31 year old female presented with abdominal pain and respiratory distress in the third trimester of her second pregnancy. Her blood workup revealed a lipemic sample (Figure 1) due to markedly elevated serum triglycerides of 8178 mg/dl (Glycerol Phosphate Oxidase method). Total cholesterol and Low Density Lipoprotein were elevated at 1701 mg/dl and 788 mg/dl respectively. There was no family history of lipid disorders. Diagnosis was consistent with gestational hypertriglyceridemia with acute pancreatitis (Serum Amylase-50 U/L, Serum Lipase- 96 U/L), though genetic tests to rule out pre-existing primary hypertriglyceridemia was not feasible. In view of the life threatening condition, she was initiated on Insulin-Dextrose infusion and offered one session of Plasma Exchange. Figures 2,3 depict membrane plasma separation with the obtained effluent as lipemic plasma. Her serum triglycerides showed a declining trend and was discharged in good health (serum triglycerides at discharge-651 mg/dl). 

Internet has become an important part of our life, including during pregnancy where it is broadly used to find information (84%). The aims of this study were (1) to describe the proportion of women using Internet Social Networks (ISN) concerning their pregnancy, during pre or postpartum hospital stay, (2) to define how ISN users refer to their pregnancy and delivery on these social networks, (3) to compare anxiety level, social sustain level, sociodemographic characteristics of the both population (4) and to determine profiles of the ISN users with multiple correspondence analysis. Methods: 399 questionnaires were distributed in the postpartum wards of two academic hospitals in Paris, and 258 fully filled were retrieved. Tools: Anxiety scale (STAI- A and B), Cutrona Social Provisions Scale, sociodemographic and obstetrical questionnaire. Results: 76% (n = 195) were ISN users. We compared ISN users versus ISN non users women. Demographically, the two populations were comparable. Anxiety scores were similar in both groups, whereas social support scores showed a statistical difference in social integration. In the global population, 84% use Internet for information concerning pregnancy; this rate is higher for ISN users than ISN non users (tendency 0.058). ISN were used in priority for sharing with relatives, and 10% with other pregnant women. Concerning pregnancy, patients posted in priority the birth announcement (28%), the pregnancy announcement (23%), and the newborn’s pictures (12%). 6% posted their fetuses’ ultrasound pictures. Three clusters of ISN users were extracted with statistically different social support scores (p = 0.019) and comparable anxiety scores. The third one, with at risk profile, used ISN as social support. For all women, but specifically for younger and more socially fragile women, Internet gives to professional new perspectives to develop information and prevention tools during the perinatal period.

Sleep and menstrual cycle both are normal physiological processes in women’s life but they are regulated by different centers. Sleep is a daily rhythm whereas the menstrual cycle lasts for 28 days. During this period the estrogen peaks twice. We have shown earlier that there is an inverse relationship between estrogen and the hormone melatonin which aids sleep. Because of this menstruating women will have sleep disorders.

A comprehensive study was carried out to assess the microbiological, nutritional, biochemical and essential oil characteristics of three Egyptian traditional cultivars seeds, namely, cumin (Cuminum cyminum) and coriander (Coriandum sativum) spices as well as basil whole herb (Ocimum basilicum) collected from different Egyptian export centers as being ready for export. The found values for humidity in dry seeds of cumin (7.4%) and coriander (6.4%), as well as total ash and ash insoluble in acid (in cumin 7.7% and 0.74%, but in coriander 5.3% and 0.55%, respectively), were lower than the maximum limits indicated by the Egyptian Specification Standards (ES) and by International Standards Organization (ISO) for cumin and coriander seeds. Analysis of essential minerals in seed spices and herbs indicated that they were rich in K, Ca, Na, Fe and Zn. The total bacterial count was low content in seeds of cumin and coriander as well as fresh whole basil herb. The microbiological load in all tested seed spices and herbs was found lower than those indicated by the ES and ISO for cumin and coriander seeds. Yields in hydro-distilled essential oils (EOs) were the highest in cumin seeds (3.762%), while both coriander and basil herbs had lower amounts (0.285% and 0.686%, respectively). EOs contents were found higher than the maximum limits for cumin (1.5% - 2.5% on a dry weight basis), but within the limits for coriander (0.1% - 0.5% on a dry weight basis) as indicated by the ES and ISO for cumin and coriander seed oils. Gas chromatography of extracted EOs from seeds of cumin and coriander as well as basil herbs indicated the presence of 41, 35 and 47 compounds, respectively, where cumin aldehyde was the major component in cumin volatiles but was linalool in volatiles of both coriander seeds and basil herbs. EOs of basil herbs grown in Egypt were of the high linalool chemotype which was characterized by high contents of linalool and relatively lower amounts of eugenol. However, the major compounds in the three tested EOs from seeds or herbs grown in Egypt are in accordance with literature reports from different parts of the world. Volatile oil components in EOs of the three tested Egyptian spices and herbs were classified into groups, based on the relative area (%). The proportion of the major and the other main components in EOs from seeds of cumin and coriander cultivars were within the ranges indicated by both the ES and ISO for cumin seed oils (cumin aldehyde between 15% - 46%) and for coriander seed oils (linalool between 65% - 78%). The aim of the present work was to Assessment study certain commonly used Egyptian spices and herbal products for characterizing their physical, biochemical and microbiological properties.

