SummaryBackgroundSurgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.MethodsThis international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.FindingsBetween Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001).InterpretationCountries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication.FundingDFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant,...

Ten polychlorinated biphenyl (PCB) congeners were determined in water samples collected along the River Nile using gas chromatography-electron capture detector (GC-ECD). PCB concentrations ranged from 14 to 20 μg/L, which were higher than those reported in previous studies, indicating serious PCB pollution in the River Nile. PCB congener profiles varied depending on the sampling sties. PCB-138 was the predominant congener accounting for more than 18% of total PCBs. The composition of PCB congeners in the water revealed that highly chlorinated PCB technical mixtures such as Aroclor 1254 was the main PCB production historically used in Egypt. An increasing trend in PCB levels from the upper stream to the Nile estuaries was observed. The calculated flux of PCBs indicated that 6.8 tons of PCBs is dumped into the Mediterranean Sea each year from the River Nile. The hazard quotients and carcinogenic risk caused by PCB pollution in the River Nile were above the acceptable level indicating that PCBs in the River Nile water pose adverse health effects for all age groups. Our findings revealed that PCBs possess a serious risk to the Egyptian population that depends mainly on the River Nile as a source of water. Thus, stricter legislation and regulatory controls should be applied to reduce the risk of PCBs in Egypt.

No abstract

Background An abdominal aortic aneurysm (AAA) is a progressive chronic dilatation of the abdominal aorta with terminally rupture when the aortic wall is so weakened that aortic wall stress exceeds wall strength. No effective medical treatment exists so far. We aimed to test whether intraluminal admission of Penta-Galloyl Glucose (PGG) treatment in a rodent AAA model could hold the potential to inhibit aneurysmal progression. Method Male Sprague Dawley rats had either intraluminal elastase infused for AAA induction or saline to serve as controls. In two independent experimental series, elastase was used to induce AAA followed by an intraluminal PGG (directly or by a drug eluting balloon) treatment. All rats were followed for 28 days and euthanized. In both series, maximal infrarenal aortic diameter was measured at baseline and at termination as a measure of AAA size. In series 2, maximal internally AAA diameter was followed by ultrasound weekly. AAA tissues were analyzed for elastin integrity by millers stain, collagen deposition by masson trichrome staining. In other AAA tissue samples the mRNA level of CD45, lysyloxidase (LOX), lysyloxidase like protein 1 (LOXL1) were determined by qPCR. Results Direct administration of PGG significantly reduced AAA expansion when compared to controls. PGG treatment resulted in a higher number and more preserved elastic fibers in the aneurysmal wall, while no significant difference was seen in the levels of CD45 and LOX mRNA levels. The drug eluting balloon (DEB) experiment showed no significant difference in AAA size observed neither macroscopically nor ultrasonically. Also the aneurysmal mRNA levels of CD45, LOX and LOXL1 were unchanged between groups.

This research aims at determining residues of thiophanate methyl and propiconazole in grape and mango fruits as an indication for their persistence in this environmental compartment. Fruit extracts were analyzed for thiophanate methyl using High Performance Liquid Chromatography and using Gas Chromatography Electron Capture Detector (GC/ECD), respectively. The results indicated that propiconazole had a less environmental impact since propiconazole had shorter residue half-lives which were 1.24 and 1.19 days in grape and mango fruits, respectively, while thiophanate methyl had half-lives of 2.49 and 2.64 days in mango and grape, respectively. The degradation rates of propiconazole in grape and mango fruits did not change significantly and neither did those of thiophanate methyl. According to the maximum residue level, the pre-harvest intervals of propiconazole were set to be 3 and 7 days for grape and mango fruits, respectively, and the pre-harvest intervals for thiophanate methyl were 15 days for both grape and mango fruits. Propiconazole was generally considered to be less hazardous to humans and will leave the environment less altered because of its faster degradation than that of thiophanate methyl.

The present work is aimed to investigate the toxicity of 1/20 LD50 of cadmium chloride (CdCl2) on male albino rats by oral ingestion and to determine the hepatoprotective effect of Solanum nigrum Linn (SN) dried fruits and their ethanolic extract against CdCl2 toxicity using biochemical parameters. Rats were divided into six groups; the first group is control, second group is CdCl2-intoxicated rats, third group is fed with a semi-modified diet with S. nigrum fruits, fourth group rats ingested with dried extract, and intoxicated rats (groups 5 and 6) were treated with fruits and ethanolic extract of S. nigrum, respectively. The results showed that rats exposed to CdCl2 induced remarkable decrease in body weight gain, feed efficiency, and Hb, Hct, RBC, and WBC count and MCHC, but increase in MCV and MCH values. In the case of plasma enzymes, there were significant stimulations observed in ALT and AST, acid phosphatase, alkaline phosphatase, and LDH activities of CdCl2-intoxicated rats (group 2) compared to control (group 1). Plasma protein profile showed decreases in total soluble protein and albumin; also globulin content was decreased by CdCl2 ingestion. Under the same condition, plasma total bilirubin and glucose levels were increased in group 2. In addition, lipid peroxidation and antioxidative system (GSH, catalase, and SOD) of liver were harmed by CdCl2 ingestion. Whereas, normal rats treated with SN showed insignificant changes in groups 3 and 4 as compared to control (group 1). The treatment with dried fruits and their ethanolic extract in CdCl2-intoxicated rats (groups 5 and 6) ameliorated and improved these harmful effects in all above parameters either for blood or liver. The results of this study suggest the protective effect of S. nigrum against liver injury happened by CdCl2 which may be attributed to its hepatoprotective activity and thereby.

The HPLC method for determination of mandipropamid residues and its dissipation in grape was investigated. The mean recoveries of the analytical method were 98–102%. The samples were collected within 2 weeks after pesticide application, and the pesticide residues were extracted by an optimized QuEChERS method. Mandipropamid dissipated rapidly with half-life 2.20 days in grape. According to maximum residue limit (MRL) the preharvest interval (PHI) of mandipropamid on grape was 4 days, after the last treatment.

Weeds represent a major constraint for successful pea cultivation, resulting in loss of green pea yield and quality. Two field experiments were carried out during the winter seasons of 2018/2019 and 2019/2020. The objectives of the current study were to evaluate the efficacy of pendimethalin, butralin, fluazifop butyl, bentazon, and hoeing on weed control, and their impact on pea growth, nodule formation, yield, quality, and storability. The results indicated that hoeing and fluazifop butyl were the most effective treatments for weed control in terms of the lowest values of total weed dry weight. The bentazon and fluazifop butyl herbicides didn’t affect active nodules number, plant height, plant weight, root length, or number of leaves and branches. Additionally, bentazon and hoeing resulted in the highest total yield per plant and protein content. Butralin and pendimetalin achieved the lowest yield, and butralin also resulted in the lowest plant height and weight. Bentazon-treated peas had the highest chemical compositions in terms of chlorophyll, carotenoids, total sugar, and vitamin C contents in pea pods at harvest and during cold storage at 4 °C and 95 RH for 45 days. No detectable residues of the four herbicides under study were detected in green pods, suggesting that pods can be safely consumed at the time of harvesting. It can be concluded that nodules formation in pea was not affected significantly by the application of the tested herbicides, except pendimethalin and butralin. Furthermore, bentazon had a positive impact on nodules formation and pods quality and could be used effectively for controlling the broadleaf weeds, and it was simultaneously a selective and safe herbicide in pea cultivation.