Perpendicularly magnetized Co/Pd-based magneto-resistive heterostructures on flexible substrates

Flexible magneto-resistive heterostructures have received a great deal of attention over the past few years as they allow for new product paradigms that are not possible with conventional rigid substrates. While the progress and development of systems with longitudinal magnetic anisotropy on non-planar substrates has been remarkable, flexible magneto-resistive heterostructures with perpendicular magnetic anisotropy (PMA) have never been studied despite the possibility to obtain additional functionality and improved performance. To fill this gap, flexible PMA Co/Pd-based giant magneto-resistive (GMR) spin-valve stacks were prepared by using an innovative transfer-and-bonding strategy exploiting the low adhesion of a gold underlayer to SiO _x /Si(100) substrates. The approach allows overcoming the limits of the direct deposition on commonly used polymer substrates, whose high surface roughness and low melting temperature could hinder the growth of complex heterostructures with perpendicular magnetic anisotropy. The obtained PMA flexible spin-valves show a sizeable GMR ratio (∼1.5%), which is not affected by the transfer process, and a high robustness against bending as indicated by the slight change of the magneto-resistive properties upon bending, thus allowing for their integration on curved surfaces and the development of a novel class of advanced devices based on flexible magneto-resistive structures with perpendicular magnetic anisotropy. Besides endowing the family of flexible electronics with PMA magneto-resistive heterostructures, the exploitation of the results might apply to high temperature growth processes and to the fabrication of other functional and flexible multilayer materials engineered at the nanoscale.

QT interval in patients receiving HCQ in SARS-CoV-2- A study on risk factors and correlation of baseline QTc with delta QTc in Pakistani population

Funding Acknowledgements

Type of funding sources: None.

Introduction

Hydroxychloroquine(HCQ) use alone or in combination with Azithromycin (AZM) in SARS-CoV-2 infection is associated with QTc prolongation and risk of arrhythmias.

Objectives

To determine changes in QTc interval and factors predictive of extreme QTc prolongation in patients receiving HCQ alone or in azithromycin combination in Pakistani patients.

Methodology

Retrospective review of records of hospitalized patients with SARS-Cov2 RT-PCR positive result who received HCQ or HCQ/Azithromycin in combination from March-May 2020. Baseline ECGs as well as post drug use ECGs data was recorded. Tisdale score was calculated for predicting risk of QTc prolongation,QTc interval was calculated using Bazett formula. Data entry and analysis was done in SPSS version 23. 

Results

A total of 134 patients were included in the study.  82.1%(110) were males and 17.9%(24) were females, mean age was 54.9 ± 13.7 years. 61.2% (82) had severe disease and 38.8 %(52) had non-severe disease. 14.2%(19) had history of cardiac disease, 35.8%(48) had hypertension and 35.1%(47) had diabetes mellitus. 70.1% (94) patients had received HCQ, AZM, or HCQ/AZM in combination. 40(29.9%) patients had not received any drug. Median baseline QTc among controls and non-control group was 383.5 (IQR 342.25-413.75)msec  and 379(IQR 358-402)msec respectively. HCQ alone was administered to 26.9%(36) and HCQ/AZM to 33.6%(45) patients. 55.6% (45/81) developed QTc prolongation(QTc> 480 msec) or delta QTc increase > 60 msec. 6.2%(5/81) had absolute QTc > 500 msec post-drug administration. 55.6%(25/45) and  30.6%(11/36) (p-value 0.024) developed QTc prolongation in combination and HCQ alone groups respectively. Delta QTc increased to >60msec in 42.0% (34/81); 53.3%(24/45) in  combination group and in 27.8%(10/36) of those receiving HCQ alone( p-value 0.021). Median delta change was 63( IQR 25-81) and 48.5(IQR 26.25-66.75) msec; Median Day 2 QTc  was 413.5 msec (IQR 377.5-436) and 413 msec (IQR361-447); and median maximum QTc was 447(IQR391-471) and 429.8(IQR401.5-45.75) msec in those receiving HCQ/AZM combination and HCQ alone respectively. 9%(12/134) had arrhythmias during hospital stay, in  8.9% (4) and 5.6%(2) patients of those receiving HCQ/AZM combination and HCQ alone respectively, no patient developed torsade de pointes, one patient had non-sustained VT. There was no statistically significant association of QTc prolongation  with mortality, acute kidney injury, myocardial injury or severity of disease. Diuretic use was found to be statistically significant association with QTc prolongation(p-value 0.038). There was a weak correlation of baseline QTc with Δ QTc(r = 0.207 and p-value 0.017)

Conclusion

QTc prolongation was observed in a significant population of patients receiving HCQ and HCQ/AZM combination, however, no significant life threating arrhythmias occurred.

