenslandicum showed 21% keratinolytic activity on chicken feathers at their respective temperature optima. The degradation potential of these fungal species showed their ability to form compost that has agro-industrial importance.

Generation of Gut Motor Patterns Through Interactions Between Interstitial Cells of Cajal and the Intrinsic and Extrinsic Autonomic Nervous Systems

The musculature of the gastrointestinal tract is a vast network of collaborating excitable cell types. Embedded throughout are the interstitial cells of Cajal (ICC) intertwined with enteric nerves. ICC sense external stimuli such as distention, mediate nerve impulses to smooth muscle cells, and provide rhythmic excitation of the musculature. Neural circuitry involving both the intrinsic and extrinsic autonomic nervous systems, in collaboration with the ICC, orchestrate an array of motor patterns that serve to provide mixing of content to optimize digestion and absorption, microbiome homeostasis, storage, transit, and expulsion. ICC are specialized smooth muscle cells that generate rhythmic depolarization to the musculature and so provide the means for peristaltic and segmenting contractions. Some motor patterns are purely myogenic, but a neural stimulus initiates most, further depolarizing the primary pacemaker cells and the musculature and/or initiating transient pacemaker activity in stimulus-dependent secondary ICC pacemaker cells. From stomach to rectum, ICC networks rhythmically provide tracks along which contractions advance.

Evaluation of indigenous plants' extracts for mosquitocidal activity against different stages of Culex quinquefasciatus say (Diptera: Culicidae)

Being vector of West Nile Virus and falariasis the control of Culex quinquefasciatus is likely to be essential. Synthetic insecticide treatment is looking most effective for vectors mosquito control. However, these products are toxic to the environment and non-target organisms. Consequently, ecofriendly control of vectors mosquito is needed. In this regard botanical insecticide is looking more fruitful. Therefore, the present research aimed to investigate the effectiveness of methanolic extract and various fractions, including, n-hexane, ethyl-acetate, chloroform, and aqueous fraction, obtained from methanolic extract of Ailanthus altissima, Artemisia scoparia, and Justicia adhatoda using separating funnel against larval, pupal, and adult stages of Culex quinquefasciatus. The larvae and pupae of Culex quinquefasciatus were exposed to various concentrations (31.25-1000 ppm) of methanolic extract and its fractions for 24 hours of exposure period. For knock-down bioassay (filter paper impregnation bioassay) different concentration of the methanolic extract and its various fractions (i.e. 0.0625, 0.125, 0.25, 0.5 and 1mg/mL) were applied for 1 hour exposure period. The results were statistically analysed using standard deviation, probit analysis, and linear regression. The R2 values of larvae, pupae, and adult range from 0.4 to 0.99. The values of LC50 (concentration causing 50% mortality) for late 3rd instar larvae after 24 hours exposure period range from 93-1856.7 ppm, while LC90 values range from 424 -7635.5ppm. The values of LC50for pupae range form 1326.7-6818.4ppm and and values of LC90 range from 3667.3-17427.9ppm, respectively. The KDT50 range from 0.30 to 2.8% and KDT90 values range from1.2 to 110.8%, respectively. In conclusion, Justicia adhatoda may be effective for controlling populations of vector mosquito.

Photosynthetic acclamatory response of Panicum antidotale Retz. populations to root zone desiccation stress

