Tracheotomy Outcomes in 71 COVID-19 Patients: A Multi-Centric Study in Saudi Arabia

Since its outbreak in late 2019, the COVID-19 pandemic has seen a sharp rise in the demand for oxygen and ventilation facilities due to the associated extensive damage that it causes to the lungs. This study is considered the first and largest study in Saudi Arabia to evaluate the outcomes of tracheostomy in intubated COVID-19 patients. This is a retrospective, observational cohort study that was conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Western Region, Saudi Arabia and King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. The findings of the study revealed that seventy-one patients with COVID-19 underwent tracheotomy between 1 March 2020 and 31 October 2020. The average period between intubation and tracheostomy was 9.97 days. Hypertension, diabetes, lung disease and obesity (BMI > 30) were significant risk factors of mortality. The overall 30-day mortality rate was 38.4%.

INFLUENCE OF DIFFERENT AGES HEIFERS LIVE WEIGHT ON THE LIFELONG COWS PRODUCTIVITY

One of the problems of modern dairy farming is the short period of productive use of cows. This is observed not only in Ukraine, but also in most countries of the world with developed dairy farming. The consequence of a short period of productive use is a decrease in lifelong productivity of cows. The aim of this paper was to study the possibility of influencing the duration of use and lifelong yield of cows by selecting heifers for live weight during their rearing. The study analyzed the lifelong productivity of 1071 cows of the Ukrainian black-spotted dairy breed, starting from their breeding and before leaving the herd. Animals were divided into five groups by living weight at the age of 3, 6, 12 and 15 months using a standard deviation (σ) from the mean value. The number of calving, the duration of productive life, lifelong yield and yield for higher lactation, as well as the average period between calving were determined within the groups. It was found that yield for higher lactation are associated with the weight of heifers during the beginning of pubertal development and the onset of sexual maturity. Animals that had a live weight of + 0.5…1.5 σ at the age of 6 months and more than +1.5 σ at the age of 12 months from the average live weight in the herd were characterized by the highest milk yield. The group of signs of lifelong productivity (number of calving, duration of productive use and lifelong yield) was positively affected by live weight of heifers aged 3, 6, 12 and 15 months, which exceeded the average live weight in the herd by 0.5…1.5 σ. Cows included in these groups outperformed other groups by 0.2…1.4 calving. During the period of use, these cows received 11…32% more milk than the herd average. The research expands the understanding of the influence of heifer breeding on the formation of lifelong productivity of cows and can be used to select livestock and adjust plans for dairy cattle breeding.

Compounded glycopyrrolate is a compelling choice for drooling children: five years of facility experience

Background Describe the efficacy of a galenic glycopyrrolate formulation and its impact on patients with sialorrhea Quality of Life (QoL), including costs analysis. Methods We performed a retrospective observational study on 21 patients who received a custom-formulated galenic glycopyrrolate syrup for sialorrhea for an average period of 14.3 months. We analyzed the telephone interviews with elaborated and validated questionnaires and the therapy costs comparing the brand marketed drug with the galenic formulation. Results Overall, 16 out of 21 patients (76.2%) reported a significant improvement in sialorrhea and QoL. In 14 subjects (66.7%), there was a remarkable decrease in the drooling severity; 10 individuals (47.6%) reported a reduction in drooling frequency. Nine patients experienced at least one adverse effect of glycopyrrolate therapy, and three of them stopped the treatment. No severe side effects were observed. The galenic drug significantly reduced costs for patients. Conclusions An oral glycopyrrolate solution easily administered to children with brain injuries is not commercially available in many European countries. This study demonstrates the efficacy of a compounded glycopyrrolate syrup on drooling severity, frequency and ensures a better QoL in patients and their caregivers.