Antimicrobial stability of Cosmos caudatus extract at varies pH and temperature, and compounds identification for application as food sanitiser

The occurrence of foodborne diseases and food poisoning due to the consumption of contaminated foods is increasing nowadays, thus become a major threat to food industries in particular. In order to overcome this problem, prevention must be taken at the early stages of food preparation like sanitization. Typically, chemically based antimicrobial sanitisers were used in food industries to remove dirt and microbial population on food surfaces or food equipment. However, the emergence of microbial resistance and consumer awareness on the formation of carcinogenic compounds and safety issues in long term effects has led researchers to find an alternative. Therefore, a study was conducted to find a natural food sanitiser that was able to minimize the number of harmful bacteria without a change in the food quality and safety. In this study, the stability of Cosmos caudatus extract at different pH (pH 3, pH 7, pH 8 and pH 11) and temperatures (25°C, 30°C, 50°C, 80°C and 121°C) were determined for suitability as food sanitiser. The identification and quantification of this plant extract also were performed using HPLC and LC-MS/MS analysis to detect the major compounds which contributed to the biological activity of C. caudatus extract. Generally, results showed that the antimicrobial activity of C. caudatus extract was stable after exposure to various pH and temperatures, in fact, the extract increased its antimicrobial activity at lower acidity (pH 3) and higher temperature (50°C) against most pathogens. Furthermore, quercetin 3-O-rhamnoside was identified as a major compound in C. caudatus extract with the relative amounts of 29.66 mg/g. It can be concluded that C. caudatus extract is stable when exposed to various pH and temperatures. These useful findings have proved the antimicrobial stability of C. caudatus extract after exposure to several pH and temperatures thus can be further developed as a food sanitiser in food industries.

Dental Caries Severity and Nutritional Status of Nigerian Preschool Children

INTRODUCTION

Malnutrition in children is one of the most prevalent global health challenges, and malnourished children have a higher risk of death from childhood diseases. Early childhood caries (ECC) is the most common chronic disease of childhood. Complications from ECC such as pain, loss of tooth/teeth, and infection can undermine a child's nutrition and growth.

AIM

This study aims to evaluate the severity of decay, missing, and filled tooth (dmft) by nutritional status using the z scores of the anthropometric measurements: height for age (HFA), weight for age (WFA), weight for height (WFH), and body mass index for age (BMIA) among children with ECC in Nigeria.

STUDY DESIGN

This is a cross-sectional study conducted in 5 local government areas (LGAs) in Lagos State, Nigeria. A multistage sampling technique was used.

RESULTS

A total of 273 cases of ECC were included in the analyses (mean age 4.19 ± 0.96 y). Overall, the mean dmft was 3.04 ± 2.28, and most (96%) were accounted for by untreated decay. The distribution of dmft within the different z score categories of BMIA (<-3 = severely wasted, -2 to -3 = wasted, -2 to +2 = normal, +2 to +3 = overweight and >+3 = obese) showed the highest dmft scores among the combined severely wasted and wasted groups, lowest among children with normal z scores, and intermediate in the overweight and obese groups. There was a significant negative correlation between BMIA z score, WFH z score, and dmft (r = -0.181, P < 0.05 and r = -0.143, P < 0.05, respectively). However, the correlations between HFA z score, WFA z score, and dmft were positive but not significant (r = 0.048, P = 0.44 and r = 0.022, P = 0.77, respectively).

CONCLUSION

Our study showed an increased severity of dental caries among severely wasted or wasted children with ECC compared to those of normal or overweight.

KNOWLEDGE TRANSFER STATEMENT

The results from this study will raise awareness among clinicians and policy makers on the need for a primary prevention program for early childhood caries in countries with high burden of malnutrition and limited resources. Also, it will help draw the attention of clinicians to the caries status of malnourished children that can be managed to improve the nutritional outcomes.

Three-dimensional MRI-based treatment planning approach for non-invasive ocular proton therapy

PURPOSE

To develop a high-resolution three-dimensional (3D) magnetic resonance imaging (MRI)-based treatment planning approach for uveal melanomas (UM) in proton therapy.

