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Background: Major surgeries can develop metabolic acidosis during the perioperative period. Any clinical condition leading to decreased tissue oxygenation causes lactate levels to rise proportionally. Aims and Objectives: This study was aimed at evaluating perioperative serum lactate as a predictor of length of hospital stay and in-hospital mortality in patients undergoing emergency major abdominal surgeries. Materials and Methods: Adult patients posted for emergency abdominal surgical procedures were enrolled for 2 years. Patients were observed intraoperatively and lactate levels were measured. In post-operative period lactate levels were recorded for 24 h. Relationship of lactate with hospital length of stay and in-hospital mortality was analyzed. Results: Total of 93 patients were enrolled for 2 years. Mean age was 50.4 years. Mean baseline lactate was 2.95 mmol/L. Total in-hospital mortality was 16.1%. Thirteen patients had perioperative serum lactate level of ≤ 2 mmol/l, with a mean hospital length of stay of 8.6 days and no mortality. Fifty-one patients having perioperative serum lactate between 2 and 4 mmol/L, with a mean hospital length of stay of 11.2 days and mortality of 13.3%. Twenty-nine patients had serum lactate of >4 mmol/L, with a mean hospital length of stay of 17.3 days and mortality of 86.7%. Elevated serum lactate was associated with a longer length of hospital stay, with lactate at 12 h having the highest predictive value (area under curve 0.987). Similarly, lactate at 12 h had the highest accuracy at predicting mortality as per receiver operating characteristic (AUC 0.895). Conclusion: Serum lactate was associated with increased in-hospital mortality and longer length of hospital stay in emergency abdominal surgeries.

Abstract Today, one of the most important challenges of non-governmental organizations is financing. Due to the lack of government funding, these organizations use public assistance to continue their activities and realize their charitable goals and visions. With the increasing use of online donation platforms in the world, non-governmental organizations in Iran have not yet been able to use this opportunity to solve their financial challenges. This is an important issue that needs to be investigated and researched. The purpose of this article is to provide a model to explain the factors affecting the willingness to donate online in line with the collective financing of non-governmental organizations, which has been carried out using a Meta-synthesis method. In this regard, using the experiences of financial managers and charity experts and previous research, the collected information was coded using the content analysis method. The components were categorized with 55 descriptive open codes, 36 basic themes and 12 organizing themes, then the reliability and validity of the model was checked and then it was presented in the form of the final model. The results showed that these components are directly and indirectly effective in online donation in line with collective financing of non-governmental organizations. These components clearly state that providing transparent and timely financial information and effective activities of non-governmental organizations, emotional and social support for people, ease of use, privacy protection, trust and the principle of the plan and project is the right way. which can make the financing of non-governmental organizations successful.Introduction One of the new methods that has recently attracted the attention of charitable organizations is the use of online crowdfunding. In this way, they can collect small donations at once. The focus of this research is crowdfunding based on donations in Iranian charities. In donation-based crowdfunding, donors do not have any expectations in return for the provided financial assistance. Due to the significant growth of crowdfunding and the facilitation of people's participation online, charitable institutions are obliged to use the opportunity created to carry out humanitarian activities continuously and long-term, and to be more successful in self-financing, the motivations and intentions of donors identify online and by spreading awareness, transparency and culture in this field, institutionalize trust in crowdfunding platforms in the society. The problem of this research is that despite the development and expansion of online donation platforms and the presence of benefactors in the country, a model for the intention of online donation charitable institutions in Iran. Has not yet been presented. The effort of this research is to provide a model of intention to donate online for collective financing of charities in Iran.Case study A model of intention to donate online for charity crowdfunding in IranMaterials and Methods The data of this study are the results and findings extracted from other similar studies. The method of this research is qualitative which was done using Meta-synthesis.Discussion and Results The components of the online donation intention model for the collective financing of charities, which is done with the meta-composite method, include the following: central norm (moral perspective, moral identity, perception of social norms); Perceived behavioral control (crowdfunding, influence on the perception and decision of donation behavior); Use of media and information technology (the space of websites, the expansion of social networks, the obsolescence of conventional fundraising methods, the adaptation of donation methods, artificial intelligence, online donation, social media and new payment technologies); specialization (applications, skills, undesirable data); Ethical norm (evoking the emotions of the visitors, reputation of the initiator); Credibility (retention of donors, accountability, frequency of visits); media specialization (spatial and geographical effects, spatial inequalities); participation and empathy (interaction and cooperation, appropriate treatment); persuasion (persuasion, understanding donors); understanding differences (mindsets, grouping); subjective norms (influence of internal factors, psychological characteristics); attitudes (motivations of personal gain, material benefits, material benefits, stock-based or reward-based collective investment, social rewards, individual interests) are those that are directly And it indirectly affects the intention to donate online for crowdfunding.ConclusionThe extracted components clearly state that presenting the main subject of projects, charity campaigns, transparency and trust building in the correct way can cause the success of Crowdfunding of charities.

