quality

Background: We have developed a femoral supporting pad with an integrated ultrasound probe holder and examined its practical usability on patients with lower limb surgery. Objectives: To evaluate the function of this novel femoral supporting pad with respect to its practicability during the performance of a distal sciatic nerve blockade, the time needed to perform this blockade including the catheter insertion and the quality of postoperative analgesia within the first 24 hours. Methods: 50 patients which had been scheduled for elective lower leg, ankle or foot surgery had received a continuous blockade of the distal sciatic nerve. Sciatic nerve blockade was performed sonographically controlled with the patients in supine position by using our novel femoral supporting pad with an integrated ultrasound probe holder. Primary endpoint: duration of the intervention. Secondary endpoints: pain intensity (visual analogue scale VAS 0-10) at the first postoperative day; cumulative opioid (piritramide) requirement during their stay on the post Anaesthesia care unit (PACU) with vs. without distal sciatic nerve blockade. Results: 49/50 patients received a distal sciatic catheter, which had been sonographically placed within a mean time (mean ± sd) of 11:30 ± 3:13 minutes. VAS at the first postoperative day was (mean ± sd) 1 ± 2 at rest and 2 ± 2 as maximum. The piritramide requirement during PACU stay (mean ± sd) was 11 ± 8 mg without vs. 3 ± 6 mg with distal sciatic nerve blockade (p< 0.05). Conclusion: Continuous distal sciatic nerve blockade using a novel femoral supporting pad with an integrated ultrasound probe holder was feasible in 49 of 50 patients within 11 minutes and 30 seconds.

The choice of the optimal muscle relaxant in one-day surgery in children with “small” surgical interventions remains relevant to this day. In modern pediatric surgery, the requirements for the quality of muscle relaxation are highest. However, along with the effectiveness of the drug, its duration and controllability of the action, as well as the safety of use, are important [1-7]. The aim of the study: To determine the pharmacoeconomic rationale for the rational use of muscle relaxants, depending on the duration of operations in one-day surgery in children. Material and research methods: The study was conducted in surgical clinics of the Azerbaijan Medical University. The study included 156 children who were operated on routinely from 0 to 16 years old (risk of anesthesia I-II ASA), who used combined endotracheal anesthesia during surgery. Based on the requirements of the GCP international program (Good Clinical Practice), the inclusion of children in the study was carried out only after the written consent of the parents. The studied patients were divided into 3 groups depending on the muscle relaxant used: IA (n = 52) - rocuronium bromide (esmeron), IB (n = 52) - atracurium besilate (tracrium), IC (n = 52) - cisatracurius besilate (nimbex). Depending on the type of general anesthesia, these groups were also divided into 2 subgroups: anesthesia based on isoflurane + fentanyl ″ + iso ″ and anesthesia based on sevoflurane + fentanyl ″ + sev ″. The main groups were also divided into 2 age subgroups: children under 2 years of age – IA1, IB1, IC1 and children from 2 to 16 years old – IA2, IB2, IC2.

Bone metastases in cancer patients are highly painful and decrease the quality of life for these group of population. Covid-19 pandemia is a global challenging issue that mostly affect the patients with immune suppression or having comorbid diseases older than 65 years old. The palliation and management of bone metastases varies from single dose to several fractionation. The main goal of this article is to decide that short or long term fit for the cancer patients with bone metastasis in the Covid-19 era. We reviewed the topic about the short course and long term radiotherapy in the patients with painful bone metastases via novel literature.