New possibilities of the PCA-Seq method in the analysis of time series (on the example of solar activity)

When analyzing a 1D time series, it is traditional to represent it as the sum of the trend, cyclical components and noise. The trend is seen as an external influence. However, the impact can be not only additive, but also multiplicative. In this case, not only the level changes, but also the amplitude of the cyclic components. In the PCA-Seq method, a generalization of SSA, it is possible to pre-standardize fragments of a time series to solve this problem. The algorithm is applied to the Anderson series – a sign alternating version of the well-known Wolf series, reflecting the 22-year Hale cycle. The existence of this cycle is not disputed at high solar activity, but there are doubts about the constancy of its period at this time, as well as its existence during the epoch of low solar activity. The processing of the series by the PCA-Seq method revealed clear oscillations fluctuations of almost constant amplitude with an average period of 21.9 years, and it was found that the correlation of these oscillations with the time axis for 300 years does not differ significantly from zero. This confirms the hypothesis of the existence of 22-year oscillations in solar activity even at its minima, like the Maunder minimum.

The Optimum Allocation For Irrigation Water of Agricultural Crops in Iraq During The Average Period (2017-2020) Using Linear Programming Method

The research aims to study the optimal allocation of irrigation water that is used to irrigate various agricultural crops at the level of Iraq. In order to achieve the research aim, two economic models were formulated according to the Simplex Algorithm. The two models included forty agricultural crops, which were restricted by twenty specific production resources. The estimated results indicated that there is a surplus of the water resource for both the actual crop composition plan and the proposed basic plans for the two estimated models amounting to about 30.943, 35.357 and 31.097 billion cubic meters for each plan, respectively, compared to the quantities of water available for agricultural use. The results of the analysis of the two estimated models indicated to prefer the results of plans with legislative restrictions due to the expansion of the area of strategic and important crops for local consumption, with less needs of water.

RISK FACTORS AND CAUSES OF INFERTILITY

Infertility is the inability of a couple to achieve pregnancy over an average period of one year (in a woman under 35 years of age) or 6 months (in a woman above 35 years of age) despite adequate, regular (3-4 times per week), unprotected sexual intercourse. There are some risk factors that may give chances for infertility like Age, diabetes, eating disorders, including anorexia nervosa and bulimia, excessive use of alcohol, exposure to environmental toxins, such as lead and pesticides, over exercising etc. Infertility may be caused by a number of different factors, either in the male or female reproductive systems. So therefore it is most important to identify the cause and treat the infertility for becoming fertile to a woman.

Characteristics of Recurrent Cases after Conservative Therapy in Adolescent Lumbar Spondylolysis

Purpose: Occasionally lumbar spondylolysis in adolescents will recur after conservative treatment. The goal of this study was to retrospectively review the conditions in which recurrence transpired in a subset of adolescent patients diagnosed with acute lumbar spondylolysis. Subjects: A retrospective survey was conducted in 152 patients who had been treated for spondylolysis and had obtained bone union. Twenty subjects were selected who had recurrent lumbar spondylolysis after returning to sports activity following the first spondylolysis treatment. There were 18 males and two females with an average age at the time of initial consultation of 13.3 years and 14.1 years at the time of recurrence.Results: The average period of initial treatment was 101 days, and the average time to recurrence after healing was 149 days. There were three cases at L3, two cases at L4 and 15 cases at L5. At recurrence, 18 patients had unilateral involvement and two patients presented with bilateral occurrence. Four cases did not achieve bony union.Discussion: In this study, the recurrence rate was 13.2%. Eighty percent of cases had recurrence within six months after healing. After recurrence, 20% of the cases reached pseudoarthrosis. It is useful to take regular MRI images to detect recurrence within six months after returning to sports.

