Impact of tumor size on the outcomes of hepatic resection for hepatocellular carcinoma: a retrospective study.

BACKGROUND: To evaluate the impact of tumor size on the perioperative and long-term outcomes of liver resection for hepatocellular carcinoma (HCC). METHODS: We reviewed the patients' data who underwent liver resection for HCC between November 2009 and 2019. Patients were divided into 3 groups according to the tumor size. Group I: HCC < 5 cm, Group II: HCC between 5 to 10 cm, and Group III: HCC ≥ 10 cm in size. RESULTS: Three hundred fifteen patients were included in the current study. Lower platelets count was noted Groups I and II. Higher serum alpha-feto protein was noted in Group III. Higher incidence of multiple tumors, macroscopic portal vein invasion, nearby organ invasion and presence of porta-hepatis lymph nodes were found in Group III. More major liver resections were performed in Group III. Longer operation time, more blood loss and more transfusion requirements were found in Group III. Longer hospital stay and more postoperative morbidities were noted in Group III, especially posthepatectomy liver failure, and respiratory complications. The median follow-up duration was 17 months (7-110 months). Mortality occurred in 100 patients (31.7%) and recurrence occurred in 147 patients (46.7%). There were no significant differences between the groups regarding recurrence free survival (Log Rank, p = 0.089) but not for overall survival (Log Rank, p = 0.001). CONCLUSION: HCC size is not a contraindication for liver resection. With proper selection, safe techniques and standardized care, adequate outcomes could be achieved.

[Revision of Vertical Banded Gastroplasty to Roux-En-Y Gastric Bypass with 2 Years of Follow-Up].

BACKGROUND: Due to weight regain and GIT symptoms associated with vertical banded gastroplasty (VBG), revisional surgery is necessary. Roux-en-Y gastric bypass (RYGB) is one of the best options as a revision procedure but comes with a high complication rate. METHODS: This prospective study included 80 patients undergoing RYGB surgery at Ain Shams University Hospitals after failed VBG surgery, with up to 2 years of follow-up. RESULTS: Eighty patients underwent RYGB correction after VBG. The mean age was 42 ± 6.45 (39-58) years and the mean preoperative body mass index was 45.46 ± 4.135 (38-55) kg/m2. The median length of hospital stay for the patients was 4.78 ± 1.84 days. The early postoperative complication rate was 8.7% and the reoperation rate within 30 days was 3.75%, with no mortality. Leakage and bowel injury were detected in 2 patients. After an average follow-up of 2 years, the percentage of EWL was 64.47 ± 19.3, and complete resolution of VBG-related GIT symptoms was achieved in approximately all patients. Late complications occurred in 7.5% of patients, of whom 3.75% required surgery. CONCLUSION: Conversion to RYGB is feasible with a limited short-term complication and reoperation rate; long-term results show a nearly complete resolution of VBG-related symptoms and a statistically significant positive impact on weight loss.

Up-regulated serum levels of soluble CD25 and soluble CD163 in pediatric patients with SARS-CoV-2.