Background: In health care systems nursing care documentation is a vital and powerful tool that ensures continuity of care and communication between health personnel for better patient outcomes. Knowledge, attitude and practice of nurses’ towards nursing care documentation affect the quality and coordination of patients’ care. Hence, this study aimed to assess knowledge, attitude, practice and associated factors towards nursing care documentation among nurses in West Gojjam Zone public hospitals, Amhara Ethiopia. Method: Institutional based cross sectional study was conducted among 246 nurses in West Gojjam Zone public hospitals from February to March 8, 2018. The study participants were selected by simple random sampling technique. Data were collected by using pre-tested and validated self-administered structured questionnaire with internal reliability of Cronbach’s Alpha values 0.912, 0.784 and 0.713 for knowledge, attitude and practice questions respectively. Epi data version 3.1 and SPSS version 20 was used for data entry and analysis respectively. Descriptive statistics and binary logistic regression model were used. Result: The overall response rate was 97.56%. Among 240 respondents 54.6% of them had good knowledge, 50% of study participants had favorable attitude and 47.5% of study participants had good nursing care documentation practice. Sex and monthly salary were found to be statistically significant with knowledge of nurses. Work setting, work experiences and knowledge of nurses had significant association with nurses’ attitude towards nursing care documentation. Availability of operational standards, knowledge and attitude of nurses had significant association with nursing care documentation practice. Conclusions and Recommendation: Results of this study showed that knowledge, attitude and practice of West Gojjam zone public hospital nurses on nursing care documentation were poor. Therefore; in order to solve this problem each hospital should recruit nurses until hospitals are saturated enough. It is recommended to avail nursing care documentation standards/guidelines in each hospital and to give training about it and also it is recommended to conduct multisite studies especially qualitative type to increase its quality.

Clarireedia jacksonii sp. nov. Formerly Sclerotinia homoeocarpa F.T. Bennett, the causal agent of dollar spot (DS), is the most destructive pathogen in turfgrass. Symptoms appear as circular patches 10-40 mm in diameter with small tan lesions surrounded by a darker band, sometimes presenting an hour glass appearance. A multi-year study was initiated with the objective of determining the efficacy of biological control agents (BCA) and tank mixes of BCA’s and synthetic fungicides on DS control. Nutrient source was also evaluated to determine any interaction with the BCA’s and tank mixes. in vitro studies evaluated the efficacy of synthetic and BCA’s for C. jacksonii control. Quarter strength potato dextrose agar was amended with ¼, ½ and full labeled rates of various products. Chlorothalonil at all rates provided greatest (> 90%) control of C. jacksonii for study duration. Biological control agents provided best efficacy at ¼ and ½ label rates. Streptomyces griseoviridis provided least efficacy and may have exacerbated formation of C. jacksonii. Preventative field evaluations for synthetic and BCA’s provided different results between two study years. In Year 1, all treatments had < 15% disease severity for the duration of the study. In year 2, disease pressure was extremely elevated. Synthetic program 1, centered on azoxystrobin + propiconazole applications and conventional fertility sources, provided best results with < 5% disease severity for the duration of the study. Reduced synthetic program 1, and synthetic program 2 followed closely with < 10% disease severity. Reduced synthetic programs were based on monthly applications of either chlorothalonil or pyraclostrobin every 30 day, alternated with biofungicide applications. Synthetic program 2 utilized rotation applications of pyraclostrobin and chlorothalonil every 14 days. Organic programs, utilizing only biofungicides and organic fertility sources, provided the least amount of control and exceeded the 15% threshold by the second month of the evaluation period.

