Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low-or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.
This study was initiated to evaluate the effect of hazardous exposure to water pollutants on Tilapia zilli Gerv inhabiting Lake Maryût at 3 different sites with varying degrees of physicochemical and organic criteria. As compared to other sites, the lower water turbidity and alkalinity plus lesser metal content in site #1, signify its picking as reference.The expected anoxicity of the polluted sites (#2& #3) was evidenced by the elevated chemicaland biological-oxygen demands added to reduced dissolved oxygen. Abundant phytoplankton and sewage effluents coupled with the high productivity of the lake have elevated water pH and nutrient salts; thus causing a chronic eutrophication problem. Emerging evidence suggests that T. zilli responded differently according to the environmental stress index in each catch area. In polluted fish, serum hyper-αl-, α 2 -, and β-globulinemia plus low albumin added to the enhanced activities of serum transaminases and lactate dehydrogenase suggests chronic functional damage in the liver. However, the hyper-y-globulinemia implies an indirect challenge response toward the invasion of endoand ectoparasites. Serum enzymes, protein, lipid, cholesterol, creatinine, and glucose fluctuated in a positive correlation contra the guidelines of water pollutants; they are thus validated as beneficial "biochemical markers" for contamination stress. Unlike other biological principles investigated, alkaline phosphatase proved to be a promising "model" for appraising moderate, sublethal, or metal-restricted contamination. Other water pollutants, as petroleum oil, seem to interfere with this peculiarity.
Regardless of the absence of spinal deformities, vitamin C deprivation in adult-sized Clarias gariepinus challenged the physical integrity and survival of ®sh, inducing changes that greatly resembled those of ®ngerlings of other species. Vitamin C was presumed to be a dietary facilitator, which when deprived in the diet of C. gariepinus, would obstruct intestinal absorption of iron and/or impair its release from the reticulo-endothelial stores. This impaired erythrocyte synthesis led into anaemia (as indicated by lowered levels of red blood cells, haemoglobin and haematocrit). Leukopenia noted in ®sh on a scorbutic (lacking vitamin C) diet suggested functional depression of phagocytic engulfment with increased susceptibility to the deteriorating action of pathogenic agents. Changes in histology included hypertrophy, oedematous separation and telangiectasia of gill lamellae. Shrunken glomeruli, sloughed Bowman's capsules and tubular dilation and distortion were also shown. Shrunken hepatocytes and the occurrence of yellowish ceroid pigments were the concrete histopathological signs in liver. Vitamin C is thus suggested as a potent antioxidant that oers protection against oxidative damage to various ®sh tissues.
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