Introduction: Anaesthetic sedatives are widely used for bronchoscopy and Endobronchial Ultrasound (EBUS) to ensure patient cooperation and minimise patient discomfort. Dexmedetomidine is an α2 adrenergic agonist used for sedation. Aim: To evaluate the safety and efficacy of nebulised dexmedetomidine in EBUS. Materials and Methods: In this randomised double-blinded controlled study, conducted in the Department of Anaesthesiology and Pulmonary Medicine at Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India from 2020 to 2022, 52 patients aged between 18 and 70 years undergoing EBUS were included. Patients were randomly assigned to the study group (S) and the control group (C). Group C received nebulised lidocaine (2%) 10 mL for 10-15 minutes in a sitting position. Group S received nebulised lidocaine (2%) 8 mL + Dexmedetomidine 2 mL (1 mcg/kg) for 10-15 minutes in a sitting position. Haemodynamic parameters, cough severity scores, patient and operator satisfaction scores, Midazolam requirements, and any complications were recorded and compared. The data were analysed statistically using the Student’s t-test and Chi-square test, whichever was feasible. A p-value of

Abstract Background Sepsis is a clinical syndrome associated with a systemic reaction to infection that is seen as a bacteremia with systemic symptoms. Sepsis is one of the most important problems in children and is associated with many deaths, so recognizing this disease and it’s causing factors and identifying the predisposing factors for it is of great importance. Globally, the prevalence and occurrences of sepsis and septic shock are increasing, while the incidence of deaths from them has decreased with the improvement of diagnostic and treatment facilities. According to a 2015 World Health Organization report, approximately 5.9 million children under 5 years old have lost their lives due to sepsis worldwide, the majority of which have occurred in developing countries. Methods This study was conducted in the pediatric department of Maiwand Teaching Hospital (MTH) in 2020 as a descriptive cross-sectional study. All children who were admitted to the pediatric department of Maiwand Teaching Hospital during 2020 were included in the research. Among them, the prevalence of sepsis in children with respect to age and sex was studied. The study included children over the age of 28 days who were admitted to the Maiwand Teaching Hospital pediatrics department in 2020. However, in this study, patients have been categorized into five categories according to age: less than two months, two months to one year, one to three years, three to five years old, and older than five years old. Results This study was conducted in the pediatric department of Maiwand Teaching Hospital in 2020 as a descriptive cross-sectional study, and it was found that the prevalence of sepsis in children who were admitted to the pediatric department at this year was 50.5%, including the highest prevalence in males (65.75%) and at the age of two months to one year (37.9%). In this study, it was found that the prevalence of sepsis was higher (88.46%) among urban children than children who were living in villages (11.53%). In this study, the mortality rate was 2.44% for patients admitted to Maiwand Teaching Hospital. Conclusions In this study, it was found that the prevalence of sepsis was 50.5% in children admitted to the pediatrics department of Maiwand Teaching Hospital, of whom 67.75% were boys, 37.94% were aged two months to three years old, and it was more prevalent (88.46%) among children living in cities. The mortality rate was 2.44%.

Abstract Background Necrotizing pneumonia is rare in children and is one of the most serious complications of a lung infection caused by antibiotic failure. We present a 12-year-old leukopenic child with a long-lasting lung infection, presenting as having a lung hydatid cyst, but diagnosing with necrotizing pneumonia in the right bilobed lung. Failure to medical treatment and ongoing leukopenia justified surgical intervention with positive results. Case presentation The patient was referred to our teaching hospital’s pediatric surgery department. He had previously been diagnosed with intestinal tuberculosis (TB) and received anti-TB treatment. On referral to our hospital, the patient was suffering from restlessness, frequent coughing, fever, vomiting, and diarrhea. Following the completion of the clinical work-up, a blood test revealed leukopenia (white blood cell count of 2100/microliter), a normal platelet count, and a lesion in the right lung. Computerized tomography scanning (CT-Scan) image reported a lung hydatid cyst. In the pediatrics ward, a broad-spectrum antibiotics regimen with triple-antibiotic therapy (linezolid, vancomycin, and metronidazole) was instituted and continued for a week with no response, but worsening of the condition. In the pediatric surgery ward, our decision for surgical intervention was due to the failure of medical treatment because of a pulmonary lesion. Our team performed right lung upper lobe anterior segment wedge resection due to necrotizing pneumonia and followed the patient 45 days post-operation with a reasonable result. Conclusion Living in remote rural areas with low resources and inaccessibility to proper and specialized diagnostic and treatment centers will all contribute to an improper diagnosis and treatment of lung infection. In total, all of these will increase the morbidity and mortality due to lung necrosis in the pediatric population, regardless of their age. In low-resource facilities, high-risk patients can benefit from surgical intervention to control the ongoing infection process.