Growth of plants is severely reduced due to water stress by affecting photosynthesis including photosystem II (PSII) activity and electron transport. This study emphasised on comparative and priority targeted changes in PSII activity due to progressive drought in seven populations of Panicum antidotale (P. antidotale) collected from Cholistan Desert and non-Cholistan regions. Tillers of equal growth of seven populations of P. antidotale grown in plastic pots filled with soil were subjected progressive drought by withholding water irrigation for three weeks. Progressive drought reduced the soil moisture content, leaf relative water content, photosynthetic pigments and fresh and dry biomass of shoots in all seven populations. Populations from Dingarh Fort, Dingarh Grassland and Haiderwali had higher growth than those of other populations. Cholistani populations especially in Dingarh Grassland and Haiderwali had greater ability of osmotic adjustment as reflected by osmotic potential and greater accumulation of total soluble proteins. Maximum H2O2 under water stress was observed in populations from Muzaffargarh and Khanewal but these were intermediate in MDA content. Under water stress, populations from Muzaffargarh and Dingarh Fort had greater K+ accumulation in their leaves. During progressive drought, non-Cholistani populations showed complete leaf rolling after 23 days of drought, and these populations could not withstand with more water stress condition while Cholistani populations tolerated more water stress condition for 31 days. Moreover, progressive drought caused PSII damages after 19 days and it became severe after 23 days in non-Cholistani populations of P. antidotale than in Cholistani populations.

Prevalence of parasites in selected captive bird species

Blood and fecal samples of chukar partridge (Alectoris chukar), albino pheasant (Phasianus colchicus), silver pheasant (Lophura nycthemera), rose-ringed parakeet (Psittacula krameri) and turkeys (Meleagris gallopavo) were analyzed to check parasitic prevalence. To record parasites these five avian species were placed kept in separate cages at Avian Conservation and Research Center, Department of Wildlife an Ecology, University of Veterinary and Animal Sciences, Lahore, Pakistan. 100 fecal and 100 blood samples for each bird species were inspected to analyze internal parasites. During present study, 17 species of endoparasites 14 from fecal samples and three from blood were examined. Two species of ectoparasites i.e. mite Dermanyssus gallinae 42% and fowl ticks Args persicus 41%were studied. Blood parasites included Plasmodium juxtanucleare 50%, Leucoctoyzoon simond having parasitic prevalence 40%, and Aegyptinella pullorum having parasitic prevalence of 40%. Parasitic species recorded from fecal samples included 6 species of nematodes viz. Allodpa suctoria 2%. Syngamus trachea with parasitic prevalence of 60%, Capillaria annulata 37.5%, Ascardia galli 24%, Capillaria anatis 40% and Heterakis gallinarum 28.3%. Similarly, two species of trematodes viz. Prosthogonimus ovatus having parasitic prevalence of 50% and Prosthogonimus macrorchis 21% were also documented from fecal avian samples . Single cestode species Raillietina echinobothrida having parasitic prevalence of 72% and 3 protozoan species i.e. Eimeria maxima having parasitic prevalence of 21%, Giardia lamblia 41% and Histomonas meleagridis 18% were documented during corpological analysis. In our recommendation, proper sanitation, medication and vaccination of bird's enclousres are suggested to avoid parasites.

Genetic variations and phylogenetic relationship of genus Uromastyx from Punjab Pakistan

During the present study, specimens were collected from selected sites of Cholistan desert and Kalabagh Game Reserve, Punjab province, Pakistan. Each captured specimen was tagged with voucher number and morphometric measurements were taken. The average snout to vent length was 172.559±1.40 mm and average weight was 92.1±1.30 g. The DNA of Uromastyx hardwickii was amplified and sequenced using 16S rRNA primer set. The obtained DNA sequence has shown reliable and clear species identification. After trimming ambiguous bases, the obtained 16S rRNA fragment was 520 bp while 16S rRNA fragments aligned with closely matched sequence from NCBI comprised of 510 bp. Closely matched sequences of genus Uromastyx were retrieved from NCBI in blast searches. Neighbour-joining tree of genus Uromastyx was constructed based on p-distance using MEGA X. The mean intraspecific variation was 0.095±0.01 while intraspecific variation was ranging from 0-1%. Similarly, interspecific variation of Uromastyx hardwikii with Saara asmussi, Uromastyx alfredschmidti, Uromastyx geyri, Uromastyx thomasi, Uromastyx alfredschmidti was 0-12%, 0-19%, 0-19%, 0-20%, 12-19% respectively. The newly produced DNA was submitted to NCBI and accession number was obtained (MW052563.1). Results of current study provided information about the molecular and morphological identification of Genus Uromastyx. In our recommendation, comprehensive molecular based identification of Pakistan's reptiles is required to report any new or subspecies from country.