Similar to hemophagocytic lymphohistiocytosis (HLH), some patients with SARS-CoV-2 have cytokine storm. Serum soluble interleukin-2 receptor (sCD25) and soluble CD163 (sCD163) are potential diagnostic biomarkers for HLH that help in guiding its treatment. This study was the first to investigate serum sCD25 and sCD163 levels in SARS-CoV-2. Serum sCD25 and sCD163 were measured by ELISA in 29 patients with SARS-CoV-2, aged between 2 months and 16 years (13 had COVID-19 and 16 had multisystem inflammatory syndrome in children (MIS-C)), in comparison to 30 age- and sex-matched healthy control children and 10 patients with HLH. Levels of these markers were re-measured in 21 patients with SARS-CoV-2 who were followed up 3 months after recovery. Patients with SARS-CoV-2 had significantly higher serum sCD25 and sCD163 than healthy control children (P < 0.001). SARS-CoV-2 patients had significantly higher sCD25 than patients with HLH (P < 0.05). Serum sCD25 was a good differentiating marker between patients with SARS-CoV-2 and HLH. Although there was a significant decrease of serum sCD25 and sCD163 of the 21 SARS-CoV-2 patients who were followed up, these levels were still significantly higher than the healthy controls levels (P < 0.001).  Conclusion: Serum sCD25 and sCD163 levels were up-regulated in SARS-CoV-2 patients. Serum sCD25 was a good differentiating marker between SARS-CoV-2 and HLH. This initial report requires further studies, on large scales, to investigate the relationship between SARS-CoV-2 and both sCD25 and sCD163, including the disease severity and outcome. The therapeutic role of sCD25 and sCD163 antagonists should also be studied in SARS-CoV-2 patients. What is Known: • Similar to hemophagocytic lymphohistiocytosis (HLH), some patients with COVID-19 have cytokine storm due to excessive pro-inflammatory host response. • Serum soluble interleukin-2 receptor (sCD25) and soluble CD163 (sCD163) are potential diagnostic biomarkers for HLH. Monitoring of serum sCD25 and sCD163 levels can also help in guiding the treatment. What is New: • Serum sCD25 and sCD163 levels are up-regulated in patients with COVID-19, including patients presenting with multisystem inflammatory syndrome in children (MIS-C). • Serum sCD25 is a good differentiating marker between SARS-CoV-2 and HLH.

Using femtosecond laser pulses for electronic distance meter calibration.

Electronic distance meters (EDMs) are widely used in different applications, such as surveying and civil engineering. In order to calibrate an EDM, different techniques can be used, including displacement interferometers and reference baselines. In this paper, an indoor baseline is designed and then accurately measured using femtosecond laser pulses from an optical frequency comb to be used for EDM calibration. The baseline consists of 13 fixed bases that cover 58 m distance. In order to accurately measure the distances between the bases, autocorrelation between femtosecond laser pulses is employed. The measurement shows a maximum precision of 14 µm over the 13 bases. Although this deviation is dominated mainly by the placement of the target mirror, the system capability is much more sufficient to safely calibrate the best available commercial EDM. The stability of the baseline is also investigated by measuring the interbase distances over long periods of time.

Adiponectin serum levels and ADIPOQ (rs2241766) polymorphism in alopecia areata Egyptian patients.

BACKGROUND: Alopecia Areata (AA) is an acquired autoimmune form of non-scarring hair loss. Adiponectin and its gene polymorphism were related to many autoimmune disorders. OBJECTIVE: Assessment of adiponectin serum levels and adiponectin gene (ADIPOQ) (rs2241766) Single Nucleoid Polymorphism (SNP) in AA patients and correlating the results with the disease severity in those patients. METHODS: This study included 75 AA patients and 75 age and gender-matched healthy subjects (controls). The severity of Alopecia Tool (SALT) score assessment to evaluate AA severity was done. Adiponectin serum levels by ELISA and ADIPOQ (rs2241766) SNP using PCR were performed. RESULTS: Adiponectin serum levels were significantly lower in AA patients than controls (p = 0.001). ADIPOQ (rs2241766) TG genotype and G allele were significantly predominant in AA patients increasing its risk by 5 and 4 folds (OR = 5.17, p = 0.001), (OR = 3.82, p = 0.001) respectively. Serum adiponectin levels were negatively correlated with SALT score (r = -0.435, p = 0.001) and associated with alopecia totalis (p = 0.016). ADIPOQ (rs2241766) TG genotype was significantly associated with low serum adiponectin levels and higher SALT score (p = 0.001). STUDY LIMITATIONS: The small sample size. CONCLUSIONS: ADIPOQ (rs2241766) gene polymorphism (TG genotype and G allele) may modulate AA risk and contribute to the development of AA in Egyptian populations. Decreased circulating adiponectin levels may have a dynamic role in AA etiopathogenesis. Adiponectin serum concentration can be considered a severity marker of hair loss in AA.

