Influence of using synbiotics by various routes on Mandarah male chicks: intestinal bacterial counts, gut morphology and histological status.

This experiment investigated the influence of different synbiotic processing methods on the intestinal bacterial count, morphology and histological status of developed male Mandarah chicks. Two hundred and ten male Mandarah line chicks aged 1 d were randomized to receive one of 7 chicks. The method and dose for 1-time synbiotics administration to the day-old chicks were as follows: G1: chicks on basal diet received no treatment (control); G2: 0.25 mL synbiotics sprayed; G3: 0.50 mL synbiotics sprayed; G4: 0.25 mL of synbiotics are added to drinking water; G5: 0.50 mL of synbiotics are added to drinking water; G6: 0.25 mL of synbiotics dripped into the mouth; and G7: 0.50 mL of synbiotics dripped into mouth drops. Lactic acid bacteria(LAB) were significantly increased (P<0.0001) compared to the control group and other treated groups and had the maximum values after the use of synbiotics via drinking water (0.25 or 0.50 mL). Furthermore, when comparing the treated birds (G4, G5) with the control birds, the Escherichia coli concentration in the drinking water containing synbiotics was significantly lower. In addition, treated chickens at (G7) showed a higher duodenum, ileum villus height (VH), and VH. - Ileum crypt depth (CD) ratio compared to other groups. In addition, birds treated with 0.50 mL of synbiotics in drinking water (G5) performed better in duodenum, ileum, CD and VH. - CD ratio than the other groups. Meanwhile, intestinal tract length and visceral pH did not differ significantly between groups. It can be concluded that the use of 0.25 mL of synbiotics in drinking water can improve the overall health of birds.

Effect of drying system, layer thickness and drying temperature on the drying parameters, product quality, energy consumption and cost of the marjoram leaves.

The main aim of this work is to study the main factors affecting the quality of the dried product and the energy requirements through optimizing these factors. To achieve that different drying systems (solar, hybrid solar and oven dryings), layers thickness (1, 2 and 3 cm) and drying temperatures (50, 60 and 70 °C) were used. The obtained results indicated that, the accumulated weight loss of marjoram leaves ranged from 73.22 to 76.9%, for all treatments under study. The moisture content of marjoram leaves ranged from 273.39 to 333.17, 258.02 to 333.04 and 269.38 to 324.90% d.b. for hybrid solar, oven and solar drying systems, respectively. The highest value of the drying rate of marjoram leaves (223.73 gwater kg-1 h-1) was obtained when the marjoram dried by oven drying system at 70 °C at 1 cm layer thickness. The highest values of the basil and marjoram oil content (2.91%) was obtained when the marjoram dried under sun drying system. The energy consumption for drying marjoram decreases with increasing drying temperature and layer thickness for hybrid solar and oven drying systems. The cost of dried marjoram dried under hybrid solar drying system was lower than those of oven drying system, the highest cost (13.48 LE kg-1) was obtained at a temperature of 50 °C and a layer thickness of 1 cm.

Improvement of the production of bio-oil and biodiesel from Egyptian Jatropha seeds by using microwave and ultrasonic.

Bio-diesel is used for engine as a replacement of diesel fuel which is characterized by lower emission, low pollution and renewable some of fuel. This study focus on how to enhance the production of bio-oil from Jatropha seeds by using microwave and ultrasonic as pre-treatments. To achieve that, the effects of extraction temperature (60, 80, 100 and 120 °C) and extraction screw speed (60, 90 and 120 rpm) on oil extraction yield and quality, extraction energy requirements and extraction time and were studied. Studying the effect of pretreatments by microwave and ultrasonic on the yield, energy and time of extraction were studied. The results most important indicate that the highest oil yield (25.1%) was recorded at 120 °C extraction temperature and 60 rpm screw speed. The energy required for extraction ranged from 8 to 11.5 W.h depending on temperature and speed of extraction. The results indicated that using both pretreatments improve the oil yield by 5.03% for microwave and by 6.75% for ultrasonic. Finally, the results concluded that to produce 1 kg of biodiesel you need 1.1 kg raw oil and consume from 2052.5 W.h energy requirement.

A novel potentiometric sensor based on ZnO decorated polyaniline/coal nanocomposite for diltiazem determination.