MATERIALS/METHODS

For eight patients with UM, a segmentation of the gross tumor volume (GTV) and organs-at-risk (OARs) was performed on T1- and T2-weighted 7 Tesla MRI image data to reconstruct the patient MR-eye. An extended contour was defined with a 2.5-mm isotropic margin derived from the GTV. A broad beam algorithm, which we have called πDose, was implemented to calculate relative proton absorbed doses to the ipsilateral OARs. Clinically favorable gazing angles of the treated eye were assessed by calculating a global weighted-sum objective function, which set penalties for OARs and extreme gazing angles. An optimizer, which we have named OPT'im-Eye-Tool, was developed to tune the parameters of the functions for sparing critical-OARs.

RESULTS

In total, 441 gazing angles were simulated for every patient. Target coverage including margins was achieved in all the cases (V95%  > 95%). Over the whole gazing angles solutions space, maximum dose (Dmax ) to the optic nerve and the macula, and mean doses (Dmean ) to the lens, the ciliary body and the sclera were calculated. A forward optimization was applied by OPT'im-Eye-Tool in three different prioritizations: iso-weighted, optic nerve prioritized, and macula prioritized. In each, the function values were depicted in a selection tool to select the optimal gazing angle(s). For example, patient 4 had a T2 equatorial tumor. The optimization applied for the straight gazing angle resulted in objective function values of 0.46 (iso-weighted situation), 0.90 (optic nerve prioritization) and 0.08 (macula prioritization) demonstrating the impact of that angle in different clinical approaches.

CONCLUSIONS

The feasibility and suitability of a 3D MRI-based treatment planning approach have been successfully tested on a cohort of eight patients diagnosed with UM. Moreover, a gaze-angle trade-off dose optimization with respect to OARs sparing has been developed. Further validation of the whole treatment process is the next step in the goal to achieve both a non-invasive and a personalized proton therapy treatment.

Comparison between standard solid fuel and a new annular fuel performance in the core of a PWR

In new generation PWR the annular fuel has been proposed as one of the options to achieve higher power density, larger safety margin and reduced electricity generation cost. In the current work, RELAP5 code is used to compare the thermal hydraulic parameters for both solid fuel and internally and externally cooled annular fuel in a core of a PWR. MCNP6 code is used to evaluate the neutronic design and basic safety parameters of the annular fuel. To accomplish this goal, RELAP5 input files for both solid and annular fuels are developed. In these files, a 13 · 13 array annular fuel design is used while the 17 · 17 standard array design is used for the solid fuel. A 100% core power, steady state normal operation is assumed in the current investigation. Also, MCNP6 code input files for both fuels are prepared. It is found that annular fuel has lower peak fuel temperature than the standard solid fuel, which is an important advantage of the annular fuel rather than the solid one. Also, comparisons were performed for reactivity feedback coefficients of the two fuel types at BOC. Burnup calculations were performed to study the energy conversion capability of the annular fuel as well as rim effects.

Neutronic analysis of gadolinia bearing fuel assemblies

Gadolinium is mixed with nuclear fuel for extended burnup, increased reactor cycle Lengths, and in-out core refueling schemes. The purpose of this work is to investigate the effect of Gadolinium on neutronic parameters. A comprehensive analysis of different fuel assemblies bearing gadolinia with different concentration and different number of gadolinia rods was carried out. The EPR fuel assemblies were chosen in this study. The fuel assemblies are of seven different types, each assembly has unique design characteristics in terms of enrichment, number of gadolinia rods and gadolinium concentration. The calculations were achieved using MCNP6 code and with ENDF/B-VII library. A fine mesh tally was superimposed on the geometry to illustrate flux distribution in the whole assembly and its change with burnup. The variation of reactivity and isotopic composition for each region of the assembly with burnup and its influence on flux distribution was studied. The results showed that the presence of gadolinium greatly affects the power distribution. It causes some skewness in axial power shape towards the top of the assembly, the assembly which has largest number of gadolinia rods and the lowest enrichment has the largest skewness of power distribution at BOC. At EOC the flux and axial power have a double hump shape due to the buildup of gadolinium isotopes and the large decrease in reactivity with burnup.