Serum and Seminal Plasma Levels of Lead and Arsenic in Cigarette Smokers and Their Relation to the Semen Parameters.

Male infertility along with altered semen parameters have been related to smoking. Smoking-related elevations in serum and seminal lead (Pb) and arsenic (As) may play a role in mediating the toxic effects of smoking on seminogram. This research aims to determine whether smoking has any significant impact on Pb and As levels in the seminal plasma and serum, as well as on the various semen parameters, when compared to nonsmokers. In total, 80 adult males were included: 60 smokers and 20 age-matched nonsmokers. Based on the number of cigarettes smoked/day (CPD), the smokers were categorized into mild (1-10), moderate (11-20), and severe (> 20). The analysis of semen was conducted in accordance with the 2010 WHO laboratory manual. Using an atomic absorption spectrophotometer, Pb and As concentrations in the serum and seminal plasma of all groups were determined. Compared to nonsmokers, smokers had a significantly reduced sperm count, motility, and viability, as well as a larger percentage of aberrant forms (P = 0.001, 0.025, 0.034, 0.002 respectively). Smokers had higher Pb concentrations in their serum and seminal fluid than nonsmokers (P = 0.002, 0.001 respectively). Seminal Pb had a significant negative correlation with sperm count (P = 0.004, r = -0.320). Serum Pb levels were found to positively correlate with seminal Pb levels (P 0.001, r = 0.648), and cigarette smokers had substantially greater seminal As levels than nonsmokers (P = 0.024). Sperm viability was strongly inversely related to seminal As (P = 0.042, r = -0.264). Seminal As levels and aberrant sperm shapes were found to be significantly correlated (P = 0.001, r = 0.414). In smokers, a significant positive relationship between seminal As and seminal Pb was observed. Therefore, semen parameters could be adversely affected by smoking through high levels of Pb and As (P = 0.012, r = 0.298).

Denitrification of nitrate in regeneration waste brine using hybrid cation exchanger supported nanoscale zero-valent iron with/without palladium nanoparticles.

The Sustainable Development Goals require that reducing waste is a priority. This work described the application of an innovative zero-waste hybrid ion exchange nanotechnology that concurrently removed nitrate and induced denitrification to ammonia, with the ability to generate fertilizer for the agriculture sector from the recycled by-products. Herein, hybrid cation exchanger-supported zero-valent iron (Fe0), and bimetallic Fe0/Pd nanoparticles (HCIX-Fe0 and HCIX-Fe0/Pd) were synthesized and successfully validated for denitrification of nitrate in spent waste brine that contained nitrate. The kinetics of nitrate catalysis by both HCIX-Fe0 and HCIX-Fe0/Pd were compared and presented by six kinetic models, namely, zero-order, pseudo first- and second-order reaction, pseudo first- and second-order adsorption, and Elovich. HCIX-Fe0/Pd displayed a higher kinetic value than HCIX-Fe0, with k1 of 0.0019 and 0.0026 min-1, respectively. Nitrate was predominantly catalysed to NH4+ at a ratio of ammonia to other nitrogen compounds of around 80:20. Although HCIX-Fe0/Pd showed slightly better (14%) kinetic results, it was determined as unfavourable for real-life application due to low selectivity toward N2 gas and the need to use H2 gas. Based on practicability, the HCIX-Fe0 was further validated. The effect of salt (using NaCl) and the role of initial pH conditions were optimized and discussed. The recovery of nitrate removal was also calculated, and a recovery range of 91.42-99.14% was obtained for three consecutive runs. The sustainable, novel, zero waste hybrid ion exchange nanotechnology using the combination of two fixed-bed columns containing nitrate-selective resin for nitrate removal and novel HCIX-Fe0 for nitrate reduction to NH4+ may be a promising sustainable solution toward the goal of discharging zero nitrate waste to the environment.

Ulcerative colitis as a possible sequela of COVID-19 Infection: The endless story.