Diltiazem (DTZ) is one of the most effective medications for treating cardiovascular diseases. It has been widely used for the treatment of angina pectoris, hypertension and some types of arrhythmia. The development and application of a modified carbon paste sensor with improved detection limits for the potentiometric determination of diltiazem are the main goals of the current study. Sensitivity, long-term stability, reproducibility and improving the electrochemical performance are among the characteristics that have undergone careful examination. A modified carbon paste sensor based on ß-cyclodextrin (ß-CD) as ionophore, a lipophilic anionic additive (NaTPB) and a ZnO-decorated polyaniline/coal nanocomposite (ZnO@PANI/C) dissolved in dibutyl phthalate plasticizer, exhibited the best performance and Nernstian slope. The ZnO@PANI/C based sensor succeeded in lowering the detection limit to 5.0 × 10-7 through the linear range 1.0 × 10-6 to 1.0 × 10-2 mol L-1 with fast response time ≤ 10.0 s. The prepared nanomaterial was characterized using X-ray diffraction (XRD), Fourier transform infrared (FT-IR) spectroscopy and scanning electron microscopy (SEM). The surface properties of the proposed sensor were characterized by electrochemical impedance spectroscopy (EIS). The selectivity behavior of the investigated sensor was tested against a drug with similar chemical structure and biologically important blood electrolytes (Na+, K+, Mg2+, and Ca2+). The proposed analytical method was applied for DTZ analysis in pure drug, pharmaceutical products and industrial water samples with excellent recovery data.

Effect of loading rate and source of energy on the drying parameters of the basil during drying.

The basil leaves were dried different sources of energy at different loading rates. Using hybrid solar drying compared to the conventional source of energy such as fossil and propane. Drying parameters were studied. Also, product quality was assessed under study treatments. The results indicated that the higher accumulated weight loss of basil leaves (75.56%) were obtained at 25 kg m-2 loading rate and solar drying system. The highest rate of the decrease in moisture content of basil leaves was happened at the 45 kg m-2 loading rates. Meanwhile, the lowest rate of the decrease in moisture content of basil leaves was found at 15 kg m-2 loading rates. The highest drying rate of basil leaves (219.54 gwater kg-1 h-1) was obtained at the loading rate of 15 kg m-2. The highest values of total chlorophyll and color of basil leaves 745.9 and 36.35 were found for solar dryer. The lowest values of total chlorophyll and color of basil leaves 703.5 and 31.66 were found for diesel dryer. The drying efficiency ranged from 33.98 to 40.33% for all batch loads. The highest essential oil yield obtained for solar dryer, the lowest essential oil yield occurred for diesel dryer. The highest value of volatile compounds with found for solar dryer. The total costs for basil drying were 19.73, 26.70 and 23.93 LE h-1 for solar, diesel and propane dryers, respectively. Also, the total costs of basil drying were 8.77, 13.15 and 12.27 LE kg-1 dried for solar, diesel and propane dryers, respectively.

Partially substituting chemical NPK fertilizers and their impact on Eureka lemon trees (Citrus limon L. Burm) productivity and fruit quality.

The main aim of this study is to improve productivity, physical and chemical properties of the fruits and fruit quality of Eureka Lemon trees while lowering production costs by investigating the use of different NPK alternative sources (slow release, and bio) to reduce the use of chemical NPK fertilizers. Ten treatments of NPK fertilizers were applied. The results indicate that the highest values of yield (111.0 and 114.0 kg/tree) were found with 100% chemical NPK (control) for both first and second seasons, respectively. The lemon fruit weight ranged from 131.3 to 152.4 and 131.4 to 153.5 g for first and second seasons, respectively, for all treatments under study. The highest values of fruit length and fruit diameter were found with 100% chemical NPK (control) for both two seasons. The highest values of juice quality parameters (TSS, juice acidity, TSS/acid ratio and vitamin C concentration) responded favorably to higher chemical NPK treatment rates. The highest values of TSS, juice acidity, TSS/Acid ratio, and vitamin C concentration were 9.45%, 6.25%, 1.524 and 4.27 mg/100 g, respectively, were found with 100% chemical NPK (control) for both two seasons. Meanwhile, the lowest value of total sugar was found with 100% chemical NPK (control) for both two seasons.

Socioeconomic risk factors for low birth weight newborns: A population-based study.

