Phosphogypsum and poultry manure enhance diversity of soil fauna, soil fertility, and barley (Hordeum aestivum L.) grown in calcareous soils.

Enrichment of calcareous soils with phosphogypsum and poultry manure amendments could increase nutrient availability, improve calcareous chemical characteristics, and enhance barley plant growth. In the current study, phosphogypsum (PG) and poultry manure (PM) were used to determine the effects of PG and PM application on soil fauna diversity, soil fertility, and barley yield. The pot experiment treatments were: C: control; PG1: 4.20 g kg-1 soil; PG2: 6.30 g kg-1 soil; PM1: 4.20 g kg-1 soil; PM: 6.30 g kg-1 soil, and their combinations. The results indicated that the application of PM alone or combined with PG had significant effects on the microbial biomass carbon (MBC), organic matter (OM), soil NPK availability, and yield of barley. Collembola and Prostigmata accounted for 50.0 and 43.3%, respectively, of the total number of soil fauna. Shannon and evenness indices increased significantly in the soil amended with PM alone or combined with PG. Amended soil with PG and/or PM significantly increased the yield and yield components of plants compared to the control. The PM1PG2 treatment increased the yield by 76.2% above the control.

Conventional manual technique of post placental IUD insertion versus intra-cesarean post placental introducer withdrawal IUD insertion technique: a new standardized technique for IUD insertion during cesarean section: a randomized controlled trial.

BACKGROUND: Inserting IUDs during cesarean section reduces the need for more manipulation and discomfort. The current conventional manual technique for IUD insertion during cesarean section is not standardized with many modifications and high rates of expulsion, displacement, missed threads, and discontinuation. This study aims to find a standard technique for IUD insertion during cesarean section with the least possible problems, especially displacement and missed threads. METHODS: A randomized controlled study was conducted at Kasr Al-Ainy Maternity Hospital, Cairo University, Egypt. The study was performed over 12 months, from September 2020 to September 2021. Two groups of patients were selected; each group included 420 patients with a desire for IUD insertion during cesarean section. Group (A) (Control group) was subjected to a post-placental intrauterine device (Copper T380) during cesarean section using a conventional manual method; Group (B) (Study group): the IUD (Copper T380) was placed at the top of the uterine fundus using a new technique (intra-cesarean post placental introducer withdrawal IUD insertion technique). RESULTS: There was a significant statistical difference between the two groups regarding displacement of the IUDs at the end of puerperium, at 6 months, non-visibility of IUD threads, and continuation of use with p-value < 0.05. There was no significant statistical difference in the term of duration of surgery. CONCLUSION: The new technique of post-placental IUD insertion can be the standard technique of intra-cesarean section IUD insertion as it is associated with more favorable outcomes among the included women in the form of lower incidence of IUD displacement, non-visibility of IUD threads, and higher rates of continuation without increasing the duration of surgery as compared with the conventional manual technique. TRIAL REGISTRATION: ClinicalTrial.gov ID: NCT05788354, registration date: 28/03/2023 (retrospectively registered).

Dimensions, Ratios, Volumes, and Weights of the Fatty Parts of the Vulva (Mons Pubis and Labia Majora).

BACKGROUND: The anatomy of the fatty parts of the vulva, specifically the mons pubis and labia majora, has not been extensively studied. OBJECTIVES: This study aimed to provide a comprehensive 3-dimensional picture of the mons pubis and labia majora by defining and measuring their dimensions. Furthermore, the study sought to calculate the different ratios, volumes, and weights of these structures. METHODS: The study included 214 women, who were divided into 2 groups based on their BMI. The researchers defined 27 dimensions to describe the width, height, and length of the mons pubis and labia majora, and specified the measuring methodology. RESULTS: The height of the mons pubis was approximately three-quarters of its length and half its width. The labia majora were wider and taller anteriorly than posteriorly, and their ratios decreased as they went posteriorly, from 4 to 2. The ratio of monal height to maximum labial height and to labial length was 3 and 1, respectively, whereas the ratio of monal width to the sum of maximum labial widths was nearly 1.5. The calculated volumes and weights of the mons pubis and labium majus were 200 mL, 30 mL, 180 g, and 27 g in Group 1, and 300 mL, 40 mL, 270 g, and 36 g in Group 2, respectively. CONCLUSIONS: The dimensions, ratios, weights, and volumes defined and measured in this study can serve as the basis for any aesthetic measures involving the mons pubis and labia majora. Moreover, BMI and the different ratios should be considered in such measures.