Cyclophosphamide exposure assessed with the biomarker phosphoramide mustard-hemoglobin in breast cancer patients: The TailorDose I study

Cyclophosphamide (CPA) dosing by body surface area (BSA, m²) has been questioned as a predictor for individual drug exposure. This study investigated phosphoramide mustard-hemoglobin (PAM-Hb, pmol g^-1 Hb) as a biomarker of CPA exposure in 135 female breast cancer patients receiving CPA during three courses based on BSA: 500 mg/m² (C500 group, n = 67) or 600 mg/m² (C600 group, n = 68). The inter-individual difference was calculated for both groups by dividing the highest through the lowest PAM-Hb value of each course. The inter-occasion difference was calculated in percentage for each individual by dividing their PAM-Hb value through the group mean per course, and subsequently dividing this ratio of the latter through the previous course. A multivariable linear regression (MLR) was performed to identify factors that explained the variation of PAM-Hb. During the three courses, the inter-individual difference changed from 3.5 to 2.1 and the inter-occasion difference ranged between 13.3% and 11.9% in the C500 group. In the C600 group, the inter-individual difference changed from 2.7 to 2.9 and the inter-occasion difference ranged between 14.1% and 11.7%. The MLR including BSA, age, GFR, and albumin explained 17.1% of the variation of PAM-Hb and was significantly better then the model including only BSA. These factors should be considered when calculating the first dose of CPA for breast cancer patients.

HD-EEG for tracking sub-second brain dynamics during cognitive tasks

This work provides the community with high-density Electroencephalography (HD-EEG, 256 channels) datasets collected during task-free and task-related paradigms. It includes forty-three healthy participants performing visual naming and spelling tasks, visual and auditory naming tasks and a visual working memory task in addition to resting state. The HD-EEG data are furnished in the Brain Imaging Data Structure (BIDS) format. These datasets can be used to (i) track brain networks dynamics and their rapid reconfigurations at sub-second time scale in different conditions, (naming/spelling/rest) and modalities, (auditory/visual) and compare them to each other, (ii) validate several parameters involved in the methods used to estimate cortical brain networks through scalp EEG, such as the open question of optimal number of channels and number of regions of interest and (iii) allow the reproducibility of results obtained so far using HD-EEG. We hope that delivering these datasets will lead to the development of new methods that can be used to estimate brain cortical networks and to better understand the general functioning of the brain during rest and task. Data are freely available from https://openneuro.org.

Measurement(s)	brain measurement • cognitive behavior trait
Technology Type(s)	electroencephalography (EEG)
Factor Type(s)	task • age • sex
Sample Characteristic - Organism	Homo sapiens

Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.13560311

A preli­minary study of endoscopic diagnosis of gastric ulcer in Egyptian donkeys (Equus asinus) pa­ra­sitised by Gasterophilus intestinalis (Diptera: Oestridae)

Equine gastric ulcer syndrome (EGUS) is a communal broad problem in equines but in donkeys, the disease is a subclinical disorder which leads to economic losses. Gasterophilus intestinalis larvae are the most predominant parasitic infestation in donkeys. The present study was planned to facilitate the early and efficient diagnosis of gastric ulceration in donkeys through gastroscopic examination. The study was conducted on 120 adult Egyptian donkeys (Equus asinus) from both sexes after a one-month acclimatisation period. Gastroscopic examination was used to evaluate the presence of gastric lesions. In the majority of infested donkeys, G. intestinalis larvae were in the non-glandular part of the stomach. The prevalence of Gastrophilus larvae in animals reached 96.66%. The infestation percentage among jennets (97.5%) was slightly higher than that among jacks (96.25%). After morphological identification of the 3rd instar of larvae, all donkeys were found to be infested by G. intestinalis larvae. The histopathological examination of the affected stomach revealed severe necrosis of the gastric mucosa. Gastroscopic examination is the main diagnostic tool for examination of gastric lesions in the donkeys, so it is necessary as a routine diagnostic tool in donkeys’ examinations.

The dynamic modular fingerprints of the human brain at rest

The human brain is a dynamic modular network that can be decomposed into a set of modules, and its activity changes continually over time. At rest, several brain networks, known as Resting-State Networks (RSNs), emerge and cross-communicate even at sub-second temporal scale. Here, we seek to decipher the fast reshaping in spontaneous brain modularity and its relationships with RSNs. We use Electro/Magneto-Encephalography (EEG/MEG) to track the dynamics of modular brain networks, in three independent datasets (N = 568) of healthy subjects at rest. We show the presence of strikingly consistent RSNs, and a splitting phenomenon of some of these networks, especially the default mode network, visual, temporal and dorsal attentional networks. We also demonstrate that between-subjects variability in mental imagery is associated with the temporal characteristics of specific modules, particularly the visual network. Taken together, our findings show that large-scale electrophysiological networks have modularity-dependent dynamic fingerprints at rest.