Low birth weight (LBW) is an important indicator of maternal health and poverty. This study explored the socioeconomic factors associated with LBW. METHODS: Data was collected from a 4-year maternal-newborn registry. RESULTS: There were 5,316 LBW and 54,029 normal birth weight (NBW). The prevalence of LBW was 9%. The Native women in the LBW group compared to non-native women were 10.4% (1784/5316) vs. 8.4% (3532/5316) with a P-value of 0.001. There were more illiterate mothers in the LBW compared to the NBW, respectively: 8.1% (1597/19497) vs. 7.5% (1763/23230) with a P-value of 0.001. Working mothers tend to have more LBW infants compared to mothers with NBW, 8.4% (1588/17217) vs. 7.9% (2532/31891) and P-value 0.001. Young mothers (<20 years old) with early childbearing had more LBW compared to older mothers, respectively 12.7% (180/1414) vs. 8.9% (5149/52919) P-value <0.001. Women with no antenatal care reported a high rate of LBW compared to women with regular antenatal care: 14.2% (516/3696) vs. 8.6% (4741/55691) P-value <0.001. LBW babies were born more from assisted conception pregnancies (38% compared to 8.4% of normal pregnancies) P-value <0.001. Smoking mothers scored higher with LBW at 13.6% vs. 8.3% and a P-value of 0.001. There were no differences between the two groups regarding religion, consanguinity, marital status, or family income. CONCLUSION: Risk factors for low birth weight can be improved by providing antenatal care, smoking cessation, optimizing high-risk pregnancy care, and governing assisted reproduction regulations.

Enhancing bio-oil yield extracted from Egyptian castor seeds by using microwave and ultrasonic.

Energy scarcity and conventional energy problems are the main reason of finding a renewable source of energy which is cheap and environmental friendly, therefore, biodiesel production is one of the most promising solutions of this problem. Also, Egyptian castor is one of the most important crops for oil production compared with other commonly used oil crops. The main aim of this study is to enhance the production of bio-oil from Egyptian castor seeds by using microwave and ultrasonic as pre-treatments. To achieve that, the effects of extraction screw speed (20, 40 and 60 rpm) and temperature (100, 150, 200 and 250 °C) on oil extraction yield and quality, extraction energy requirements and extraction time and were studied. Also, the effect of pretreatment conditions of microwave at three levels of power (Low, Med and High) and different times (1, 2 and 3 min) and pretreatment condition ultrasonic with different temperatures (40, 60 and 80 °C) and different times (15, 30 and 45 min) for castor seeds before extraction with the optimum condition of the screw press on oil extraction yield from castor seeds, extraction energy, extraction time and quality of the oil extracted. The results indicate that the optimum conditions oil extraction by screw press were 200 °C extraction temperature and 60 rpm screw speed. It could be seen that the extraction oil yield, extraction energy requirements and extraction time were 35.59%, 18.68 and 1.86 min, respectively. Microwave pretreatments had better on oil yield and energy required for extraction compared to ultrasonic pretreatments, where, microwave pretreatments recorded high oil yield and lower energy requirements compared to the ultrasonic pretreatments. Oil yield ranged from 32.67 to 37.41% compared to 13.29 to 39.83% in literature. The time required for extraction was ranged from 1.77 to 2.00 and 1.79 to 2.21 min for microwave and ultrasonic pretreatments, respectively. The pretreatment improved properties of the extracted oil.

Epigenomic charting and functional annotation of risk loci in renal cell carcinoma.

While the mutational and transcriptional landscapes of renal cell carcinoma (RCC) are well-known, the epigenome is poorly understood. We characterize the epigenome of clear cell (ccRCC), papillary (pRCC), and chromophobe RCC (chRCC) by using ChIP-seq, ATAC-Seq, RNA-seq, and SNP arrays. We integrate 153 individual data sets from 42 patients and nominate 50 histology-specific master transcription factors (MTF) to define RCC histologic subtypes, including EPAS1 and ETS-1 in ccRCC, HNF1B in pRCC, and FOXI1 in chRCC. We confirm histology-specific MTFs via immunohistochemistry including a ccRCC-specific TF, BHLHE41. FOXI1 overexpression with knock-down of EPAS1 in the 786-O ccRCC cell line induces transcriptional upregulation of chRCC-specific genes, TFCP2L1, ATP6V0D2, KIT, and INSRR, implicating FOXI1 as a MTF for chRCC. Integrating RCC GWAS risk SNPs with H3K27ac ChIP-seq and ATAC-seq data reveals that risk-variants are significantly enriched in allelically-imbalanced peaks. This epigenomic atlas in primary human samples provides a resource for future investigation.