The coronavirus disease 2019 (COVID-19), caused by the novel coronavirus SARS-CoV-2, is a new type of acute infectious respiratory syndrome that usually presents with mild flu-like symptoms. However, the disease caused widespread illness and death worldwide, and new sequelae are still being discovered. SARS-CoV-2 RNA was isolated from the fecal samples of some infected patients. Many pathogens, including many viral infections, were linked either to the onset or the exacerbation of inflammatory bowel disease (IBD). With this, we report a series of 2 IBD cases that were diagnosed shortly after recovery from COVID-19. This is the first report that discusses the possibility of developing IBD following COVID-19 infection to the best of our knowledge. This could highlight the importance of thoroughly investigating COVID-19 patients who presented with diarrhea, particularly those with bloody diarrhea, and not consider it a simple manifestation of COVID-19 infection.

The COVEG score to predict severity and mortality among hospitalized patients with COVID-19.

INTRODUCTION: COVID-19 severity and mortality predictors could determine admission criteria and reduce mortality. We aimed to evaluate the clinical-laboratory features of hospitalized patients with COVID-19 to develop a novel score of severity and mortality. METHODOLOGY: This retrospective cohort study was conducted using data from patients with COVID-19 who were admitted to five Egyptian university hospitals. Demographics, comorbidities, clinical manifestations, laboratory parameters, the duration of hospitalization, and disease outcome were analyzed, and a score to predict severity and mortality was developed. RESULTS: A total of 1308 patients with COVID-19, with 996 (76.1%) being moderate and 312 (23.9%) being severe cases, were included. The mean age was 46.5 ± 17.1 years, and 61.6% were males. The overall mortality was 12.6%. Regression analysis determined significant predictors, and a ROC curve defined cut-off values. The COVEG severity score was defined by age ≥ 54, D-dimer ≥ 0.795, serum ferritin ≥ 406, C-reactive protein ≥ 30.1, and neutrophil: lymphocyte ratio ≥ 2.88. The COVEG mortality score was based on COVEG severity and the presence of cardiac diseases. Both COVEG scores had high predictive values (area under the curve 0.882 and 0.883, respectively). CONCLUSIONS: COVEG score predicts the severity and mortality of patients with COVID-19 accurately.

Depression among health workers caring for patients with COVID-19 in Egypt.

BACKGROUND: Health care workers caring for patients with COVID-19 pandemic are prone to extraordinary stressors and psychological problems. The aim of this study was to estimate the prevalence and risk factors of major depressive disorder among health care providers who are caring for patients with COVID-19. METHODS: Two hundred-seventy of health care workers were screened for depressive symptoms by DASS-21 Questionnaire. Only 152 of the participants accepted to be interviewed using SCID-I for diagnosis of major depressive disorder. RESULTS: According to DASS-21, 28.1% of HCWs had mild-to-moderate depressive symptoms, and 64.8% with severe symptoms. Of 152 who were interviewed using SCID-I, 74.3% were diagnosed with major depression disorder.Young age, decreased sleep hours, female sex, past history of a psychiatric disease, fear of COVID-19 infection for themselves or their relatives, and fear of death with COVID-19 for themselves or their relatives were significant predictors for major depressive disorder and its severity. CONCLUSION: Major depressive disorder is common among HCWs during COVID-19 pandemic. Screening for depression, particularly for young females, and early treatment are recommended.

Original Article--Predictors of Persistent Functional Tricuspid Regurgitation After Transcatheter Closure of Atrial Septal Defect and its Relationship to Tricuspid Valve Remodeling.

