Environmental impacts of industrial activities on floral coverage with special emphasis on detoxification enzyme activities in Cataglyphis savignyi as pollution biomarker.

The present study investigates the environmental impact of industrial activities on floral coverage within the major industrial district of Borg El-Arab City, Egypt. Additionally, it aims to evaluate the detoxification enzymatic activity of Cataglyphis savignyi as a pollution biomarker. To achieve this objective, seasonal soil samples were collected from the studied sites to determine soil properties and heavy metal concentrations. Furthermore, a seasonal specimen of C. savignyi was collected to study the enzymatic activity of acetylcholinesterase (AChE) and glutathione-S-transferase (GST). Heavy metal contamination pollution indices were calculated, and fourteen plant species were identified at the investigated sites for four successive seasons from 2020 to 2021. The soil physicochemical parameters significantly varied in the industrial sites compared to the control site. The accumulation of heavy metal contamination in soil for investigated sites followed the order Ni > As > Pb > Hg. Calculated Cdeg and PLI for industrial 3 revealed a very high degree of contamination, attributed to increased industrial activity from the chemical and silicate factories that characterize this region. The current results highlight the inhibition of GST levels in C. savignyi at the industrial site compared to the control site. In contrast, AChE increases, which might be due to heavy metals enhancing acetylcholine activity at synapses. Consequently, the antioxidant enzymatic activities are useful as biomarkers for assessing and monitoring environmental contamination. In conclusion, this study underscores insects as potent biomarkers for heavy metal contamination, marking a significant advancement in environmental monitoring. These bioindicators offer crucial insights into the impacts of climate change and industrial pollution. The research reveals distinct plant diversity variations and higher heavy metal content in industrial sites, indicating pronounced contamination. Additionally, the study highlights altered enzyme activities in insects, emphasizing their utility as biomarkers for assessing environmental contamination. This work represents a substantial leap forward in comprehending the complex dynamics between contamination and ecological balance.

Independent predisposing factors for subcutaneous and deep wound collection after total thyroidectomy, a prospective cohort study.

BACKGROUND: The literature contains diverse and sometimes contradicting results about wound seroma following thyroidectomy. This is probably due to the subjective clinical estimation of seroma, or due to failure to differentiate between the occurrence of subcutaneous (SC) and deep wound collections. This work aimed at objectively investigating the factors affecting subcutaneous and deep wound seroma after thyroidectomy. METHODS: The relation between various operative and clinico-pathological factors and the collection formation was prospectively analyzed in a cohort of 100 patients after conventional thyroidectomy. Wound seroma was assessed clinically and via high-resolution ultrasonography at 24 h, 48 h and two weeks postoperatively. Sonographically detected collections were expressed as SC and/or deep wound collections according to the relation to strap muscles. RESULTS: Operative duration was the only independent factor significantly affecting the incidence of clinical seroma. Older patients (>40ys) showed significantly larger volumes of early SC collections. Early postoperative pain was significantly related to drain insertion, to the occurrence of clinical seroma and to the volume of SC collections.Sonographically, suction drains and shorter operative durations resulted in significantly less amount of deep collections. Suction drains did not result in less amount of SC collections or in a lower incidence of clinical seroma. CONCLUSIONS: Operative duration is the only independent factor significantly related to clinically-detected postoperative seroma with its subsequent postoperative pain. Especially in elderly patients, a flapless technique would be recommended as these patients developed larger volumes of SC collections with subsequent higher pain scores, even if seroma was not clinically detected.

Endoscopic Variceal Ligation followed by Argon Plasma Coagulation Against Endoscopic Variceal Ligation Alone: A Randomized Controlled Trial.

GOALS: Our aim was to study the efficacy and the safety of argon plasma coagulation (APC) in secondary prophylaxis against esophageal varices in view of many contraindications and side effects to ß-blockers in cirrhotic patients. BACKGROUND: Rebleeding rates from esophageal varices after endoscopic variceal ligation (EVL) are high; thus, the current recommendation is to combine nonselective ß-blockers to it, but side effects and relative contraindications to nonselective ß-blockers hinder their usage or require discontinuation in 15% to 20% of the cirrhotic patients. Thus, it is important to find another combination. STUDY: This study included all patients admitted to the Alexandria Main University Hospital during the period between April 2012 and October 2012 with variceal bleeding. After exclusions, the total number of included patients was 40. All participants were subjected to EVL and eradication of varices, and then they were randomized to either APC (group 1) or just observation (group 2). Both groups were followed up by endoscopy every 3 months for 30 months. RESULTS: During the 2.5-year follow-up, 21% of the participants in group 1 experienced esophageal variceal recurrence, but no one needed rebanding. In group 2, 68.4% of the participants experienced esophageal variceal recurrence (P=0.003) and 63.2% underwent rebanding (P<0.001). CONCLUSIONS: APC after esophageal variceal eradication using EVL can decrease the risk of recurrence of esophageal varices and the need for rebanding. This technique may be recommended in secondary prophylaxis against esophageal variceal bleeding in those who have contraindications, are intolerant, or are noncompliant to nonselective ß-blockers.