Using of geographic information systems (GIS) to determine the suitable site for collecting agricultural residues.

The main aim of this study is to use the Geographic Information Systems (GIS) techniques to determine the optimum site to collect the residues in order to reduce cost and increase the benefits. To achieve these three scenarios were studied to reach the best collection sites for recycling rice straw in Sinbilawin center. The results indicate that the first scenario: The result was forty (40) collection sites in this status the cost of transfer will be very high because the collecting starts from inside village to the 40 sites and transfer to main sites to recycle operation. The second scenario: The total lengths of roads are not much then the cost of transfer is low and save time and efforts. The third scenario: The result was five collecting sites. It was shortest length and lowest cost. Transportation costs in the first scenario were difficult to calculate because of the difficulty to access a network of documented roads from satellite maps to use it with the GIS program. The total internal transport costs were 987,308.86 and 826,966.43 L.E (Egyptian pound, $ = 19.15 L.E) for second and third scenarios, respectively. The average transport costs per ton were 17 and 14 L.E/ton for the second and third scenarios, respectively. Also, the total lengths of roads were 817.62 and 615.65 km for the second and third scenarios, respectively.

Prevalence of restless legs syndrome in pregnant women in Oman and its effect on pregnancy and neonatal outcomes.

BACKGROUND: Restless legs syndrome (RLS) is a common sensorimotor disorder during pregnancy. The purpose of this study was to assess the prevalence of RLS and explore the associated risk factors and outcomes in Omani women in the first and third trimester and at 2-week postpartum. MATERIALS AND METHODS: This cross-sectional study included 305 pregnant women visiting four health centers in Muscat between May 2018 and October 2020. A structured questionnaire was used and data were collected through review of electronic records and face-to-face interviews. The International RLS Study Group criteria were used to diagnose RLS. Participants were interviewed during their first trimester, their third trimester, and at their 2-week postpartum visit. Results were presented as means and standard deviations or percentages, as appropriate. To assess the association between RLS and various variables, unpaired t-test or McNemar's test were used, as appropriate. RESULTS: The mean age at baseline was 29.8 ± 5.28 years. The prevalence of RLS was significantly higher in the third trimester (41.0%) than in the first trimester (15.7%) and postpartum period (15.1%) (P < 0.001), although there was no significant difference in severity. Family history and personal history of RLS were the only independent correlates of RLS (P < 0.001 and 0.002, respectively). No associations were noted with pregnancy and neonatal outcomes or other comorbidities, including anemia. However, there was a significant relationship between the development of RLS and weight gain during pregnancy (P = 0.023). CONCLUSION: One in six pregnant Omani women may be at risk of RLS during the first trimester, while one in 2-3 may be at risk in the third trimester, particularly those with a personal or family history of RLS and those who gain >12 kg during pregnancy.

Microstructural, Physicochemical, Microbiological, and Organoleptic Characteristics of Sugar- and Fat-Free Ice Cream from Buffalo Milk.

Ice cream is a popular dessert product across the world. Structure, body, taste, and odor properties are created by adding non-milk ingredients and milk ingredients. The main aim of the study is to decrease the caloric value of ice cream by using sugar and fat replacements. Ice cream treatments were investigated based on microstructural, chemical, physical, microbiological, sensory, and calorific values. Four different ice creams were used (control ice cream (SC1), ice cream with stevia (SC2), ice cream with sucralose (SC3), and ice cream with sorbitol (SC4)). The chemical properties in all treatments of ice cream were significantly recorded (p < 0.05). The highest sucrose and fat levels were detected in the SC1 treatment compared with the other treatments (p < 0.05). The lowest fat and sugar amounts were observed in the SC2, SC3, and SC4 treatments (p < 0.05). The highest viscosity, overrun, and hardness values (p < 0.05) were detected in the control ice cream. Total aerobic mesophilic bacterial counts were not significantly recorded between different ice cream treatments (p < 0.05). The sensory scores were not significantly affected by sweeteners and bulk agents in the different treatments. The highest calorific value was calculated in the SC1 samples (p < 0.05). On the other hand, the lowest calorific value was calculated in SC2, followed by the SC3 and SC4 treatments. In scanning electron microscopy (SEM), the gel exhibited a homogeneous structure with a fine network within the SC2, SC3, and SC4 treatments, as it contained a cohesive structure with small-sized pores.