OBJECTIVES: The aim of this study is assessment of persistent functional tricuspid regurgitation in patients with atrial septal defect before and after successful device closure and its relationship to tricuspid valve remodeling. METHODS: The current study was conducted on 60 patients referred to Tanta University Hospital Cardiology Department with the provisional diagnosis of atrial septal defect secundum type for transcatheter closure from December 2017 to December 2019. All patients were subjected to history taking, clinical examination, 12 lead electrocardiography, plain chest X-ray, full two dimension transthoracic echocardiography (for assessment of tricuspid regurgitation severity) before and at 3, 6 months after transcatheter closure. RESULTS: Tricuspid regurgitation was decreased significantly after atrial septal defect closure due to remodeling in the right side. Age, estimated systolic pulmonary artery pressure, right atrium end systolic area, right ventricular end diastolic area, tricuspid valve tenting area and height, tricuspid septal leaflet angle and tricuspid annular diameter were predictors of persistent tricuspid regurgitation after 3 and 6 months of closure. Only estimated systolic pulmonary artery pressure, tricuspid septal leaflet angle and tricuspid annular diameter were independent predictors of persistent tricuspid regurgitation after 3, and 6 months of closure. CONCLUSION: Tricuspid regurgitation significantly improved after transcatheter atrial septal defect closure despite its significance at baseline due to remodeling in right side and tricuspid valve.

COVID-19 Infection Stigma Scale: psychometric properties.

BACKGROUND: Stigma has been noticed towards patients with COVID-19 in several regions of the world. This social discrimination has contributed to delay in diagnosis and treatment. Also, it may increase the suffering of the patients leading to poor outcome of the illness. Stigma can be assessed with the use of a valid and reliable instrument developed and adapted to our culture. Our objective was to analyze the psychometric properties of COVID-19 Infection Stigma Scale (CISS) for measuring the social stigma among patients with COVID-19 in Egypt. A cross-sectional study that included 182 COVID-19 patients was carried out. The reliability, the convergent validity, and the external and internal consistency of the scale were measured. Factor analysis was used to exclude the weak items. RESULTS: The mean of the COVID-19 Infection Stigma Scale scores was 34.97±10.35 which was higher than 50% of the score. Absence of the floor and ceiling effects was observed. Cronbach's alpha coefficient for scale reliability ranged from 0.75 to 0.94 with 0.82 for the total score. The convergent validity coefficients ranged from 0.36 to 0.63. Test-retest validity Pearson's correlation coefficients ranged from 0.72 to 0.92 with 0.89 for the total score. The split half correlation coefficient was 0.86, and the reliability coefficient was 0.92. Both were acceptable correlation coefficients for internal consistency of the scale. Factor analysis showed two factors had latent root greater than 1. The rotated component matrix of the 2 factors revealed that all questions had r value more than 0.30, which means that no need to exclude any of them. CONCLUSION: The results showed that the COVID-19 Infection Stigma Scale is a valid and reliable instrument for the Egyptian people. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41983-021-00317-0.

Cost-effectiveness analysis of three methods of surgical-site infection surveillance: Less is more.

BACKGROUND: A considerable proportion of surgical site infections (SSI) could be prevented by surveillance. The study aimed to compare the cost-effectiveness of 3 methods of SSI surveillance: Inpatient, phone, and out-patient clinic (OPC); to ensure that the risk of SSI is independent from loss-to-follow-up in phone and OPC surveillances, and to determine the reliability of phone surveillance. METHODS: A cohort of 351 surgical patients were followed by 3 different surveillance methods: inpatient, follow-up in OPC and over the phone. Costs of nurse time and phone calls were expressed in 2019 USD. Effectiveness of surveillance was assessed using number of detected SSIs. RESULTS: Phone surveillance was more cost-effective than OPC surveillance. Compared to inpatient surveillance, the OPC method costs USD 15.6 per extra detected SSI, whereas the phone method costs only USD 4.6 In phone and OPC surveillances, the risk of SSI was independent of loss-to-follow-up. However, the higher rate of SSI among OPC attendees raises the suspicion that the incidence of SSI estimated by OPC surveillance could be biased upward. Phone surveillance was reliable with high sensitivity and specificity. CONCLUSIONS: Phone surveillance was a reliable cost-effective method. Inpatient surveillance was less effective, but it still can be used to detect severe SSI at low cost. While out-patient-clinic surveillance had the highest cost, the incidence estimated by it might be biased upward.