Amygdalar activity among patients with head and neck cancer predicts cerebrovascular events: a retrospective FDG PET/CT Cohort Study

Background

Radiation therapy for head and neck cancer (HNC) associates with an increase in cerebrovascular events. Amygdalar metabolic activity (AmygA), a measure of stress-associated neurobiological activity, associates with cardiovascular events in patients without cancer. In this study, we tested whether AmygA was associated with cerebrovascular events among patients treated with radiation therapy.

Methods

The associations between AmygA (at cancer staging) and subsequent cerebrovascular events as well as inflammatory biomarkers and arterial inflammation, were tested among consecutive patients with HNC treated with radiation therapy who underwent 18F-FDG-PET/CT.

Results

Among 240 patients (59±13 years; 30% female, 48% had stage 4 disease), there were 26 events over a median follow-up period of 3 years (IQR: 1.7–5.1). AmygA at cancer staging was associated with subsequent cerebrovascular events, an effect that remained significant after adjustment for age, sex, and cerebrovascular risk factors (adjusted hazard ratio 1.47, 95% CI 1.04–2.09, P=0.031). The association persisted when the analysis was restricted to patients with no prior history of CV disease and even among those with lower predicted CV risk (P&lt;0.001). Higher AmygA at cancer staging also associated with serum inflammatory markers and arterial inflammation (P&lt;0.05 each).

Conclusions

Amygdalar activity, a quantifiable biomarker of stress-associated brain activity, associated with subsequent cerebrovascular events among patients with cancer treated with radiation therapy.

Funding Acknowledgement

Type of funding source: None

Antibiotic prophylaxis in colorectal surgery: are oral, intravenous or both best and is mechanical bowel preparation necessary?

BACKGROUND

The benefit of adding oral antibiotic prophylaxis (OA) to intravenous prophylaxis (IV) in elective colorectal surgery to prevent surgical site infection (SSI) and whether the benefit of OA requires a mechanical bowel cleansing (MBP) are assessed in a systematic review. Meta-analyses compare randomized trials of IV versus IV plus OA, both with MBP; OA versus IV plus OA, both again with MBP; OA plus IV in studies randomizing patients to MBP or no MBP; and IV versus IV plus OA in patients with no MBP.

METHODS

MEDLINE, EMBASE, and the Cochrane Library were searched for eligible studies from 1965 to April 1, 2020. The outcome assessed was SSI, superficial and deep, but not organ space. For each included study, risk of bias was assessed using the Cochrane Risk of Bias tool version 1. For each comparison, meta-analysis was performed from data from eligible studies to obtain a summary effect and heterogeneity using RevMan. Sensitivity analyses were performed excluding studies of poor quality. Certainty of evidence was assessed using GRADE for each comparison.

RESULTS

Sixty-one studies published in 1971-2020 from 55 publications reporting 12,297 patients were eligible for inclusion. A total of 36 studies compared IV to OA plus IV with MBP. The risk ratio (RR) and 95% confidence interval (CI) for SSI with oral and IV vs. IV alone are 0.47, 0.40-0.56. The RR in 19 studies for IV plus OA versus OA alone is 0.48, 0.38-0.62. The RR for OA plus IV with MBP versus without MBP in 5 studies is 1.17, 0.84-1.64. The RR for OA plus IV versus IV alone when no bowel prep was used in two studies is 0.36, 0.18-0.72. RRs were similar in sensitivity analyses. The GRADE is high for the first two comparisons, moderate for the 3rd, and low for the 4th due to imprecision and heterogeneity.

CONCLUSIONS

Combined OA and IV is superior to either alone in preventing SSI. The certainty of evidence is such that further research is unlikely to alter this relationship when MBP is used. In randomized trials of MBP, OA plus IV shows no benefit from MBP versus no MBP. The last comparison shows in just two studies that as in the first meta-analysis, but in the absence of MBP, combined OA plus IV is also superior to IV alone.

AB0762 METABOLIC SYNDROME IN EGYPTIAN PSORIATIC ARTHRITIS PATIENTS

Background:

Psoriatic arthritis (PsA) is a chronic inflammatory arthritis affecting 20:30% of patients with skin Psoriasis (PsO). It is strongly associated with obesity, particularly excess visceral adiposity, which leads to insulin resistance, hyperglycemia, dyslipidemia, and hypertension (HTN).