Background: Proximal humerus fractures (PHFs) are common injuries particularly in older adults. Evidence-based protocols for PHF rehabilitation are lacking and physiotherapists use a variety of interventions. Purpose: To determine practice patterns and perceptions of physiotherapists who treat adults with PHF in Ontario, Canada. Method: A paper and pencil survey asking about respondent demographics and management of Neer Group 1 (minimally/nondisplaced) and complex (displaced 3- and 4-part) PHF was mailed to 875 randomly selected physiotherapists who were registered with the College of Physiotherapists of Ontario in 2013/2014 and working in practice areas likely to be accessed by adults with PHF. Results: The response rate was low (10%); 83 physiotherapists completed the survey - 80% had experience managing PHF. Respondents treated 1-5 individuals with PHF annually; more treated Neer Group 1 PHF (89%) than complex PHF (68%). Most individuals with PHF were older than 60 years (64%), female (76%) and accessed physiotherapy through a doctor’s referral (91%) more than 1 month post injury (33%). Main findings: Physiotherapists manage PHF using multi-component interventions and a minimum of 76% include the following elements: education and progression of passive, active assisted, active range of motion exercises and muscle retraining to build coordination and strength. Use of other elements was variable. The main factors influencing the treatment plan were the ability of the individual with PHF to comply, bone quality, and fracture type. Most respondents were unsure that there is sufficient PHF rehabilitation literature to guide treatment. Conclusions:This environmental scan is the first North American study to document practice patterns and attitudes of physiotherapists providing PHF rehabilitation. Elements used by physiotherapists in Ontario treating small numbers of individuals with Neer Group 1 or complex PHFs each year align well with the limited PHF rehabilitation literature available. Potential implications:Multi-disciplinary collaborations to design and conduct large, high quality, multi-centre prognostic studies and RCTs that evaluate the effectiveness of key aspects of non-surgical PHF rehabilitation in various patient groups are needed. Meanwhile, consensus guidelines should be developed in the context of region-specific physiotherapy service models to inform best practice in PHF rehabilitation management.

This study investigated the water quality of tanker waters that was collected from Bengaluru urban areas to assess its suitability for domestic purpose. A total of 50 samples were collected in dry (March 2019) season. All samples were analyzed for various hydrochemical parameters, such as pH, total dissolved solids (TDS), electrical conductivity (EC), turbidity, dissolved oxygen (DO), total hardness (as CaCO3), calcium (CaCO2+), chloride (CaCO−) and nitrate (NO3−). Bacteriological analyses of water samples were analyzed for total coliform count. A very high level of total hardness (186 - 434.6 mg L-1) was determined in 27 water samples tested in this study indicating the necessity of water treatment before used for domestic purpose. Of the 50 samples tested, 7 showed a most probable number (MPN) index of < 23 and 9 showed < 240 and the remaining 34 were unsatisfactory with an MPN index of > 1600 per 100 ml. In some locations, the presence of high MPN index, in particular, rings the bell before using the tanker water in houses and restaurants. Exploration of the mechanisms by which water quality deteriorates during supply chain and potential implication for regulatory policy for monitoring of tanker water while distribution is the need of the hour.

Introduction: Uterine rupture is one of the peripartum complications, which cause nearly about one out of thirteen maternal deaths. This study aimed to assess the prevalence and associated factors of mortality among women with uterine rupture in referral hospitals of Lubumbashi, in the south east part of the Democratic Republic of Congo. Methods: Institution based cross sectional study was conducted from December 1st, 2012 to 31st, 2016 on uterine rupture. During the study selected 158 women were included by using exhaustive sampling method. Data were checked, coded and analyzed into STATA version 12. Chi-square test was used to identify the predictors of maternal and perinatal mortalities in women with uterine rupture and 95% Confidence Interval of odds ratio at p - value less than 0.05 was taken as a significance level. Results: The overall prevalence of uterine rupture was 0.49%. The average age of the patients was 29.5 ± 6.2 years and 71.52% of them were between 20 and 34 years old; more than 60% had a parity ≥4 (average parity: 4.7 ± 2.5). 81.17% of the cases had a fully ruptured uterus and 51.17% of the uterine ruptures were located in the lower segment. Repair of the pregnant ruptured uterus was performed in 93.04% of the cases and hysterectomy in 5.06%. Maternal and perinatal mortalities were 8.86% and 72.04% respectively. Regarding maternal mortality, no parameter showed a significant association with maternal death. As for perinatal mortality, parity ≥4, complete rupture and segmento-corporeal lesion were significantly associated with perinatal death (p < 0.05). Conclusion: Uterine rupture remains one of the causes of maternal and perinatal mortality in Lubumbashi. The place occupied by uterine ruptures in obstetric activity requires joint and urgent action by all stakeholders in the health system in order to combat this scourge, witness to poor quality obstetric care.