Adiponectin serum levels and ADIPOQ (rs2241766) polymorphism in alopecia areata Egyptian patients

Abstract Background Alopecia Areata (AA) is an acquired autoimmune form of non-scarring hair loss. Adiponectin and its gene polymorphism were related to many autoimmune disorders. Objective Assessment of adiponectin serum levels and adiponectin gene (ADIPOQ) (rs2241766) Single Nucleoid Polymorphism (SNP) in AA patients and correlating the results with the disease severity in those patients. Methods This study included 75 AA patients and 75 age and gender-matched healthy subjects (controls). The severity of Alopecia Tool (SALT) score assessment to evaluate AA severity was done. Adiponectin serum levels by ELISA and ADIPOQ (rs2241766) SNP using PCR were performed. Results Adiponectin serum levels were significantly lower in AA patients than controls (p = 0.001). ADIPOQ (rs2241766) TG genotype and G allele were significantly predominant in AA patients increasing its risk by 5 and 4 folds (OR = 5.17, p = 0.001), (OR = 3.82, p = 0.001) respectively. Serum adiponectin levels were negatively correlated with SALT score (r = -0.435, p = 0.001) and associated with alopecia totalis (p = 0.016). ADIPOQ (rs2241766) TG genotype was significantly associated with low serum adiponectin levels and higher SALT score (p = 0.001). Study limitations The small sample size. Conclusions ADIPOQ (rs2241766) gene polymorphism (TG genotype and G allele) may modulate AA risk and contribute to the development of AA in Egyptian populations. Decreased circulating adiponectin levels may have a dynamic role in AA etiopathogenesis. Adiponectin serum concentration can be considered a severity marker of hair loss in AA.

An Assessment Scale for Patients with Postoperative Superficial Incisional Surgical Site Infection: a Cross-Sectional Study.

Superficial incisional surgical site infection (SSI) is a common postoperative complication in surgical patients. The aim of this study was to assess the predictive power of an assessment scale for identifying patients at risk of superficial incisional SSI. A cross-sectional survey was conducted at the Department of Surgery at the Medical Research Institute Hospital, Alexandria University. A sample of 150 adult patients aged from 18 to 65 years, who undergoing general surgeries that had clean sutured surgical wounds, was randomly selected. Forty-six patients (30.7%) had SSI. The total score can significantly discriminate between positive and negative superficial incisional SSI patients with diagnostic accuracy of AUC (SE) = 0.66 (0.048). Each score more than the cutoff point (11.5) will increase the risk of surgical site infection development by 2.5 times (OR (95% CI) = 2.5 (1.26-3.1)). The developed assessment scale can discriminate between patients who are at risk of superficial incisional SSI and those who are not. It can be used as a preliminary screening tool for subsequent investigation for the presence of infection.

Synthesis and characterization of hybrid iron oxide silicates for selective removal of arsenic oxyanions from contaminated water.

A series of hybrid silicates containing iron oxides was synthesized by adding various amounts of iron into silica on the basis of using post precipitation mechanism from aqueous solutions in order to form hydrated iron oxide species (HFO). The obtained materials were characterized by XRD, SEM, TEM, FTIR, Zeta potential and low temperature nitrogen sorption. XRD analysis confirmed that HFO-Si was amorphous and iron oxide crystals in the silica cannot be detected due to the lower size of HFO, which is the probability of its occupied interstitial positions in the silicate matrix. However, TEM image showed the presence of nano-sized HFO located inside the silicate matrix. The adsorption properties and selective efficiency of the synthesized materials were examined with respect to the removal of As(V) and As(III) species from contaminated water under different experimental conditions and in the presence of competing anions. Increasing iron loading enhanced the arsenic adsorption capacity of HFO-Si; the maximum level of arsenic removal was 300mg As/g HFO-Si after 5 successive loads.

Synthesis, Characterization, Tautomeric Structure and Solvatochromic Behavior of Novel 4-(5-Arylazo-2-Hydroxystyryl)-1-Methylpyridinium Iodide as Potential Molecular Photoprobe.