Level I lymph node involvement in patients with N1b papillary thyroid carcinoma: a prospective study.

Most of the studies on the incidence, pattern, and predictive factors of lymph node (LN) metastasis with papillary thyroid carcinoma (PTC) have been performed retrospectively and no common consensus has been reached regarding the predictors for the involvement of level I LNs. This study was conducted prospectively to determine the incidence and the possible predictors of level I involvement in N1b PTC patients. The study included 30 consecutive patients with N1b stage of PTC. All the patients underwent neck dissection (ND) including level I. The relation between involvement of level I LNs and various clinicopathological variables was studied. Unilateral neck dissection was performed in 24 patients and bilateral neck dissection in six patients leading to 36 NDs. Level I was excised in all patients, with five specimens (14%) positive for metastasis. Levels II, III, IV, V, VI, and VII were positive in 52.8, 58.3, 58.3, 33.3, 63, and 22.2%, respectively. Level I involvement was significantly related to the number of lymph node levels affected (p = 0.003) and macroscopic extranodal invasion (p = 0.04). It was not related to the involvement of other individual levels, gender, age, size of the largest thyroid nodule, size of the largest LN involved, or histo-pathological variant of the tumor. This study suggests that including level I in therapeutic neck dissection for N1b PTC patients might be recommended in selected cases of multiple level involvement and macroscopic extranodal invasion requiring sacrifice of internal jugular vein, spinal accessory nerve, or sternomastoid muscle.

Four-arm randomized trial comparing laparoscopic and open hernia repairs.

AIM: To compare four approaches in primary repair of inguinal hernia as regards operative and postoperative outcome. METHODS: One hundred consecutive patients with primary inguinal hernia Nyhus I-III were randomized into four groups. Group I had open pro-peritoneal repair, group II had Lichtenstein tension-free mesh repair, group III had Transabdominal pro-peritoneal (TAPP) repair while group IV had laparoscopic totally extraperitoneal (TEP) hernia repair. RESULTS: Operative time ranged from 10.71 to 120.61 min. Laparoscopic operations were significantly longer than open operations (54.5+13.2, 34.21+23.5 versus 96.12+22.5, 77.4+43.21; t=3.891, p<0.001). Open pro-peritoneal approach had significantly longer operative time compared to Lichtenstein approach (54.5+13.2 versus 34.21+23.5). Postoperative pain was significantly higher in patients who had open repairs (7.067+1.831, 6.5+3.5 versus 5.8+1.568, 4.8+2.33; t=3.424, p=0.002). There was one case of conversion in each of the two laparoscopic groups. Laparoscopic operations were associated with significantly faster return to normal domestic activities and to work. CONCLUSION: Laparoscopic hernia repair offers less postoperative pain and faster recovery on the expense of longer operative time. TEP and TAPP laparoscopic techniques gave similar results.

Video-assisted submandibular resection: two-step technique.

BACKGROUND: The relative delay in the development of endoscopic neck surgery has been attributed to the relatively narrow operative field and to the presence of many vital structures in it. For endoscopic neck surgery to be feasible, it is essential to create a comfortable working space. A method of creating a working space is the gasless skin-lifting technique. To date, there have been only few reports on the transcervical endoscopic approach to the submandibular gland. AIM: Assessment of a new modification in the technique of video-assisted submandibular sialadenectomy aiming at improving the visibility and safety of the operation. METHODS: The study included 12 adult patients indicated for sialadenectomy. Patients having large, hard or fixed submandibular gland were excluded. Laboratory work-up and ultrasound of the neck were obtained in all patients. All patients had video-assisted submandibular sialadenectomy, using a "two-step resection" technique: A 15-20-m skin incision was performed. The superficial part of the submandibular gland down to the plane of the mylohyoid muscle was dissected free and excised, leaving behind a roomy working space and a clearer view to the deeper part (step 1). The remaining deep part of the gland was then dissected and removed (step 2). A gasless skin lifting was adopted using Army-Navy retractors. Dissection was performed using ultrasonic sealing device. RESULTS: Mean operative time was 89.67 ± 37.97 min. Mean blood loss was 45 ± 19.78 ml. There was no permanent nerve injury. CONCLUSION: The two-step submandibular sialadenectomy using skin-lifting gasless technique offers good visibility and good working space that allow safer dissection.