Shatt al-Arab river is the main water source in Basrah province, subjected to significant environmental and hydrological changes that have led to the complete degradation of its ecosystem, particularly the middle section. Nineteen water quality variables were selected to assess Spatio-temporal changes in the middle section. Eight variables were chosen with the most significant impact on Shatt al-Arab river water quality in calculating the water quality index (WQI). These variables were measured every month from December 2020 to November 2021at five observation stations (Abu-Flous, Mhela, Baradeyea and Maqal) located on the main river and one on the Karmat Ali canal, which connects the Shatt al-Arab river with east Hammar marsh. The study was divided into two seasons of the year, the wet season (December 2020 - May 2021) and the dry season (July2021-November 2021), in the calculation of the WQI and its annual calculation. The results of the current study show a deterioration in the values of most water quality variables, particularly those related to dissolved salts and organic and bacterial pollution. Water quality was also classified as poor on the WQI scale at all stations for the duration of the study. The results of the WQI indicated the deterioration in the quality of the water middle section, particularly during dry season. The degradation of the waters of the middle section of the Shatt al-Arab river is due to two main factors: increase salinity and organic pollution. In general, the Shatt al-Arab river and the middle section, in particular, need comprehensive management, including a clear and expeditious plan to identify and address the degradation of the river's environment, which has a great importance to all residents of Basrah province.

Background: Antimicrobial drugs are the most frequently prescribed drugs in hospital settings with intensive care unit (ICU) patients showing the highest consumption of these drugs. Antimicrobial overuse and misuse is attributed to antimicrobial resistance (AMR). AMR in coming years will emerge as a global pandemic, maiming the modern health-care system. High consumption of antimicrobial drugs is one of leading factors contributing to AMR. Aims and Objectives: This study aimed at evaluating the prescription pattern of antimicrobial drugs in ICU and estimates the burden of inappropriate antimicrobial drug utilization in ICU settings of a tertiary level teaching hospital. Materials and Methods: The current study was conducted on 100 patients over a period of 6 months, admitted in surgical ICU (SICU), and neuro SICU (NICU) of a tertiary level hospital in Jammu and Kashmir, India. Study patients were identified through daily review of pharmacy records and antimicrobial drugs prescribed for the initial 5 days of ICU admission were documented in a well-designed questionnaire consisting all the necessary information regarding antibiotic therapy. Results: Out of the 100 enrolled study subjects, 98% received an empiric therapy. Majority of the patients were given a combination antimicrobial therapy during the initial 5 days of ICU admission. The most common antibiotic prescribed as monotherapy was ceftriaxone during the initial 2 days of ICU stay followed by piperacillin-tazobactam and meropenem in the next 3 days. Amikacin was the most frequently prescribed antibiotic in combination therapy during first 2 days followed by vancomycin in the consecutive days. A total of 27 antimicrobial drugs belonging to 15 classes were prescribed to the study participants during the initial 5 days of ICU admission. Conclusion: The study reports a very high consumption of antimicrobial drugs in ICUs with maximum of antimicrobial therapies prescribed empirically. A robust action plan, consisting of proper protocol for prescribing empiric antimicrobials, regular monitoring of antibiotic consumption in ICUs with a system of prospective audit, and feedback and timely interventions are a keystone of good antibiotic stewardship and should be the focus in ICU and NICU.

