To investigate the impact of the inhalation effort on the peak inspiratory flow through Turbuhaler, 100 asthmatics having a wide range of asthma severity (baseline forced expiratory volume in one second 28-127% of predicted normal) were studied. Each patient inhaled through four modifications of empty Turbuhaler inhalers, using first a "deep" inhalation and then a "forceful and deep" inhalation manoeuvre. Peak inspiratory flow increased by an average of 20% using a "forceful and deep" as compared to a "deep" inhalation, with a markedly higher increase for the patients who had a low peak inspiratory flow using the deep inhalation. Virtually all patients (97-100%) attained a peak inspiratory flow > or = 40 L x min(-1) after a "forceful and deep" inhalation. This study demonstrates that instructing the patient to take a "forceful and deep" inhalation optimizes the use of Turbuhaler. Irrespective of asthma severity, the vast majority of patients could attain a sufficiently high peak inspiratory flow with a "forceful and deep" inhalation.
When perusing a plastic surgery journal or attending a plastic surgery meeting, it is evident that the results shown in any given aesthetic presentation are considered by some to be excellent, whereas others deem the same results to be average or less than optimal. This disparity occurs when the interpretation of posttreatment results is based solely on subjective opinion. Certainly, the task of quantifying the results of aesthetic surgery (rather than just subjectively assessing their quality) is immense, but it is essential for aesthetic surgery to follow the trend toward evidenced-based medicine (EBM) that is becoming ingrained in the fabric of the medical profession as a whole. In fact, the quantification of aesthetic surgery results has more far-reaching ramifications than simply determining objective measures by which results can be judged. Objectively assessing the results of our cosmetic surgeries has the potential to change the way surgery is performed.
As we all learn more about the philosophies behind EBM (eg, in the Editorial1 by Dr. Felmont Eaves and Dr. Andrea Pusic in this month’s issue, on page 117), it is helpful to also find support among colleagues who have begun implementing it in their own practices. To that end, we would like to share with you the ways in which adding quantitative outcomes assessment, which is the cornerstone of EBM, has changed some of our own clinical approaches. Rigorous research has been conducted and published on how to quantify (instead of merely qualify) patient satisfaction outcomes.2-4 However, as Millard5 taught us, patient satisfaction or dissatisfaction with surgical results should never dissuade us from critically evaluating the results themselves objectively. Thus, it is necessary for us, as plastic surgeons, to adopt a two-pronged approach to the critical evaluation of our surgical results: we must understand our patients’ …
Samples from medial retropharyngeal, superficial cervical and deep femoral lymph nodes of four camels were fixed in neutral buffered formalin and prepared for light and electron microscopic examination.The camel lymph nodes were formed of stroma and parenchyma.A dense collagenous capsule and trabeculae beside fine reticular framework represented the stroma.The parenchyma was formed of follicular and non-follicular forms of lymphoreticular tissue.The lymphoid follicles were mainly secondary in nature formed of germinal center and outer corona.Afferent and efferent lymph vessels were noticed at the same area of the capsule.Capsular, subcapsular, trabecular, peritrabecular and parenchymal lymph sinuses were noticed in camel lymph nodes.
Background: Laparoscopic reversal of Hartmann’s procedure has been increasingly practiced worldwide since the laparoscopic era. However, so far only a few studies have been published regarding the results of this procedure. Aim of this study was to compare laparoscopic reversal of Hartmann’s (LHR) versus open reversal of Hartmann’s (OHR) procedure regarding to operative time, postoperative pain, hospital stay, postoperative complications and cost.Methods: This study was conducted on 40 patients with Hartmann’s colostomy admitted to the general surgery department, Tanta university hospitals, during the period from February 2017 to August 2019.Results: Regarding operative time, it was with a mean value 274.75±80.65 min in the LHR group and 156.75±32.81 min in the OHR group. The difference in time to pass flatus was with a mean value 1.78±0.68 days in the LHR group and 2.49±0.78 days in the OHR group. The difference in the hospital stay was with mean value 6.1±2.47 days in the LHR group and 9.3±2.20 days in the OHR group. Regarding post-operative complications; 6 patients (30%) developed post-operative complications while in the OHR group 10 (50%).Conclusions: In this era of minimal-access surgery and with increasing attention to fast-track protocols, we believe the laparoscopic approach should be the standard technique for patients undergoing reversal of Hartmann’s procedure. However, laparoscopic reversal of Hartmann’s procedure needs a surgical learning curve.
Plant diseases and pests are risk factors that threaten global food security. Excessive chemical pesticide applications are commonly used to reduce the effects of plant diseases caused by bacterial and fungal pathogens. A major concern, as we strive toward more sustainable agriculture, is to increase crop yields for the increasing population. Microbial biological control agents (MBCAs) have proved their efficacy to be a green strategy to manage plant diseases, stimulate plant growth and performance, and increase yield. Besides their role in growth enhancement, plant growth-promoting rhizobacteria/fungi (PGPR/PGPF) could suppress plant diseases by producing inhibitory chemicals and inducing immune responses in plants against phytopathogens. As biofertilizers and biopesticides, PGPR and PGPF are considered as feasible, attractive economic approach for sustainable agriculture; thus, resulting in a “win-win” situation. Several PGPR and PGPF strains have been identified as effective BCAs under environmentally controlled conditions. In general, any MBCA must overcome certain challenges before it can be registered or widely utilized to control diseases/pests. Successful MBCAs offer a practical solution to improve greenhouse crop performance with reduced fertilizer inputs and chemical pesticide applications. This current review aims to fill the gap in the current knowledge of plant growth-promoting microorganisms (PGPM), provide attention about the scientific basis for policy development, and recommend further research related to the applications of PGPM used for commercial purposes.
The current investigation was carried out to evaluate oxidative stress serum biomarkers , antioxidant concentrations and isolation the most common etiology of bacterial pneumonia. Thirty goats of different age and sex belonging to private farms in Giza governorate were used in this study .All goats were exposed to complete and comprehensive clinical examination. The animals were divided into two equal groups apparently healthy (15), diseased (15). Blood samples were collected from both groups to determine enzymatic activates of superoxidase dismutase (SOD), glutathione peroxidase (GPX) in erythrocyte haemolysate, catalase (CAT), vitamin C, vitamin E and Albumin, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), urea and creatinine, as well as nasal swabs were collected for isolation of possible bacteria. The levels of CAT, SOD and GPX were significant higher (p≤0.05), vitamins C, E were significant decrease (p≤0.05), Significant decrease (p≤0.05) in Albumin in pneumonic goats. Of 30 goats’ nasal swabs, 73.3% (22/30) yielded different bacterial isolates. Mannheimia (Pasteurella) haemolytica was the predominant isolates (81.8%; 18/22) and other isolates . It can concluded that pneumonia served to produce oxidative stress in the goat with increased activities of antioxidant enzymes to facing excessive production of free radicals. For healthier status in small ruminant antioxidant supplementation is very important as supportive treatment in diseased cases and preventive aid in healthy cases.
Keywords: Oxidative stress, Antioxidant, Vit. C, Bacteria, Pneumonia, goat