Effect of integration of poultry manure and vinasse on the abundance and diversity of soil fauna, soil fertility index, and barley (Hordeum aestivum L.) growth in calcareous soils.

BACKGROUND: In Egypt, calcareous soils represent a large part of desert soils suffering from a shortage of nutrients and organic matter, affecting production and biological diversity in agroecosystems. Organic wastes, negatively affect the environment, recycling it as a promising technology in different farming systems, and its impact on crop productivity and soil fauna is largely unknown. In this study, the effects of integrating poultry manure (PM) alone or combined with vinasse (V) at rates of 4.2 g kg- 1 and 6.3 g kg- 1 in pots, on improving soil fauna diversity, soil fertility, soil consistency and yield of barley (Hordeum aestivum L.) grown in a calcareous soil were investigated. RESULTS: The results showed that the addition of PM alone or combined with V at different rates led to a significant increase in the microbial biomass carbon (MBC), organic matter (OM), NPK soil availability and yield of barley. The addition of 6.3 g PM and 4.2 g V kg- 1 soil have the best results in OM with 65.0% compared to control, and V contributes more than 16% of them. Prostigmata and Collembola were the dominant groups and accounted for 43.3% and 50.0% in the PM1 and 50.0% and 20.0% in the PM2 of the total individuals, respectively. Shannon and Evenness indices increased significantly with the soil amended by PM alone or combined with V. Soil fauna plays a key role in soil consistency because of a significant relationship between soil fauna and soil OM, MBC and soil fertility index. The addition of 6.3 g PM and 4.2 g V kg- 1 soil gave the best results in grain yield by 76.90% compared to the control. CONCLUSION: In conclusion, the interaction between PM and V can be used as a promising organic amendments to increase barley yield and improve efficiency of a recycled PM and V on soil fauna and soil fertility of calcareous soil.

ERCP quality indicators: The experience of a high-volume tertiary care center in Saudi Arabia.

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most technically demanding and high-risk procedures performed by GI endoscopists. Therefore, guidelines or position statements on various aspects of quality indicators, safety indicators and credentialing for ERCP have been developed by gastroenterology associations. In this paper, we evaluate the ERCP quality in a single, high-volume, tertiary care center in Saudi Arabia using a number of measures commonly stated by these organizations, and compare the experience of that center to the previously-published standards in this regard. PATIENTS AND METHODS: This is a descriptive, retrospective chart review of a consecutive sample taken over 12 continuous months (July 2016-June 2017). Data collected included demographic characteristics, and technical/clinical details from three time periods: preprocedure, intraprocedure, and postprocedure. Measurement parameters were all taken from the ASGE/ACG guidelines. Data was represented by the percentage of which each indicator was achieved, and the 95% proportion confidence intervals (CIs) when needed. RESULTS: From July 2016 to June 2017, 281 ERCP procedures were performed. An outstanding majority of them (95.7%) was done for therapeutic purposes, whereas 4.3% were diagnostic procedures. The sample included 206 patients, of whom 83 (40.3%) were males. The age of the participants ranged between 11 and 101 years (mean age ±â€¯SD; 51 ±â€¯19). The quality of ERCP at the center in which the study was done met the performance targets stated by the ASGE/ACG for almost all indicators. Adverse events reported in our series were lower than previous studies for pancreatitis and perforation, and slightly higher in the incidence of bleeding, cholangitis, and death. CONCLUSION: In a single, high-volume, tertiary care center in Saudi Arabia, the quality of ERCP met the performance targets stated by the ASGE/ACG for almost all indicators.