Development of chitosan based microencapsulated spray dried powder of tuna fish oil: oil load impact and oxidative stability

The impact of fish oil concentration on the oxidative stability of microcapsules through the spray drying process using chitosan and maltodextrin as wall material was studied. Emulsions were prepared with different Tuna fish oil (TFO) content (TFO-10%, TFO20%, TF030% TF0-40%) while wall material concentration was kept constant. Microencapsulated powder resulting from emulsion prepared with high fish oil load have high moisture content, wettability, total oil and low encapsulation efficiency, hygroscopicity and bulk tapped density. Oxidative stability was evaluated periodically by placing microcapsules at room temperature. Microcapsules prepared with TFO-10% presented high oxidative stability in terms of peroxide value (2.94±0.04) and anisidine value (1.54±0.02) after 30 days of storage. It was concluded that optimal amounts of fish oil for microencapsulation are 10% and 20% using chitosan and maltodextrin that extended its shelf life during study period.

Interstitial cells of Cajal and human colon motility in health and disease

Our understanding of human colonic motility, and autonomic reflexes that generate motor patterns, has increased markedly through high-resolution manometry. Details of the motor patterns are emerging related to frequency and propagation characteristics that allow linkage to interstitial cells of Cajal (ICC) networks. In studies on colonic motor dysfunction requiring surgery, ICC are almost always abnormal or significantly reduced. However, there are still gaps in our knowledge about the role of ICC in the control of colonic motility and there is little understanding of a mechanistic link between ICC abnormalities and colonic motor dysfunction. This review will outline the various ICC networks in the human colon and their proven and likely associations with the enteric and extrinsic autonomic nervous systems. Based on our extensive knowledge of the role of ICC in the control of gastrointestinal motility of animal models and the human stomach and small intestine, we propose how ICC networks are underlying the motor patterns of the human colon. The role of ICC will be reviewed in the autonomic neural reflexes that evoke essential motor patterns for transit and defecation. Mechanisms underlying ICC injury, maintenance, and repair will be discussed. Hypotheses are formulated as to how ICC dysfunction can lead to motor abnormalities in slow transit constipation, chronic idiopathic pseudo-obstruction, Hirschsprung's disease, fecal incontinence, diverticular disease, and inflammatory conditions. Recent studies on ICC repair after injury hold promise for future therapies.

Qureshi A, H. Shirazi J. Synthesis, characterization, anti-microbial and cytotoxic applications of zinc(II) complexes

ABSTRACT. In the present research, three zinc(II) complexes were synthesized using 3-(3-fluorophenyl)-2-methylacrylic acid (HL), 1,10-phenanthroline and 2,2'-pyridine as ligands. The composition, structural confirmation, coordination way of ligand and assignment of geometry to the complexes were made by different analytical tools like elemental analysis, FTIR and 1H-NMR. The ligand 3-(3-fluorophenyl)-2-methylacrylate appeared to coordinate the metal (Zn) atom via COO- moiety in all of the complexes (1-3) while 1,10-phenanthroline and 2,2'-pyridine co-ordinated to Zn(II) atom through N-donor sites in complexes 2 and 3, respectively. The complex 1 showed four while 2 and 3 showed six co-ordinated geometry. The synthesized complexes were evaluated for antimicrobial and cytotoxic activities. The obtained results showed that complexes are active against microbial agents and exhibited significant cytotoxicity.                     KEY WORDS: Co-coordination, Geometry, Zinc(II) complexes, Biological activity   Bull. Chem. Soc. Ethiop. 2021, 35(2), 287-299. DOI: https://dx.doi.org/10.4314/bcse.v35i2.6