Association of Osteopontin gene single nucleotide polymorphism with lupus nephritis.

AIM: To determine the association of single nucleotide polymorphism at 9250 C/T in exon 7 of the Osteopontin (OPN) gene among Egyptian patients with lupus nephritis (LN) and healthy controls and assess its relation with clinical and laboratory features in addition to both activity and chronicity indices in these patients. MATERIALS AND METHOD: The study population includes 100 patients with LN and 100 age- and gender-matched controls. OPN gene 9250 C/T polymorphism was detected by polymerase chain reaction and restriction fragment length polymorphism. RESULTS: We observed a significant difference in the frequencies of the OPN gene 9250 T allele between the patients with LN and the controls (74.5% vs 57.5%, P < .001); also, TT and CT + TT genotypes showed significant differences in frequencies between LN patients versus controls (59% vs 35% P = .005 and 90% vs. 80% P = .048, respectively). We also observed a non-significant association between OPN gene 9250 genotypes and each of the laboratory data and clinical features in addition to activity and chronicity indices in all studied LN patients. There were no statistically significant increased TT and CT + TT genotypes and T allele frequencies in LN patients with renal failure compared to those without renal failure. Logistic regression analysis revealed that only OPN (CT + TT) genotype could predict LN development in Egyptian patients. CONCLUSION: TT and CT + TT genotypes and T alleles of OPN 9250 are considered risk factors for LN development in Egyptian systemic lupus erythematosus patients. However, these genotypes showed no association with each laboratory data and clinical feature or activity and chronicity indices in these patients. OPN 9250 (CT + TT) genotype could be used to predict LN development in SLE.

Evaluation of serum cardiac troponin I and N-terminal pro-B-type natriuretic peptide levels in patients with alopecia areata.

Alopecia areata (AA) is a recurrent, immune-mediated, hair-loss disorder. It is associated with other autoimmune disorders that carry a high risk of cardiovascular disease (CVD). However, there is a lack of reports on the association of cardiovascular comorbidities and AA. Cardiac troponin I is a biomarker of myocardial ischaemia and inflammation, while N-terminal pro-B-type natriuretic peptide is used in the diagnosis of congestive heart failure. This study was conducted to assess the serum level of both markers by ELISA in 44 patients with AA compared with 44 healthy controls (HCs). None of the participants had CVD, CVD risk factors or other diseases associated with elevation of either marker. The study revealed that serum levels of both markers were significantly higher in patients with AA compared with HCs (P < 0.001). The inflammatory milieu encountered in AA may be associated with subtle myocardial inflammation that causes elevation of levels of both of these cardiac markers.

Stroke symptoms impact on mental and physical health: A Lebanese population based study.

BACKGROUND/OBJECTIVE: Stroke symptoms in the absence of diagnosed stroke are common worldwide and associated with stroke risk factors and great impact on the physical and mental health functioning. The aim of this study was to assess, at the national level, the association of stroke symptoms with mental and physical health. METHODS: Quality of life was assessed using physical and mental component summary scores (PCS and MCS) of the Short Form 12v2 Health Survey in the Lebanese population. We assessed the differences in the mean PCS and MCS scores among asymptomatic individuals with no stroke/transient ischemic attack (TIA) history (n=1167), symptomatic individuals with no stroke/TIA history (n=125) and those with stroke/TIA history (n=46). Psychometric properties of the Lebanese version of the SF- 12v2 were evaluated using principal component analysis. RESULTS: Symptomatic individuals had an average PCS scores of 2.31 (95%CI: 0.75-3.88) points lower and those with stroke/TIA history had 3.26 (95%CI: 1.01-5.51) points lower when compared with asymptomatic individuals with no stroke/TIA history. Similarly, MCS scores for symptomatic individuals were 2.58 (95%CI: 1.02-4.13) points lower and those with stroke/TIA history had 3.28 (95%CI: 1.06-5.50) points lower than asymptomatic individuals. CONCLUSION: Physical and mental health functioning declined among symptomatic individuals and those with stroke/TIA history. Thus, frequent monitoring for the early detection of stroke symptoms may be recommended.