The effects of storage of Ogbona seed flour (Irivingia gabonensis and Irivingia excelsa), at ambient condition (30±20C, 65-74% RH) for 0-4 months on some physical characteristics were investigated. The samples were subjected to storage in air tight polyethylene bags for up to four months. Samples were removed at intervals of 0, 1, 2, 3 and 4 months for analysis. The chemical: proximate constituents, free-fatty acids and peroxide values; selected functional properties: water/oil absorption capacity, foam capacity and viscosity and sensory attributes of the samples were investigated. The result shows that there was no observable change in the chemical composition, selected functional and sensory properties of the two varieties of Ogbona seed flours when stored up to two months but decreased from third to fourth month during storage at ambient temperature. Therefore, storage at ambient temperature (30±20C, 65-74% RH) could extend the shelf life of the samples for up to two months in air-tight polyethylene bags of 0.7mm thickness without losing its quality characteristics.

A study was undertaken the effect of pretreatments and drying methods on quality parameters of tomato slices with respect to storage using two factors as treatments i.e. 5 pre-treatment levels (P1-Peeled by hot water dip blanching, P2-Peeled by hot brine dip blanching, P3-Unpeeled by hot water blanching, P4-Unpeeled by hot brine blanching, P5-Control- No peeled and no blanched) and 2 drying methods i.e. (D1-Tray drying, D2-Sun drying) with completely randomized design of factorial concept with three repetitions at Post Graduate Laboratory of Horticulture Department, College of Agriculture, Junagadh Agricultural University, Junagadh. The quality was evaluated on the basis of physicochemical (i.e. drying time (h) and moisture content (%) at 1, 20, 40, 60 and 80th day of storage. Result of study depicts that the pretreatment P2 i.e. peeling of tomato by hot brine dip blanching followed by tray drying (D2) recorded minimum (14.50 h) drying time and the minimum changes in moisture content (4.00%-6.54%) observed in treatment P1 at 1st to 80th day of storage, respectively.

Effect of drying methods (sun-drying and cabinet oven drying) on the physicochemical properties and fatty acid composition of oils extracted from moringa seeds was investigated. Oil from the seeds was extracted using solvent (hexane) after drying. Drying increased the yield from 30.30-33.11%. The oil samples were less dense than water with specific gravities of 0.9032, 0.9075 and 0.9030 respectively. A significant difference exists in the moisture contents (0.11-0.21%); smoke point (202-2250C), flash point (310-3170C) and fire point (360-3690C). Sun-drying and cabinet oven drying brought about a decrease in the acid value (1.80-1.08mgKOH/g), saponification value (174.87-105mgKOH/g), Iodine value (16.10-13.90wijs) and peroxide value (11.24-2.3-Meq/kg). The decrease is an indication of quality improvement of the oils. More unsaturated fatty acids were present in the samples between 76.61% and 81.66%. Oleic acid was predominant (44.92% raw, 45.71% sundried and 43.60% cabinet oven dried). Sun-drying and cabinet oven drying did not have much significant effect on the physical, chemical and fatty acid compositions of the oil. The results obtained from this study showed that the three oil samples are good as edible oil and for commercial purpose.

This study was carried out to evaluate the effect of pretreatments and drying methods on the chemical quality and microbial density of wild edible oyster mushroom. The mushroom samples were pretreated by steeping in 0.5% citric and sodium metabisulphite at room temperature for 10 minutes before being subjected to sun and cabinet drying until a constant weight was reached. The dried samples including the control samples (Samples not pretreated with chemicals) were evaluated for proximate, mineral composition and microbial density. The proximate analysis (protein, ash, fat, moisture and fibre) showed that untreated mushroom samples (both sun and cabinet dried) had the overall best results followed by samples pretreated with 0.5% sodium metabisulphite while samples pretreated with 0.5% citric acid had the lowest values. The mineral analysis (calcium, sodium, magnesium and potassium) of the mushroom samples followed the same trend as the proximate analysis. The microbial density of the samples showed that samples pretreated with 0.5% citric acid had the lowest count followed by samples pretreated with 0.5% sodium metabisulphite while the untreated samples had the highest microbial density. This implies that pretreatment with citric acid and sodium metabisulphite reduced the microbial density which may invariably extend the storage life of the edible oyster mushroom.