All the previous findings are grouped in Metabolic Syndrome (MetS) which increase the risk of development of Type 2 diabetes mellitus (T2DM) by five folds and cardiovascular disease (CVD) by two folds.

Objectives:

The aim of this work was to define those who fulfill MetS criteria in PsA patients thus of greater risk to develop CVD and T2DM.

Methods:

Fifty PsA patients diagnosed according to the CASPAR criteria and 50 matched healthy controls were included in this study.

All patients were subjected to thorough clinical evaluation of the musculoskeletal system. The disease activity was assessed by DAPSA and BASDAI. Skin severity was assessed by the PASI. Disability assessment was done by the HAQ-DI. Laboratory investigations included: CRP, uric acid and diabetic profile (includingHOMA-IR) and lipid profile in patients and control subjects.

Subjects were defined as having MetS according to International Diabetes Federation (IDF) criteria:

Abdominal obesity was measured by Waist circumference (WC) for Egyptian cutoffs values (WC>100.5 cm in men and >96.25 cm in women).The subjects must have central obesity to identify MetS plus any two of the following four factors:

Results:

Metabolic syndrome was significantly higher among PsA patients than control group (42% Vs 16% respectively).

Regarding frequency of MetS components, obesity was the highest component among PsA patients (62%) as illustrated in Figure 1.

CRP mean level was significantly higher in PsA patients compared to control group with p <0.001*. CRP serum level showed a positive significant correlation with DAPSA score and HOMA-IR (P= 0.031, 0.002 respectively)

Correlations between MetS components and (disease activity, skin severity and physical function) are shown in Table 1.

Conclusion:

1-There is high frequency of MetS in PsA patients compared to control group.

2- Obesity and DMT2 were the most common components of MetS.

References:

[1]Eder L, Harvey P, Chandran V, Rosen CF, Dutz J, Elder JT, et al. Gaps in diagnosis and treatment of cardiovascular risk factors in patients with psoriatic disease: an international multicenter study. The Journal of rheumatology. 2018:jrheum. 170379.

[2]Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome—a new world-wide definition. A consensus statement from the international diabetes federation. Diabetic medicine. 2006;23(5):469-80.

Psoriatic ArthritisMetabolic syndromeWCBMITGHDLFBSHOMA-IRSystolic BPDiastolic BPDAPSArs-0.2330.0810.086-0.1160.2630.3870.136-0.170P0.3080.7280.7100.6160.2500.0830.5570.462BASDAIrs0.798*0.1520.060-0.110-0.424-0.2940.168-0.027P<0.001*0.5090.7980.6360.0550.1960.4670.906PASIrs0.435*0.2260.363-0.521*-0.276-0.253-0.054-0.060P0.049*0.3240.1060.015*0.2270.2680.8180.795HAQ-DIrs0.1890.1760.168-0.286-0.240-0.184-0.343-0.276P0.4130.4450.4660.2090.2950.4240.1280.225

Disclosure of Interests:

None declared

Demographics and Mortality Rates of Surgical Emergencies Treated at the Casualty Operation Theater: A Six-month Retrospective Analysis

Introduction

Emergencies such as appendicitis, peritonitis, road traffic accidents and gunshots require immediate surgical intervention. Patients are first resuscitated at the emergency department and then shifted to the casualty operation theater (COT). COT is a state-of-the-art operation theater that is open 24/7 and ready to deal with any surgical crisis. Once surgery is performed, the patients are admitted to the surgical ward for post-operative care.

Jinnah Postgraduate Medical Centre (JPMC) is the largest tertiary care hospital in Karachi. There is very limited data on the cases that are dealt with on regular basis at the COT in JPMC. Here we break the mold and analyze the various aspects of surgical emergencies treated at the COT over the course of last six months.

Objectives

To evaluate the demographics and mortality rates of emergencies treated at the COT in the last six months.

Methods

This was a retrospective study, held for six months (July 1^st 2019 to December 31^st 2019). Data was obtained from the Records and Administration section, Surgical Unit IV (ward 21), Jinnah Postgraduate Medical Centre.

Results

Three hundred and fifty-five patients were inducted into the study, predominantly male. Majority (71.54%) of the referrals were made from within the city. The mean age of the patients was 48.57 ± 14.92 years. Appendicitis was the most common emergency treated at the COT. The overall mortality rate was 23.94%. Peritonitis and road traffic accidents contributed significantly to the mortality rate.

Conclusion

Surgical emergencies treated at the COT have a high mortality rate at one week. Prompt recognition, early referrals and intervention can help reduce mortality in the future.