Evaluation of Pesticide Residues in Vegetables from the Asir Region, Saudi Arabia.

This study's aim was to determine the pesticide residues in 10 different vegetable commodities from the Asir region, Saudi Arabia. We evaluated 211 vegetable samples, collected from supermarkets between March 2018 and September 2018, for a total of 80 different pesticides using ultrahigh-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) and gas chromatography-tandem mass spectrometry (GC-MS/MS) after extraction with a multi-residue method (the QuEChERS method). The results were assessed according to the maximum residue limit (MRL) provided by European regulations for each pesticide in each commodity. All lettuce, cauliflower, and carrot samples were found to be free from pesticide residues. A total of 145 samples (68.7%) contained detectable pesticide residues at or lower than MRLs, and 44 samples (20.9%) contained detectable pesticide residues above MRLs. MRL values were exceeded most often in chili pepper (14 samples) and cucumber (10 samples). Methomyl, imidacloprid, metalaxyl, and cyproconazole were the most frequently detected pesticides. Based on the results of this study, we recommend that a government-supported program for the monitoring of pesticide residues in vegetables be established to promote consumers' health and achieve sustainable farming systems.

Rectal vs. sublingual misoprostol before cesarean section: double-blind, three-arm, randomized clinical trial.

PURPOSE: The commonest surgical procedure for women is cesarean delivery. Postpartum hemorrhage and intra-operative blood during cesarean delivery is a major concern to all obstetricians. This study was conducted to assess the efficacy of the adjuvant use of misoprostol and oxytocin in decreasing intra-operative blood loss in cesarean delivery. METHODS: This was a double-blinded randomized clinical trial including 636 term pregnant woman scheduled for cesarean section at Ain Shams University Maternity Hospital, Cairo, Egypt, between February 2013 and February 2014. Participants received either 400-µg misoprostol rectally or sublingually or placebo before cesarean section together with 5-IU oxytocin IV. The main outcome measure was intra-operative blood loss. Difference between the three groups was analyzed using one-way ANOVA test (for numeric variables) and Chi-square test (for categorical variables). P < 0.05 was considered statistically significant. RESULTS: Intra-operative blood loss was higher in patients who did not receive misoprostol (Placebo Group) (295-1075 ml, 641.7 ± 135.7) than those who received it, regardless the route of administration, rectal (135-830 ml, 457.5 ± 140.7; P < 0.001), and sublingual (135-680 ml, 357.8 ± 129.7; P < 0.001). In addition, sublingual route was associated with significantly lower estimated intra-operative blood loss compared to rectal administration (P < 0.001). CONCLUSIONS: Misoprostol with oxytocin is an effective drug-combination for decreasing intra-operative blood loss during cesarian section with clinical superiority to sublingual over rectal route.

Opening-wedge high tibial osteotomy without bone graft.

Open wedge high tibial osteotomy has become the trend for correction of varus knee deformities. The drawbacks were the need of autogenous bone graft with its associated morbidity, and later the use of bone substitutes with their cost and delayed healing. In this study, a total of 58 consecutive patients underwent high tibial osteotomy with internal fixation by wedge (toothed) plate and screws without bone graft, from 2004 to 2008. Age of the patients ranged from 24 to 65 years. There were 37 women and 21 men. The osteotomy opening size ranged from 8 to 14 mm. The mean follow-up was 38 months. The osteotomy united in all patients. Average time to union was 12.4 weeks (range 8-16 weeks). Partial loss of correction occurred in one osteotomy. There was significant difference between the healing time and the size of the osteotomy opening. The results at the final follow-up using the HSS score were excellent in 51 knees (88%) and good in seven knees (12%). Despite the routine addition of bone graft as a part of the high tibial osteotomy procedure, this study supports medial opening-wedge high tibial osteotomy up to 14 mm without bone graft or bone substitutes, which shortens the operative time and avoids unnecessary morbidity.