The seasonal nature of most fruits available in the market coupled with inadequate storage and processing facilities has limited their consumption by majority of the people in the country. Jams made from fruits are good bread spread rather than any other food products because they serve as adequate balance diet and it contains antioxidant such as vitamin C and A which play an important role in preventing cancer, cardiovascular problem and improvement of eyesight. Pawpaw and watermelon fruits have been reported to be nutritive and high in antioxidant properties that can scavenge free radicals, thereby improving the antioxidant status of the body. It is therefore deemed fit to produce jam from these perishable commodities in other to make them available all through the year and as well as adding to varieties of food products. The aqueous extracts of watermelon with pawpaw juice were processed into jam and the physicochemical properties of the jam samples were analysed. The resulting jam samples showed moisture content ranging between 30.60-35.30%, protein 0.40-0.80%, fat 0.20-0.40%, ash 1.20-1.70%, crude fibre 0.10-0.30%, carbohydrate 62.10-67.16%, β-carotene 610-1350µg/100g and ascorbic acid 9.60-15.40mg/100g. The jam samples were found to be very nutritive and high in antimicrobial and antioxidant properties that can scavenge free radicals, thereby can improve the antioxidant status of the body. Sensory evaluation tests showed that the samples were acceptable and compared favourably with the commercial imported brand while sample AA had the highest preference in all the sensory attributes evaluated by the panellists. Microbiological examination also showed that the jam samples had total plate count ranging from 4.10x101 to 2.00 x101 cfu/g, yeast and mould count ranged from 2.10x101 to 1.00 x101cfu/g with no observable coliform count.

The quality characteristics of selected black gram varieties viz., VBN 5, VBN 7, ADT 3, T9 and CO 6 and were evaluated for their suitability for the preparation of thick pancake. The foaming stability and foaming capacity were found to be maximum in VBN 5, CO 6 and T9. Maximum rise in volume was recorded in CO 6 (149 ml) followed by VBN 5 (148 ml) and T9 (147 ml) which is an indication good quality of thick pancake. Thick pancake prepared using 5 black gram varieties were analyzed for the physicochemical and microbial load. The texture profile viz., springiness, cohesiveness, chewiness and gumminess was evaluated for VBN 5, CO 6, T9 and VBN 7 respectively. The protein content was higher in thick pancake prepared from VBN 5 (25.47/100 g) compared to CO 6 (24.66 g/100g). Among the selected varieties, CO 6, T9 and VBN 5 had good batter content, texture, and microstructure and were found to be most suitable for thick pancake preparation.

The nutritional compositions of sorghum stem sheath-Spondias mombin extract were evaluated. The enriched stem sheath extract were obtained by mixing sorghum stem sheath and Spondias mombin (iyeye) extract in varied proportions at 100:0; 0:100; 95:5; 90:10 and 85:15. The five samples were subjected to analysis: proximate, mineral, vitamin C, antinutrient composition. Data obtained were analysed using descriptive and inferential statistics. The result showed that observable increases were noticed in proximate, vitamin C and mineral composition from 5% inclusion of Spondias mombin extract in sorghum stem sheath drinks. The anti-nutrient compositions: tannin, oxalate and saponin, ranged from (0.144 to 0.442, 0.303 to 0.385, 0.070 to 0.198) mg/100 ml, respectively for sorghum stem sheath- Spondias mombin extract which were within consumable safe limits. The study concluded that nutritious enriched drinks could be produced from sorghum stem sheath and Spondias mombin extract at ambient temperature.

