Optimizing nutrient utilization, hydraulic loading rate, and feed conversion ratios through freshwater IMTA-aquaponic and hydroponic systems as an environmentally sustainable aquaculture concept.

Water quality in land-based fish production can be controlled through either instantaneous water exchange or costly wastewater treatment followed by recirculation. Agricultural-aquaculture integration is an excellent alternative technique for reducing nutrient discharge levels, boosting profitability, and converting fish culture wastewater into valuable products. The current study employed a solar energy system to power two separate IMTA-aquaponics systems (Nutrient Film Technique, NFT, and Floating Raft Systems, FRS) for the cultivation of Nile tilapia, African catfish, thin-lipped grey mullet, freshwater crayfish, freshwater mussels, and a variety of vegetables. Tilapia and catfish were fed exclusively on diets under the IMTA system. All wastewater from tilapia and catfish ponds, both dissolved and solid, flows sequentially to ponds containing other cultivated species. The water then flows through the IMTA system's terminal point to the NFT and FRS systems before returning to the tilapia and catfish ponds, allowing complete control of the nutrient flow throughout this entire circular system. Two 147-day production cycles were concluded. The results from the second production cycle are reported. Total biomass gain for aquatic species in the IMTA system was 736.46 kg, compared to 145.49 kg in the tilapia and 271.01 kg in the catfish monoculture systems. The current IMTA system had a cumulative feed conversion ratio (FCR) of 0.90, while the FCRs for tilapia and catfish were 1.28 and 1.42, respectively. Nile tilapia and catfish consumed 571.90 kg of feed containing 25.70 kg of nitrogen (N) and 9.70 kg of phosphorus (P), reflecting, and gaining 11.41 and 3.93 kg of dietary N and P, representing 44.40 and 40.46% dietary N and P retention, respectively. In the IMTA system, the addition of mullet and prawn as detrivores aquatic animals improves dietary N and P utilization efficiency to 59.06 and 51.19%, respectively, while the addition of mussels as herbivore animals improves dietary N and P utilization efficiency to 65.61 and 54.67%, respectively. Finally, using FRS and NFT as hydroponic systems increased dietary N and P efficiency to 83.51% N and 96.82% P, respectively. This study shows that the IMTA-Aquaponic system, as a bio-integrated food production system, can convert the majority of fish-fed residues into valuable products suitable for desert, rural, and urban areas in impoverished and developing countries.

Auditory function assessment in patients with chronic obstructive pulmonary disease.

Background: Chronic obstructive pulmonary disease is a multisystem disease with multiple comorbidities. Hearing is dependent on the cochlear functions that may be affected by oxygenation. Affection of hearing is problematic and represents a major concern that should be seriously investigated as an important comorbidity in chronic obstructive pulmonary disease patients. Objective: To assess auditory status among chronic obstructive pulmonary disease patients. Methodology: The current study was carried out at Al-Azhar University Hospitals, Cairo, from 1 August 2021 to 2022, including 120 participants. In addition to the control group (60 healthy participants), there were two study groups: chronic obstructive pulmonary disease patients with respiratory failure group (30 patients) and non-respiratory failure group (30 patients). Hearing functions were studied using pure tone audiometry, and auditory brain stem response. Results: There was statistically significant hearing impairment in chronic obstructive pulmonary disease patients in comparison to control group. The hearing impairment was more significant in chronic obstructive pulmonary disease with respiratory failure group in comparison to chronic obstructive pulmonary disease without respiratory failure group. The auditory impairment shows a negative interrelationship with oxygen tension (PaO2) and a positive interrelationship with the smoking index. Conclusion: Hearing affection was meaningfully higher among chronic obstructive pulmonary disease patients and more prominent in patients with respiratory failure. Hypoxia results in deterioration of pure tone audiometry and increased absolute and interpeak latencies in auditory brain stem response. At every frequency, the mean pure tone audiometry thresholds were higher for chronic obstructive pulmonary disease groups than control group albeit remaining in the mild to moderate area of hearing loss. Retro-cochlear affection was suggested among patients with chronic obstructive pulmonary disease as evidenced with the prolongation of auditory brain stem response waves latencies.

Assessment of C-reactive protein levels as an indicator for lung infiltrates in patients with COVID-19 pneumonia.

Lung infiltrates are frequently observed in patients with COVID-19 infection and require specialized management. Identifying reliable laboratory parameters to reduce the need for chest CT scans in non-desaturation patients is of great interest. This study aimed to investigate the potential of C-reactive protein (CRP) as an indicator to identify the presence of lung infiltrates in early COVID-19 infection. The study was conducted at Al-Azhar University hospitals from May 2021 to March 2022 and included 210 patients with COVID-19 infection confirmed by positive PCR, all of whom were previously healthy, non-smokers, and non-hypoxemic. CRP levels were assessed and correlated with lung infiltrates observed in CT chest examinations. The mean value of CRP was 40.3±14.3 mg/L in males and 36.6±15.2 mg/L among females. One hundred sixty-two patients had pneumonic infiltrates, while 48 had no infiltrates. The mean value of CRP was 45.02±10.2 mg/L in patients with radiological infiltrates and 18.8±7.8 mg/L in patients without radiological infiltrates. Based on our findings, a CRP value greater than 29.8 mg/L was suggested as a cut-off value to indicate the presence of lung infiltrates. CRP is a simple laboratory marker that, at certain limits, may point to the presence of pneumonic infiltrates in early non-hypoxemic patients with COVID-19 infection.

Diaphragmatic excursion by ultrasound: reference values for the normal population; a cross-sectional study in Egypt.

Background: Measurement of diaphragmatic motion by ultrasound is being utilized in different aspects of clinical practice. Defining reference values of the diaphragmatic excursion is important to identify those with diaphragmatic motion abnormalities. This study aimed to define the normal range of diaphragmatic motion (reference values) by Mmode ultrasound for the normal population. Methods: Healthy volunteers were included in this study. Those with comorbidities, skeletal deformity, acute or chronic respiratory illness were excluded. Diaphragmatic ultrasound in the supine position was performed using a lowfrequency probe. The B-mode was applied for diaphragmatic identification, and the M-mode was employed for the recording of the amplitude of diaphragm contraction during quiet breathing, deep breathing and sniffing. Results: The study included 757 healthy subjects [478 men (63.14%) and 279 women (36.86%)] with normal spirometry and negative history of previous or current respiratory illness. Their mean age and BMI were 45.17 ±14.84 years and 29.36±19.68 (kg/m2). The mean right hemidiaphragmatic excursion was 2.32±0.54, 5.54±1.26 and 2.90±0.63 for quiet breathing, deep breathing and sniffing, respectively, while the left hemidiaphragmatic excursion was 2.35±0.54, 5.30±1.21 and 2.97±0.56 cm for quiet breathing, deep breathing and sniffing, respectively. There was a statistically significant difference between right and left diaphragmatic excursion among all studied subjects. The ratio of right to left diaphragmatic excursion during quiet breathing was (1.009±0.19); maximum 181% and minimum 28%. Only 19 cases showed a right to left ratio of less than 50% (5 men and 14 women). The diaphragmatic excursion was higher in males than females. There was a significant difference in diaphragmatic excursion among age groups. Age, sex and BMI significantly affected the diaphragmatic motion. Conclusions: Diaphragmatic excursion values presented in this study can be used as reference values to detect diaphragmatic dysfunction in clinical practice. Diaphragmatic motion is affected by several factors including age, sex and body mass index.