Pedicled Anterolateral Thigh Flap As A Workhourse Flap for Reconstruction of Inguino-Scrotal Defects

Background: Reconstructions around inguinoscrotal region has been a challenging task owing to complex anatomy. There are variety of flap options available for reconstruction of Inguinoscrotal region. Our study was done to evaluate the use of pedicled anterolateral thigh flap for reconstruction of defects around inguinoscrotal regions. Methodology: In this study a total of 18 patients with various types of defects around inguinoscrotal region were evaluated. The etiology of defects included trauma (𝑛=6), infection (𝑛=8), malignancy (𝑛=2) and burn (𝑛=2). Patients were evaluated in terms of viability of the flap, number of perforators included, pedicled length and flap dimensions and donor site morbidity. Results: All flaps were survived well except 1 flap develop venous congestion in immediate post operative period due to tension over vascular pedicle which was managed by increasing pedicle length. 2 patients had developed partial loss of the skin graft at the donor site which got healed secondarily in due course. All patients were followed up for an average period of 6 months, ranging from 1 to 12 months. Donor site morbidity was minimal. Conclusion: Pedicled ALT flap is a versatile, reliable flap, with wide arc of rotation which makes it as an ideal flap for the coverage of defects around inguinoscrotal region.

A single-centre analysis of post-colonoscopy colorectal cancer

Patients and methods : A prospective registration of patients with colorectal cancer and a colonoscopy within the last 10 years. We tried to classify these post-colonoscopy colorectal cancers (PCCRCs) by most reasonable explanation and into subcategories suggested by the World Endoscopy Organization (WEO) and calculated the unadjusted PCCRC rate. Results : 47 PCCRCs were identified. The average age at diagnosis of PCCRC was 73 years. PCCRCs were more located in the right colon with a higher percentage of MSI-positive and B-RAF mutated tumours. The average period between index colonoscopy and diagnosis of PCCRC was 4.2 years. Sixty-eight % of all PCCRCs could be explained by procedural factors. The mean PCCRC-3y of our department was 2.46%. Conclusions : The data of our centre are in line with the data of the literature from which can be concluded that most post-colonoscopy colorectal cancers are preventable. The PCCRC-3y is an important quality measure for screening colonoscopy. Ideally all centres involved in the population screening should measure the PCCRC-3 y annually, with cooperation of the cancer registry and reimbursement data provided by the Intermutualistic Agency (IMA).

Soliton-Like Waves in the Vicinity of the Southern Kuril Islands

urpose. This paper focuses on modulated solitons detected in time series of observational data on sea level oscillations in the Sea of Okhotsk, verifying the presence of nonstationary processes within a quantitative framework of methods. Methods and Results. The paper reports an analysis of wave observation data collected using ARW-type, bottom-mounted pressure sensors in the area of the Capes Castricum, Van-der-Lind and Lovtsova in the southern Kuril Islands. The time series obtained were bandpass filtered using hardware with a passband of 20 minutes to 2.5 hours. Residual time series show the presence of wave packets generated at the beginning of the K1 (diurnal) tide, which consistently appear as a group consisting of 5–7 packets. It is shown that the synchronicity between each wave packet and the K1 wave initiation is associated with the cyclic separation of the tidal flow of the K1 oscillation at the elevation in the Urup Strait located between the islands, along with a concomitant spawning of vortices. It is speculated that the vortices generate the detected wave packets, which are each found to encase a cluster of waves with an average period of about 1.6 hours that are attributed to either edge waves or shelf seiches or a combination of both. A numerical model simulation of the detected wave packets was performed using the Korteweg – de Vries equation, confirming that the envelope of the observed wave packets is close to the modeled one and behaves like a soliton. Conclusions. It is shown that synchronous initiation of a wave packet and a K1 wave is associated with the cyclic separation of the tidal flow of the K1 oscillations at a subsurface elevation in the Urup Strait located between the islands, with a concomitant spawning of vortices. The vortices are assumed to generate the detected wave packets. Each packet contains a cluster of waves with an average period of about 1.6 hours, which is conditioned by the period of the edge wave or shelf seiche. Spectral analysis performed for the 4.5-day-long time series with and without the groups of solitons, showed that the wave energy increases in the 0.5–5.5 hour period range when solitons occur. Application of a simple amplitude-based criterion permitted the authors to identify the waves detected in the wave packets as anomalous. Transformation of the time series into normalized time and normalized amplitude coordinates show that all the examples of anomalous wave packets could be modeled using the Korteweg – de Vries time equation