A novel series of the title compound 4-(5-arylazo-2-hydroxystyryl)-1-methylpyridinium iodide 6 has been synthesized via condensation reactions of the arylazosalicylaldehyde derivatives 4a-i with 1-methyl-picolinium iodide 5. The structures of the new arylazo compounds were characterized by ¹H NMR, IR, mass spectroscopy, as well as spectral and elemental analyses. The electronic absorption spectra of arylazomerocyanine compounds 6 were measured in different buffer solutions and solvents. The pK's and pK*'s in both the ground and excited states, respectively, were determined for the series and their correlations with the Hammett equation were examined. The results indicated that the title arylazomerocyanine dyes 6 exist in the azo form 6A in both ground and excited states. The substituent and solvent effects (solvatochromism) of the title compound arylazomerocyanine dyes were determined using the Kamlet-Taft equation and subsequently discussed.

Rare extraperitoneal involvement with fatal outcome in a case of bilateral luteinized thecoma of the ovaries with sclerosing peritonitis.

We report the case of a woman diagnosed with bilateral luteinized thecoma of the ovaries with sclerosing peritonitis, multiple intraperitoneal cystic lesions, and extraperitoneal lesions of the liver, inferior to the spleen, and high suspicion of bone marrow involvement. The patient developed profound pancytopenia with rapid clinical deterioration and a fatal outcome.

Comparing a combination of penicillin G and gentamicin to a combination of clindamycin and amikacin as prophylactic antibiotic regimens in prevention of clean contaminated wound infections in cancer surgery.

BACKGROUND AND AIM: Appropriate antibiotic selection and timing of administration for prophylaxis are crucial to reduce the likelihood of surgical site infection (SSI) after a clean contaminated cancer surgery. Our aim is to compare the use of two prophylactic antibiotic (PA) regimens as regards efficacy, timing, and cost. PATIENTS AND METHODS: Two hundred patients with gastric, bladder, or colorectal cancer were randomized to receive preoperative PA, group A received penicillin G sodium and gentamicin and group B received clindamycin and amikacin intravenously. The demographic data of patients were collected, and they were observed for wound infections. RESULTS: Infected wounds occurred in 19 patients with a rate of 9.5%. Highest incidence of SSI was among bladder cancer patients (14.2%); p=0.044. The rate of SSI was 11% in group A, and 8% in group B, p=0.469. The cost of PA administered in group A was significantly less than that of group B (21.96±3.22LE versus 117.05±12.74LE, respectively; p<0.001). SSI tended to be higher among those who had longer time for antibiotic and incision (≥30min) than those who had shorter time interval (<30min), (13% vs. 6.5%, respectively). CONCLUSION: Both penicillin+gentamicin and clindamycin+amikacin are safe and effective for the prevention of SSI in clean contaminated operative procedures. In a resource limited hospital, a regimen including penicillin+gentamicin is a cost-effective alternative for the more expensive and broader coverage of clindamycin+amikacin. Timing of PA is effective in preventing SSIs when administered 30min before the start of surgery.

Carminic acid modified anion exchanger for the removal and preconcentration of Mo(VI) from wastewater.

Removal and preconcentration of Mo(VI) from water and wastewater solutions was investigated using carminic acid modified anion exchanger (IRA743). Various factors influencing the adsorption of Mo(VI), e.g. pH, initial concentration, and coexisting oxyanions were studied. Adsorption reached equilibrium within <10 min and was independent of initial concentration of Mo(VI). Studies were performed at different pH values to find the pH at which maximum adsorption occurred and was determined to be at a pH between 4.0 and 6.0. The Langmuir adsorption capacity (q(max)) was found to be 13.5mg Mo(VI)/g of the adsorbent. The results showed that modification of IRA743 with carminic acid is suitable for the removal of Mo(VI), as molybdate, from water and wastewater samples. The concentration of Mo(VI) was determined spectrophotometrically using bromopyrogallol red as a complexation reagent. This allows the determination of Mo(VI) in the range 1.0-100.0 µg/mL. The obtained material was subjected to efficient regeneration.