Appraisal of iron accumulation in soil, forages, and blood plasma of sheep and goats: a case study in different districts of Punjab, Pakistan.

Minerals are essential for ruminants affecting significantly the production of grazing livestock. Iron level in forages, soil, and blood plasma of the small ruminants (goat and sheep) was investigated in three districts of Punjab. Atomic absorption spectrophotometer was used to determine the concentration of iron in collected samples. The results revealed that the mean Fe concentrations in soil of districts Sargodha, Mianwali, and Bhakhar were significantly varied and ranged from 21.85 to 23.78, 28.45 to 31.2, and 18.079 to 24.33 mg/kg, respectively. The Fe level in soil of Mianwali significantly varied and was higher than Sargodha and Bhakkar. The mean Fe concentration in forages which were used for feeding purpose were significantly varied and found between 10.95-14.49, 23.63-25.65, and 6.616-9.45 mg/kg for Sargodha, Mianwali, and Bhakhar, respectively. The mean Fe concentrations in blood plasma of goat which consumed the contaminated forages were 8.5026-11.763 mg/L in district Sargodha, 19.77-20.19 mg/L in Mianwali, and 5.508-5.858mg/L in Bhakkar. In blood plasma of sheep, the residual levels of Fe in districts Sargodha, Mianwali, and Bhakhar were ranged from 9.987 to 12.455, 15.8 to 19.785, and 3.425 to 6.383 mg/L, respectively. This study provides the data of metals effected by different sites and also their mobility from low to higher trophic level which enables us to study the iron toxicity in different trophic levels, and we recommend different safe limits and treatment in case of low and high metal profile.

Appraisal of chromium in chicken reared on maize irrigated with sewage water.

In the present study, the outcome of sewage, canal, and ground water on the chromium (Cr) concentration in corn and ultimately in chicken body parts was reported. To evaluate Cr level, atomic absorption spectrophotometer (Flame Atomic Absorption Spectrophotometer AA 6300, Shimadzu Japan) was used. The highest level of Cr in grains (0.50 ± 0.05 mg/kg), shoots (0.90 ± 0.01 mg/kg), and roots (1.01 ± 0.02 mg/kg) were noticed in the Sadaf variety watered with canal water. The least concentration of Cr was recorded in grains (0.07 ± 0.01 mg/kg), shoots (0.59 ± 0.01 mg/kg), and roots (0.71 ± 0.01 mg/kg) of Pearl variety irrigated with ground water. The maximum concentration of chromium in the blood (1.68 ± 0.02 mg/kg) and bones (1.26 ± 0.24 mg/kg) was observed in chicks fed on Millet Research Institute (MMRI) grains reared with the sewage water. The lowest concentration was observed in the blood (1.60 ± 0.04 mg/kg) and in bone (0.80 ± 0.01 mg/kg) of the chicks fed Pearl variety grains reared with canal water. In the second experiment, the maximum content of Cr was determined in the blood (0.74 ± 0.04 mg/kg) and bones (1.76 ± 0.02 ppm) of chicks consuming Sadaf variety grains reared with canal water and the least concentration in the blood (0.26 ± 0.03 mg/kg) and bones (1.64 ± 0.01 mg/kg) was determined on the consumption of the Pearl variety grains reared with ground water. A similar trend was observed in other body organs. It was concluded that polluted water causes higher accumulation levels of Cr in plant parts and even in animals' body parts after the utilization of such plants.

Patient experience in a surgical assessment unit following a closed-loop audit using a Kaizen Lean system.

BACKGROUND: The Acute Surgical Assessment Unit (ASAU) in University Hospital Limerick (UHL) has provided a solution to overcrowding and long waiting times since centralization of emergency services to UHL. Recognising the importance of its evolving role, the ASAU in UHL has recently undergone a major revamp to ease the pressure in the overcrowded emergency department (ED). This included a new purpose state-of-the-art-built unit and equipment, improved staffing levels and use of a Kaizen Lean system to identify key area of delays and inefficiency with subsequent implementation of suggestions derived after Kaizen Lean. Patient satisfaction reporting was analysed in the older building and subsequently in the new site post Kaizen Lean to complete a closed-loop audit. The aim of the study was to examine patient satisfaction response rates with the ASAU prior to and following Kaizen Lean implementation and transfer to a new purpose-built unit. METHODS: The survey comprised of two phases. In phase 1, 100 questionnaires were distributed to patients in ASAU (older building, pre-Kaizen Lean). In phase 2, the survey was repeated (100 patients) after Kaizen Lean implementation and transfer to the new state-of-the-art unit. Questionnaire design was based on WHO strategy on responsiveness measurement guidelines and was tailored to a population of surgical patients. Results were analysed using IBM SPSS, version 21 and Excel 2013. RESULTS: Two hundred questionnaires were analysed. Implementation of suggestions derived post Kaizen Lean translated into improved resource usage with reduced waiting time to be seen by nurses and doctors. Patients had better awareness about their treatment plan and planned next steps in the management. Satisfaction across different domains, perceptions of privacy and overall treatment were also improved. CONCLUSIONS: A Kaizen Lean approach improved the transition of an ASAU to a new purpose-built unit and further improved overall patient satisfaction with services of the ASAU.

Patient satisfaction reporting-a cohort study comparing reporting of patient satisfaction pre- and post-discharge from hospital.

BACKGROUND: Patients' satisfaction reporting is important for assessing the quality of care in surgical practice. Post-discharge questionnaire reporting is considered best practice; however, the logistics of this method remains problematic. AIMS: To examine patient satisfaction response rates prior to and following discharge from the hospital in a general surgery department. METHODS: Two patient groups were examined: group 1-questionnaires were completed by patients prior to discharge; and group 2-questionnaires were posted to patients following discharge and were advised to return the questionnaire in a given time frame. The questionnaire design was based on the WHO strategy on measuring responsiveness guidelines tailored to a population of surgical patients. RESULTS: Four hundred and fifty patients were examined [group 1 (N = 150); group 2 (N = 300)]). Results from pre- and post-discharge questionnaires were similar in almost all parameters. The response rate dropped significantly in group 2, and the cost was also significantly higher. CONCLUSIONS: There were no significant differences in reporting between pre- and post-discharge questionnaire responses. As pre-discharge reporting is more efficient, less costly and has a higher response rate, this should be considered the preferred practice in patient satisfaction assessments.