The inhibitory effect of Cannabis Sativa L. and Morus nigra L. against lipid peroxidation in goat liver and brain homogenates

The present study was aimed to evaluate the antioxidant potential and inhibitory effect ofCannabis sativa and Morus nigra against lipid peroxidation in goat brain and liver homogenates. The formation of free radicals, highly reactive oxygen species (ROS) and reactive nitrogen species (RNS) is a normal metabolic process for cellular signaling and countering the antigens. However, they may cause serious damage if they produced at amplified tolls. In addition, metabolic disorders also serve as sources of these reactive species. Although the issue can be addressed through supplements and other phytochemicals. In this study, two plant species were evaluated for their biological potential by employing a spectrum of antioxidant assays. The antioxidant activity was performed by lipid peroxidation assay. The water extract prepared from leaves of Cannabis sativa and Morus nigra showed significant (P<0.05) inhibition as compared to control i.e., 522.6±0.06 and 659.97±0.03 µg/mL against iron-induced lipid peroxidation in goat brain homogenate while the inhibitions were 273.54±0.04 and 309.18±0.05 µg/mL against nitroprusside induced lipid peroxidation of the brain. The iron and nitroprusside induced lipid peroxidation was also significantly inhibited by leaf extracts of Cannabis sativa and Morus nigra in liver homogenates such as 230.63±0.52 and 326.91±0.01 µg/mL (iron-induced) while 300.47±0.07 and 300.47±0.07 µg/mL (nitroprusside induced), respectively. The extracts of Cannabis sativa extract showed promising activity (96.04±0.060%) against DPPH radicals while Morus nigra showed a moderate activity (34.11±0.120%). The results suggest that different accessions ofCannabis sativa and Morus nigra are a potential source of antioxidants and have a therapeutic effect against disease induced by oxidative stress and hence can be used for novel drug discovery and development.

1085 Equestrian Related Pelvic and Acetabular Fractures – Experience from a Major Trauma Centre in England

Introduction

Equestrianism is enjoyed by three million people in the UK; however, there is a lack of literature on pelvic and acetabular (P&A) injuries incurred through the sport. We aim to describe P&A injuries sustained in equestrian accidents, discuss management, and establish their outcomes.

Method

Data was extracted from a prospectively collected database of referrals to the P&A Service of a Major Trauma Centre (MTC) from 01/01/2016 to 31/12/2020 and cross-referenced with medical records.

Results

60 of the 1,218 P&A referrals were secondary to horse-riding accidents. Mean age 45 (SD 16.59); 46 female; 33 managed non-operatively and 27 managed operatively at the MTC. There was sufficient information for 59 cases to be classified; 46 of the injuries were pelvic fractures (10 anterior-posterior compression; 29 lateral compression; 4 sacral and 3 pubic rami fractures) and 13 were acetabular (2 anterior column; 1 anterior wall; 2 associated both columns; 1 posterior column and posterior wall; 1 posterior wall; 2 T-shaped and 4 transverse fractures). The operative group were managed by examination under anaesthesia (n = 3), open reduction internal fixation (n = 22) or percutaneous fixation (n = 2). Mean hospitalisation was 9.2 days (SD 5.44). 81% were non-weight-bearing post-operatively and mean time to independent mobilisation was 12.6 weeks (SD 7.09). Return-to-riding information was available for 8 patients with a mean of 29.5 weeks (SD 11.55).

Conclusions

Equestrianism can result in significant P&A injuries. Patients should be counselled that they may have a long recovery, a protracted return-to-riding time and some may never return to the sport.

579 Emergency Surgical Admissions During The COVID-19 Pandemic; Comparative Study of Emergency Surgery Outcome Before and During The COVID-19

Introduction

There are relatively few studies on emergency surgical practice in the COVID-19 pandemic. Our aim is to analyse the outcomes of emergency surgery before against those during COVID-19.