Background: Obstetric fistula is a condition that results from obstructed labour, which occurs when the baby cannot pass through the mother’s birth canal because it either does not come head first or is too large for her pelvis. Prompt medical intervention, often including Caesarean section, permits a safe delivery for both mother and child. Despite this possibility, yearly, thousands of women across the country receive no such aid and their labour is a futile agony lasting between three and five days, with uterine contractions constantly forcing the baby, usually head first, against the organs of the pelvic and unyielding pelvic bone resulting in Vesico Vaginal Fistula (VVF). The main thrust of this study was to examine how health system factors affect health seeking behaviour of women with obstetric fistula in Akwa Ibom and Ebonyi States, Nigeria. Methods: Qualitative and descriptive research approaches were adopted for the study and a total sample of two hundred and sixteen (216) respondents comprising of one hundred and fifty (150) post fistula repair operative patients and sixty six (66) health workers were purposively selected using simple random techniques. The data were analyzed using thematic analysis and tables of frequency. Results: The respondents views showed that availability of treatment centre and quality of health care services influenced health seeking behaviour of women with obstetric fistula in Nigeria. Conclusion: The study indicated that health seeking behaviour of women with obstetric fistula is a major challenge in Nigeria. Establishment and proper equipment of obstetric fistula treatment centres as well as subsidization of the cost of treatment to allow women with this health problem to access health care services are strongly recommended. Therefore, government at all level and non-governmental organizations need to educate the women and create awareness on the causes and dangers of VVF.

Advanced technologies, such as electrochemical impedance spectroscopy (EIS), are a valuable tool which can enhance and simplify the industrial process monitoring if used correctly. State-of-the-art approaches for screening the cell growth of for example yeast during the brewing process still heavily rely on offline methods such as methylene blue or florescence dye-based staining, and/or the usage of flow cytometric measurements. These methods, while being accurate, are very time consuming and require heavy manual effort. Furthermore, the time span needed to obtain the counting result can lead to a time-delayed response signal and can impact the quality of the final product. In recent studies, applications of low-frequency EIS in the α-regime were used for the determination of cell counts and the metabolic state in Saccharomyces cerevisiae. This method has proven to be a reliable tool which has also shown high potential in industrial scale applications. The online biomass monitoring, as well as viable cell count, for feasibility study was performed in-house at Stiegl Brewery in Salzburg/Austria founded in 1492.

Purpose: Adaptive planning is often needed in lung cancer proton therapy to account for geometrical variations, such as tumor shrinkage and other anatomical changes. The purpose of this study is to present our findings in adaptive radiotherapy for lung cancer using uniform scanning proton beams, including clinical workflow, adaptation strategies and considerations, and toxicities. Methods: We analyzed 165 lung patients treated using uniform scanning proton beams at our center. Quality assurance (QA) plans were generated after repeated computerized tomography (CT) scan to evaluate anatomic and dosimetric change during the course of treatment. Plan adaptation was determined mutually by physicists and physicians after QA plan evaluation, based on several clinical and practical considerations including potential clinical benefit and associated cost in plan adaption. Detailed analysis was performed for all patients with a plan adaptation, including the type of anatomy change, at which fraction the adaption was made, and the strategy for adaptation. Toxicities were compared between patients with and without plan adaptation. Results: In total, 32 adaptive plans were made for 31 patients out of 165 patients, with one patient undergoing adaptive planning twice. Anatomy changes leading to plan adaptation included tumor shrinkage (17), pleural effusion (3), patient weight loss (2), and tumor growth or other anatomy change (9). The plan adaptation occurred at the 15th fraction on average and ranged from the 1st to 31st fraction. Strategies of plan adaptation included range change only (18), re-planning with new patient-specific hardware (9), and others (5). Most toxicities were Grade 1 or 2, with dermatitis the highest toxicity rate. Conclusion: Adaptive planning is necessary in proton therapy to account for anatomy change and its effect on proton penetration depth during the course of treatment. It is important to take practical considerations into account and fully understand the limitations of plan adaptation process and tools to make wise decision on adaptive planning. USPT is a safe treatment for lung cancer patients with no Grade 4 toxicity.