Menstrual patterns and disorders among secondary school adolescents in Egypt. A cross-sectional survey.

BACKGROUND: To our knowledge, no large population - based studies have been performed on the topic of menstrual patterns among Egyptian adolescent in recent years. The aims of this study were to identify menstrual patterns and associated disorders as well as the sources of menstrual health knowledge among Egyptian adolescents. METHODS: A cross-sectional survey. A total of 800 questionnaires were administered to post-menarcheal Egyptian adolescents attending secondary schools in Giza, Egypt, from September 1, 2012, to December 1, 2013. Participants were asked to respond to a semi-structured questionnaire on menstrual health awareness. The questionnaire included items on girl's socio-demographic and menstrual pattern characteristics, concerning their age at menarche, menstrual cycle length and regularity, duration and amount of flow, type and severity of pain related to menstruation, need for analgesia; and symptoms suggestive of premenstrual syndrome (PMS) Main Outcome Measure: description of menstrual patterns, disorders and source of knowledge. RESULTS: Four hundred twelve (51.5 %) out of 800 adolescents completed the questionnaire. The mean age of the girls was 14.67 ± 1.7 years. Mean age at menarche was 12.49 ± 1.20 years. 382 respondents reported various menstrual disorders, giving a prevalence rate of 95 %. Dysmenorrhea was the most prevalent (93 %) menstrual disorder in our sample, followed by PMS (65 %), and abnormal cycle lengths (43 %). Menstrual disorders interfered with social and academic life of 33 and 7.7 % of respondents respectively. Most participants lacked menstrual health knowledge and only 8.9 % of girls reported consulting a physician. CONCLUSION: To the best of our knowledge, this is one of the largest studies on menstrual pattern and disorders among Egyptian adolescent girls. Our Findings of the present study are consistent with other studies and reported higher than expected prevalence of menstrual disorders.

Staphylococcal sepsis with multiple abscesses, urinary tract infection, and bilateral renal vein thrombosis in a patient with uncontrolled diabetes mellitus.

We report a case of staphylococcal sepsis with vascular complications including peripheral emboli and renal vein thrombosis. Bilateral renal vein thrombosis has not been reported as a complication of Staphylococcus aureus (SA) axillary abscess. Uncontrolled diabetes was the only detected predisposing medical condition. The patient was treated successfully with incision and drainage of soft-tissue abscesses and intravenous antibiotic for six weeks and with anticoagulation for renal vein thrombosis.

Integration of patient safety systems in a suburban hospital.

Public awareness of hospital misadventure is now common. In response, we describe our integrated hospital safety system, which is dependent on the linkage of multiple individual safety committees, and the presence on each committee of senior and junior multidisciplinary healthcare professionals to provide feedback to their peer groups on required improvements.

A case of Aggregatibacter actinomycetemcomitans endocarditis presenting as quadriceps myositis.

An 80 year old female was admitted with an eight week history of fever associated with painful swelling of her right thigh, and a long history of poor dentition. Culture of blood stained fluid aspirated from the abscess grew Aggregatibacter actinomycetemcomitans (Aa) sensitive to ampicillin and cephalosporins. Transoesophageal echocardiography indicated endocarditis. Four weeks treatment with intravenous ceftriaxone and appropriate dental care was followed by full recovery.

Extensive bilateral extraluminal perivascular pulmonary haemorrhage associated with stanford type a aortic dissection.

We present the case of an 80-year old man with a Stanford Type A dissecting thoracic aortic aneurysm plus the unusual CT finding of extramural haemorrhage along the pulmonary vessels. The clinical and radiological picture has an extremely high mortality.