Hunterkelleher1400
T) of surgery with and without alpha-blockade will provide an answer.
Patients with sigmoid volvulus (SV) are at a high risk of recurrence with increased morbidity and mortality. This study aims to review whether patients with SV underwent definitive surgical treatment after initial endoscopic reduction according to the guidelines, and to compare mortality rate between surgical and conservative management.
Retrospective study conducted at East Kent Hospitals University NHS Foundation Trust, included all patients with SV between 2016 and 2018. The primary outcome was 30-day mortality following the initial management of the acute attack. check details Secondary outcomes were recurrence rate and overall mortality. The median follow-up period was 3 years.
A total of 40 patients were identified with a median age of 82 years; 27 (67%) were males. Of these 40 patients, 6 (15%) had emergency surgery, 26 (65%) received endoscopic decompression only, and 8 (20%) had planned definitive resection; 32 patients (80%) had recurrence and the median interval between any two episodes was 86 days. The mortality rate among patients with ASA grade 3 or 4 in the three groups, elective surgery, emergency surgery and decompression only, was 0%, 25% and 70% respectively, whereas it was 0%, 50% and 33% in those with ASA grade 2. The mortality rate among patients with similar ASA who had a planned surgery was significantly lower compared with those who did not undergo surgery (
=0.003).
In patients with sigmoid volvulus, regardless of ASA grade, performing early definitive surgery following initial endoscopic decompression resulted in a statistically significant lower mortality rate.
In patients with sigmoid volvulus, regardless of ASA grade, performing early definitive surgery following initial endoscopic decompression resulted in a statistically significant lower mortality rate.
This is the first study aimed at objectively quantifying the benefit of virtual education using WhatsApp-based discussion groups.
A prospective, non-randomised interventional study was undertaken in the Department of General Surgery, at a tertiary care centre in Kolkata, India, with 200 undergraduate students over a period of 5days each for 2weeks, with the first week acting as a control arm. A WhatsApp group was created consisting of 197 eligible undergraduates, faculty members and the authors of this study. Each day, three questions were posted on this group. The second week involved an hour-long WhatsApp-based discussion between the participants and the faculty. Responses were recorded and compared for improvements between the two weeks. Participant feedback was collected and analysed.
Statistically significant improvements were observed in the study group compared with the control group in rates of one in three, two in three and three in three correct responses (
=0.01649, 0.01146 and 0.00946, respectively). A total of 68 (51.92%) feedback respondents were satisfied with the programme. Convenience of use was the principal reason behind satisfaction in 79 respondents (60.31%), whereas 62 participants (47.33%) reported lack of hands-on training as a major drawback.
WhatsApp was found to be a satisfactory supplement to traditional medical teaching. It can be implemented to fill lapses in medical education, especially in light of the COVID-19 pandemic, which has caused great disruption to traditional teaching methods. Research is needed to assess the feasibility of incorporating it into the curriculum.
WhatsApp was found to be a satisfactory supplement to traditional medical teaching. It can be implemented to fill lapses in medical education, especially in light of the COVID-19 pandemic, which has caused great disruption to traditional teaching methods. Research is needed to assess the feasibility of incorporating it into the curriculum.
Patients with lingual thyroglossal duct cyst (TGDC) can present as symptomatic with obstructive airway and feeding difficulties.
We present 3 cases of symptomatic lingual TGDC.
All 3 patients were diagnosed with laryngomalacia and underwent further concurrent or delayed airway intervention, in addition to cyst removal.
We reason that there is a phenotype of laryngomalacia in the symptomatic lingual thyroglossal duct cyst patients who present with symptoms due to disruption in laryngeal anatomy rather than the cyst itself causing obstructive symptoms. Distinguishing this phenotype, especially in comparison to other pathologies such as vallecular cysts, may better allow for planning of concurrent or delayed airway procedures and overall counseling of parents.