Background: Primary percutaneous coronary intervention (PCI) of the infarct-related artery (IRA) is the most effective treatment modality in ST-segment elevation myocardial infarction (STEMI). Incidence of no flow is 8.8% - 10% in primary PCI of STEMI patients. Our aim was to study actual incidence and outcome of no flow patients. Methods: Five hundred and eighty primary PCI patients were enrolled and evaluated from 2016 January to 2017 December. We used drug eluting stents in all cases. Majority of our patients (> 90%) presented to emergency six hours after onset of symptoms. There were many patients where there was no flow even after mechanical thrombus aspiration and pharmacological vasodilator therapy. We have studied primary outcome (mortality) of no flow in those patients. Results: There were 44 cases of no flow in our series (7.75%). Involvement of Left anterior descending artery (LAD) was in eighteen patients. Right coronary artery (RCA) was culprit in twenty four cases. Only two cases were seen in LCX territory. One month mortality rate in no flow group was 50% and 6.25% in successful recanalization group. One year mortality was 12.5% in successful recanalization group and 66% in no flow group. Conclusion: Refractory no flow during STEMI intervention is associated with increased incidence of major adverse cardiovascular events (MACE). There is no established strategy to solve this phenomenon.

Objective: To evaluate whether the occurrence of maternal pathologies, mainly Diabetes Mellitus and Hypertensive Syndromes in the gestational or pre-gestational period may be related to hearing impairment in postpartum women. Methods: Observational, prospective study including 361 puerperal women who had their deliveries at a reference University Hospital for pregnant women with clinical history of risk. Auditory evaluation was performed by Distortion Product Otoaccoustic Emissions (DPOAE) within 14 days after delivery. Measures of central tendency and absolute and relative frequencies were used to describe the sample and the chi-square test and binary logistic regression to assess the correlation among variables. Significance higher than 95% was observed and the study was approved by the Research Ethics Committee. Results: A total of 361 postpartum women were studied and 7.5% had hearing impairment. The frequency of gestational hypertension was 13.9%, that of gestational diabetes was 8.6% and that of pre-pregnancy diabetes mellitus was 5.8%. The presence of hearing impairment was significantly correlated with the occurrence of pre-pregnancy diabetes mellitus (OR: 4.5 - CI: 1.51-1.47), and maternal age greater than 29 years (OR: 3.72 - 1, 58-8.76); A correlation was also found between maternal age and the presence of pre-pregnancy diabetes mellitus (OR: 3.84 - CI: 1.45-10.15). Conclusion: In the population of postpartum women evaluated, having Diabetes Mellitus prior to pregnancy and belonging to the age group older than 29 years increases the chance of having hearing loss.

A 3-month-old girl presented to the surgical consultation room with bilateral cleft lip incomplete. A girl weighing 4205 g, was born at term after an uneventful pregnancy with a birth weight of 2500 g. There was no family history. On examination, a congenital, linear, erythematous cutaneous anomaly on the left side of her neck was highlighted with ocular anomalies (strabismus and the eyes are widely spaced) and a broad nose with a flattened tip. The examination of the other systems was unremarkable. In front of the association of these different anomalies BOFS was suspected but molecular diagnosis has not been made. The child benefited surgery to correct cleft lip with tennisson procedure with a good postoperative result.

Background: In light of the COVID-19 pandemic and the health crisis left in its wake, our goal is to develop extensive machine-learning techniques to provide a clear picture of the treatment, and possible mistreatment, of specific patient demographics during hospital triaging.Objective: We aim to reveal whether a patient’s treatment and hospital disposition is related to the following attributes - Emergency Severity Index (ESI), gender, employment status, insurance status, race, or ethnicity which our 100 MB dataset included.Materials and methods: Our work is separated into two parts - the classification task and data analysis. As part of the classification task, we used the k-Nearest-Neighbor classifier, the F1-score, and a random forest. We then analyze the data using SHapley Additive exPlanations (SHAP) values to determine the importance of each attribute.Results: Our findings show that significance varies for each attribute. Notably, we found that patients with private insurance programs receive better treatment compared to patients with federal-run healthcare programs (e.g. Medicaid, Medicare). Furthermore, a patient’s ethnicity has a greater impact on treatment for patients under 40 years of age for any given ESI level. Surprisingly, our findings show language is not a barrier during treatment.Discussion and conclusion: We, therefore, conclude that although hospitals may not be doing so intentionally, there is a systemic bias in hospital triaging for specific patient demographics. For future works, we hope to aggregate additional patient data from hospitals to find whether specific demographics of patients receive better healthcare in different parts of the United States.