The oocyte is the female gamete that contributes not only half of the genetic material but also all of the cytoplasm to the zygote, supplying the transcripts, proteins, mitochondria and other components necessary for early embryonic development. The intrinsic oocyte quality is one of the main factors affecting the embryo yield, the implantation rate and the rate of healthy offspring. It is obvious that a fertilized oocyte must reach the blastocyst stage within 6–9 days in the proper culture conditions to have a significant chance of inducing a pregnancy and producing an offspring. The ability to sustain the first week of embryonic development is clearly influenced by the follicular status from which the oocyte is obtained indicating that this developmental potential is inherent within certain oocytes. Since most early embryos that do not reach the blastocyst stage are blocked at or close to the maternal to zygotic transition (MZT)-stage, which occurs at the eight-cell stage in cattle, one could speculate that incompetent oocytes fail to appropriately activate the embryonic genome. Oocyte selection based on glucose-6-phosphate dehydrogenase (G6PDH) activity has been successfully used to differentiate between competent and incompetent bovine oocytes. Recently, molecular regulation of genes regulating biological process of Brilliant Cresyl Blue staining (BCB) selected oocytes and embryos was investigated to explain their variation in quality and developmental potentiality. This short review will highlights some of these efforts that have been done in this interesting area of research.

Care of kidney transplant recipient remains complex and long-term graft survival is not seen in every transplant recipient. Due to reduced supply and increased demand of human organs, more transplants are carried out using marginal grafts on emergency lists. Transplant recipients have altered physiology due to known end-stage renal disease, recent surgery and the use of potent analgesic and immunosuppressive medications. Amongst the known surgical complications, urine leak remains the most common. It can result from poor graft preparation due to excessive peri ureteric or lower pole dissection or damage to lower polar artery resulting in ischemic necrosis. In addition, poor surgical technique, bladder outflow obstruction, iatrogenic injury to bladder or renal pelvis may contribute to urine leak. Ongoing urine leak may manifest itself as swelling, pain, high drain output, sepsis, ileus and eventual graft loss. Early identification, localisation and quantification of leak remain essential in management of these patients. In addition, sepsis should be identified and treated promptly as these patients are highly susceptible to infections. Early recognition of this complication can significantly reduce hospital stay, improve quality of life and reduce graft loss and mortality. In this article, we aim to develop an evidence-based management approach to a patient with urine leak using a clinical scenario.

Climate change and the increasing global population pose a severe threat to the availability of freshwater in the world. Over consumption of water and deteriorating water quality are problems that should be addressed in order to ensure water availability for the coming decades. In this context, the increasing presence of micropollutants in water has shown to cause detrimental impact on water quality, given the negative disturbances that they can cause on human health and on the environment. Thus, it is important to study and quantify the presence of micropollutants in water bodies and also in regenerated wastewater based irrigation systems. 

Introduction: Forty-six per cent children have allergic rhinoconjunctivitis (Allergologica 2005). Working hypothesis: Ocular topical cyclosporine improves the quality of life for these patients. Material, methods, design: 2-year prospective study (2015-16), 40 patients with topical corticosteroids without improvement, followed 20 and 20 switched to corticosteroids cyclosporine 0.05%. Interview with Quality of Life Questionnaire in Children with rhinoconjunctivitis (PRQLQ) before and at the end of treatment. Mean age of 10.3 years with 60% male-40% female. Treatments were applied from January to March. There were 15 questions divided into two blocks. Children responded using a card with responses rated from zero (not bothered at all) to 6 (quite upset). Results: Before the 100% reported that, the itching was very bothersome. In the group of 40 children, 80% showed symptoms of epiphora and 60% showed symptoms of ocular inflammation. 100% complained of significant discomfort in rubbing their eyes, 30% did not like to take medications. Headaches affected 20%. 100% stated that they cannot play normally. 80% showed decreased concentration in class. Continuing with corticosteroids did not show statistically significant changes. Patients with cyclosporine improved the results by 3 points, with decreased itching, tearing, swelling, pain, eye rubbing, medication and headaches. In the 2nd questionnaire there was limited variation in the results related to fatigue, malaise, and irritability but with substantially improved balance of sleep, insomnia and concentration at school. Conclusion: Cyclosporine A is a cyclic polypeptide calcineurin inhibitor developed from the fungus Tolypocladium inflatum. The first dilution was 2% but it is currently used at a dilution of 0.05% and recent publications suggest nanosuspensions. Our study showed improvement in parameters related to symptoms, especially itching and lower improvement of psychological aspects, this achieves a better quality of life for children and more willingness to adhere to the treatment.