We reason that there is a phenotype of laryngomalacia in the symptomatic lingual thyroglossal duct cyst patients who present with symptoms due to disruption in laryngeal anatomy rather than the cyst itself causing obstructive symptoms. Distinguishing this phenotype, especially in comparison to other pathologies such as vallecular cysts, may better allow for planning of concurrent or delayed airway procedures and overall counseling of parents.Blueberries (Vaccinium spp.) have been considered to be a superfood because of their health benefits. Stem blight or dieback of blueberry has been frequently observed in commercial plantations, with incidences between 15 and 30% being observed in China. The causal agents of blueberry stem blight and dieback were surveyed at four commercial blueberry plantations in the Shandong, Fujian, Guizhou, and Yunnan Provinces of China during 2017 and 2019. Twenty-eight isolates of Neofusicoccum were obtained from 75 diseased and dead stem samples. Two taxa were identified. Of these, one novel species, Neofusicoccum vaccinii, was identified based on morphological characteristics and DNA sequence analysis of the concatenated internal transcribed spacer, the translation elongation factor-1α gene, and the beta-tubulin gene. Koch's postulates tests indicated that N. vaccinii was pathogenic toward blueberry. N. parvum is the other species isolated in this study. The optimal temperature for mycelial growth was 30°C for both N. vaccinii and N. parvum. N. vaccinii, however, was more virulent than N. parvum in this study at temperatures ranging from 25 to 30°C. Coinoculation of N. vaccinii and N. parvum did not lead to increased disease severity. On the contrary, the aggressiveness of N. vaccinii was suppressed by the presence of N. parvum at 25 to 35°C.Hevea brasiliensis is widely planted in tropical and subtropical regions and is the main source of natural rubber production. The growth of rubber trees is plagued by various leaf diseases, resulting in decreased rubber production. From January to March in 2020, a severe leaf spots disease on Hevea brasiliensis found in Agricultural Science Base in Haidian campus of Hainan University (20° 03' 31″ N, 110° 19' 07″ E), Haikou, Hainan province, China. Spots were only observed on the mature green rather than young and bronze-colored leaves. This symptom has never been reported on the leaves of Hevea brasiliensis. During the early stages of the disease, gray leaf spots were concentrated to the leaf margins, but later expanded forming irregular gray lesions with chlorotic edges (Figure 1A). Eventually, lesions became necrotic shot holed, and leaves curled, wilted, and dropped. Five small pieces were cut from the margin of spots from different infected leaves, and were surface disinfected with 75% alcohol three timesycopersici causing leaf spot of Hevea brasiliensis in China, and Hevea brasiliensis is the global new host of S. lycopersici. Hevea brasiliensis is the main source of natural rubber and is widely planted in southern China. Therefore, it is imperative to implement disease management measures to prevent potential threats.Dendrobium officinale Kimura et Migo is a Chinese medicinal plant within the Orchidaceae. In September 2021, D. officinale seedlings in a greenhouse farm in the region of Wenzhou City (N28.11°, E120.98°), Zhejiang Province, China, were affected by stem rot. Symptoms initially occurred at the stem base with dark gray to black lesions, vascular discoloration, wilting and death. Approximately 30% of the surveyed plants were affected. To determine the causal agent, 10 symptomatic plant samples were collected. The necrotic tissue pieces (3×3 mm) from symptomatic stems were disinfected with 10% sodium hypochlorite for 1 min, rinsed three times with sterile water, and dried on sterile paper. Samples were then placed on potato dextrose agar (PDA), and incubated at 25℃ in the dark. After 3 days, reddish-white to yellow aerial mycelium with deep red pigments developed on PDA. A total of 15 single-spore isolates from all ten infected tissues were identified as Fusarium kyushuense based on morphological features (Aoki anuense has been reported to cause diseases on a broad range of plants in China, such as tobacco (Wang et al. 2013), maize (Wang et al. 2014) and rice (Zhao et al. 2007). To the best of our knowledge, this is the first report of F. kyushuense on D. officinale in China. D. officinale is native to Wenzhou, and spread of the disease may seriously affect the local economy and food security. This report will help diagnose stem rot of D. officinale and provide a foundation for development of management tools.Asian pear (Pyrus pyrifolia Nakai cv. cuiguan), is widely grown in Zhejiang province of China. In April 2019, symptoms consisting of small black, round leaf spots and blight flower petals were observed on over 30 % of 'Cuiguan' pear trees in an orchard (ca. 0.8 ha) near Cixi city, Zhejiang province, China. Initially, leaf spots were observed on leaf petioles, which, with time, enlarged and coalesced into necrotic streaks (1-2 cm) along the length of the petioles. Irregularly, reddish brown spots developed on flower petals, which hastened their senescence. Additional symptoms included round, black spots on leaves (2-3 mm in diameter) and necrosis of shoot tips. Symptomatic tissues from petals, petioles and leaves were plated onto potato dextrose agar (PDA). After five days of incubation at 26 °C, slimy fungal colonies (48×48 mm) with pinkish to orange-colored mycelia and with regular annulations were isolated from all tissues. After 10 days, cultured were shiny and dark brown in the center. The color of conidiom all inoculated plant. Overall, this disease shortened the life of pear flowers and reduced fruit set. To our knowledge, A. pullulans var. pullulans has not previously been reported as a pathogen of P. pyrifolia.Cowpea (Vigna unguiculata L. Walp) is one of the important legume crops of Nepal, which is consumed as a green vegetable or a dried pulse. In recent years, virus diseases have caused significant yield and quality losses in cowpea. In September 2019, five cowpea plants showing virus-like symptoms of mosaic, yellow mosaic, vein clearing, chlorotic spots, (Fig. S1) were collected in Chitwan, Nepal. The incidence of symptomatic plants in the three kitchen gardens was about 10-20%. To identify the viruses associated with the disease, a pooled sample from all five plants was screened initially by next generation sequencing (NGS). Total RNA was extracted from the symptomatic leaves using RNeasy Plant Mini Kit (Qiagen, Germany) and a transcriptome library was generated using the TruSeq Stranded Total RNA LT Sample Prep kit (Illumina, San Diego, CA) according to the standard protocol. NGS was performed using an Illumina NovaSeq 6000 system (Macrogen Inc. Korea). A total of 324,807 contigs in the range of 201-14,645 nucleotides (nt) were obtained and analyzed against the viral reference genome database in GenBank by BLASTn and BLASTx search.