Despite improvements in the detection and control of infectious diseases, many new pathogens are emerging and re-emerging in various parts of the world. Most of these emerging and re-emerging infections are of zoonotic origin, which highlights the importance of the human–animal interface. Similarly, the rate of vector-borne diseases has increased recently due to changes in human habitats, climate change, deforestation, changes in food production practices, and increased population movement. The risk of spread of these zoonotic and vector-borne diseases is higher in the Eastern Mediterranean Region (EMR) of the World Health Organization due to its topography and geopolitical situation, fragile health systems, complex humanitarian emergencies, and, in some countries, other socioeconomic risk factors. Many countries in the region have reported outbreaks of zoonotic and vector-borne diseases over the last few decades, and some of these diseases have spread to other WHO regions as well. Avian influenza A (H5N1) and Middle East respiratory syndrome coronavirus (MERS-CoV) are among the greatest threats to global health security and both viruses are endemic in the EMR. Countries in the EMR have made significant progress toward the control of zoonotic and vector-borne diseases in recent years, and prevention, preparedness, and response capacities have been improved. However, there are still many challenges associated with the control of these diseases in the EMR, particularly in countries facing humanitarian emergencies. In this paper, we present the current situation of emerging and re-emerging infections in the EMR and discuss progress, challenges, and ways forward.

The quality of tropical fruits and vegetables and the expanding global interest in eating healthy foods have resulted in the continual development of reliable, quick, and cost-effective quality assurance methods. The present review discusses the advancement of non-destructive spectral measurements for evaluating the quality of major tropical fruits and vegetables. Fourier transform infrared (FTIR), Near-infrared (NIR), Raman spectroscopy, and hyperspectral imaging (HSI) were used to monitor the external and internal parameters of papaya, pineapple, avocado, mango, and banana. The ability of HSI to detect both spectral and spatial dimensions proved its efficiency in measuring external qualities such as grading 516 bananas, and defects in 10 mangoes and 10 avocados with 98.45%, 97.95%, and 99.9%, respectively. All of the techniques effectively assessed internal characteristics such as total soluble solids (TSS), soluble solid content (SSC), and moisture content (MC), with the exception of NIR, which was found to have limited penetration depth for fruits and vegetables with thick rinds or skins, including avocado, pineapple, and banana. The appropriate selection of NIR optical geometry and wavelength range can help to improve the prediction accuracy of these crops. The advancement of spectral measurements combined with machine learning and deep learning technologies have increased the efficiency of estimating the six maturity stages of papaya fruit, from the unripe to the overripe stages, with F1 scores of up to 0.90 by feature concatenation of data developed by HSI and visible light. The presented findings in the technological advancements of non-destructive spectral measurements offer promising quality assurance for tropical fruits and vegetables.

Limiting the scope of Maritime English (ME) courses to nautical subject matters, due to the conventional views who define ME as the global language used at sea, may not be based on a real needs analysis of English for Specific Purposes (ESP) courses in ports and maritime related organizations. Utilizing a mixed-methods approach, this study aimed to challenge this traditional perception through conducting an ESP needs analysis in Ports and Maritime Organization (PMO) of Iran. All the 17 departments’ managers and/or their delegates were interviewed, then a researcher-made questionnaire which was developed according to the interviews was distributed among the experts (70 respondents). The deductive content analysis was used for analyzing the qualitative part, and the quantitative data were analyzed through descriptive statistics. It was revealed that the overall needs of PMO in terms of ESP does not concord with conventional nautical-based Maritime English courses, and it in fact encompasses a much wider variety of content areas such as “port economic, marketing and investment, legal, tariffs, agreements and contracts, education, research, strategic port administration, logistics” etc.

Root rot of Panax ginseng caused by Cylindrocarpon destructans, a soil-borne fungus is typically diagnosed by frequently checking the ginseng plants or by evaluating soil pathogens in a farm, which is a time- and cost-intensive process. Because this disease causes huge economic losses to ginseng farmers, it is important to develop reliable and non-destructive techniques for early disease detection. In this study, we developed a non-destructive method for the early detection of root rot. For this, we used crop phenotyping and analyzed biochemical information collected using the HSI technique. Soil infected with root rot was divided into sterilized and infected groups and seeded with 1-year-old ginseng plants. HSI data were collected four times during weeks 7–10 after sowing. The spectral data were analyzed and the main wavelengths were extracted using partial least squares discriminant analysis. The average model accuracy was 84% in the visible/near-infrared region (29 main wavelengths) and 95% in the short-wave infrared (19 main wavelengths). These results indicated that root rot caused a decrease in nutrient absorption, leading to a decline in photosynthetic activity and the levels of carotenoids, starch, and sucrose. Wavelengths related to phenolic compounds can also be utilized for the early prediction of root rot. The technique presented in this study can be used for the early and timely detection of root rot in ginseng in a non-destructive manner.