Method

Retrospectively we collected the emergency admissions to the general surgery department at a district general hospital during November 2019, which is a representative of our regular activity, and April 2020, the height of the COVID-19. The primary endpoint was the number and nature of surgical admissions and procedures. The secondary endpoints were morbidities and mortalities, laparoscopic and procedure approach (laparoscopic vs open), inflammatory markers (white cell count and C-reactive protein), hospital stay, gender and age.

Results

During the two months a total of 332 patients were admitted; 177 during November 2019 and 146 patients during April 2020. The mean age was 51 years in the November group and 49 years in the April group. 146 operations were conducted in November, while 117 procedures were performed in April. Hospital stay average was 5.87 days and 5.43 days for November and April groups, respectively. In the April group, seven patients tested positive for COVID-19. Mortality was slightly higher during April (2.05%) than November (1.6%). Postoperative complications, C-reactive protein level and prevalence of acute cholecystitis were much higher during April, while abscess and diverticulitis prevalence were significantly lower.

Conclusions

Morbidity, mortality and acute cholecystitis were significantly higher during the COVID-19 pandemic, while abscess and diverticulitis were significantly less prevalent likely due to and tendency by patients to avoid hospitals and hence late clinical presentation.

Isolation and characterization of bacteria residing in the oral, gut, and fecal samples of different pheasant species

There is a paucity of research conducted on microbial prevalence in pheasants. The microbiota of captive birds has zoonotic significance and must be characterize. Present study is therefore planned to assess the microbiota from oral, fecal and gut content of captive avian species. It will be helpful in characterization of harmful microbes. Different samples taken from oral, gut and feces of ring-necked pheasants (Phasianus colchicus), green pheasants (Phasianus versicolor), golden pheasant (Chrysolophus pictus) and silver pheasant (Lophura nycthemera). Samples were collected, diluted, and inoculated onto different agar plates (MacConkey, SS agar, MSA and nutrient agar) for cultivation of bacterial species. Colonies of E.coli, Staphylococcus spp. Brachyspira spp. and Campylobacter spp were observed based on colony morphology. Colony forming unit showed E. coli as frequently found bacteria in fecal, oral and gut contents of all the above pheasants. The overall significance difference was found among bacterial species of golden pheasants, green pheasant, ring-necked pheasant, and silver pheasants. It was concluded that E.coli is predominant isolated from heathy pheasants followed by Campylobacter, Staphylococcus and Brachyspira.

Wild birds trade in Dera Ismael Khan and Bannu divisions of Khyber PakhtunKhwa (KPK) Province, Pakistan

Wildlife trade is a profitable economic activity. Birds are among the most heavily traded animals worldwide, with numerous species threatened by pet trade. The present case study was stretched for period of one year to find out the status of wild birds' trade in Bannu and Dera Ismael Khan Divisions. The study was aimed to find out the types of species, commercial prices of bird, trade routes, overall income generated from birds' trade and the status of dealers whether licensed or not. Bimonthly visits were conducted to interview 52 bird dealers/pet shops owners/venders (23 in Dera Ismael Khan and 29 in Bannu). A sum of 16 conceivable sites were visited during the study period. Out of these, 8 sites were located in Dera Ismael Khan and 8 sites in Bannu Division. The highest priced species was Demoiselle crane (Grus virgo) and the lowest priced species was house sparrow (Passer domesticus). Total number of species traded in both regions were 8 and 14 while the income generated by bird trade was amounting to PkR 1,322,200 and 7,128,950 in Dera Ismael Khan and Bannu respectively. Majority of the birds were trapped locally with the exception of few from adjacent areas. Commercial activity led by illegal bird traders was found 75% and 100% species in Dera Ismael Khan and Bannu respectively. There was no significant difference between prices of birds, number of species sold and income generated by bird trade in two divisions.