Endoscopy management algorithms: role of cyanoacrylate glue injection and self-expanding metal stents in acute variceal haemorrhage.

Mortality from acute variceal bleeding (AVB) has improved markedly over the last 2-3 decades due to increased specialisation and standardisation of medical and endoscopic practice culminating in the production of consensus guidance based on expert opinion. Nonetheless, despite greater exposure, training and endoscopic practices, 30-day mortality still remains high at around 30%. This is a reflection of the high morbidity with liver disease, and limited endoscopic experience and/or endoscopic techniques used by the majority of general endoscopists. Clinical necessity defines our drive for further endoscopic innovation to improve 'best practice' and, therefore, clinical outcomes accordingly. Sclerotherpy, variceal band ligation and/or rescue balloon tamponade have been entrenched in most treatment algorithms over the decades. However, in recent years and albeit limited to specialised liver centres, cyanoacrylate glue injection therapy (for oesophageal and gastric varices), and the placement of a self-expanding metallic stent for oesophageal varices have begun to offer improved endoscopic care in experienced hands. Yet even in specialised centres, their application is sporadic and operator dependent. Here, we discuss the evidence of these newer endoscopic approaches, and hope to propose their inclusion in endoscopic therapy algorithms for 'best practice' management of AVB in all appropriately supported endoscopy units.

Template polymerization synthesis of hydrogel and silica composite for sorption of some rare earth elements.

New sorbents containing 2-acrylamido 2-methyl propane sulphonic acid monomer onto poly(vinyl pyrilidone) P(VP-AMPS) hydrogel and P(VP-AMPS-SiO2) composite have been synthesized by radiation template polymerization. The effect of absorbed dose rate (kGy), crosslinker concentration and polymer/monomer ratio on the degree of template polymerization of P(VP-AMPS) hydrogel was studied. The degree of polymerization was evaluated by the calculated percent conversion and swelling degree. The maximum capacity of P(VP-AMPS) hydrogel toward Cu(+2) metal ion found to be 91 mg/gm. The polymeric composite P(VP-AMPS-SiO2) has been successfully synthesized. The structure of the prepared hydrogel and composite were confirmed by FTIR, thermal analysis (TGA and DTA) and SEM micrograph. Batch adsorption studies for La(3+), Ce(3+), Nd(3+), Eu(3+) and Pb(+2) metal ions on the prepared hydrogel and composite were investigated as a function of shaking time, pH and metal ion concentration. The sorption efficiency of the prepared hydrogel and composite toward light rare earth elements (LREEs) are arranged in the order La(3+)>Ce(3+)>Nd(3+)>Eu(3+). The obtained results demonstrated the superior adsorption capacity of the composite over the polymeric hydrogel. The maximum capacity of the polymeric composite was found to be 116, 103, 92, 76, 74 mg/gm for La(3+), Ce(3+), Nd(3+), Eu(3+) and Pb(2+) metal ions respectively.

Experience of propofol sedation in a UK ERCP practice: lessons for service provision.

OBJECTIVE: Endoscopic retrograde cholangiopancreatography (ERCP) in the UK has been historically performed under conscious sedation. However, given the increasing complexity of cases, the role of propofol-assisted ERCP (propERCP) is increasing. We describe our experience of propERCP and highlight the importance of this service. DESIGN: Our prospective ERCP database was interrogated between January 2013 and January 2014. Data collection included procedural information, patient demographics, American Association of Anaesthesiologists (ASA) status, Cotton grade of endoscopic difficulty and endoscopic and anaesthetic complications. Comparison was made with patients undergoing conscious sedation ERCP (sedERCP). RESULTS: 744 ERCPs were performed in 629 patients (53% male). 161 ERCPs were performed under propofol. PropERCP patients were younger compared with the sedERCP group (54 vs 66 years, p<0.0001) but ASA grade 1-2 status was similar (84% vs 78%, p=0.6). An increased number of Cotton grade 3-4 ERCPs were performed in the propERCP group (64% vs 34%, p<0.0001). Indications for propERCP included sphincter of Oddi manometry (27%), previously poorly tolerated sedERCP (26%), cholangioscopy (21%) and patient request (8%). 77% of cases were elective, 12% were urgent day-case transfers and 11% were urgent inpatients. 59% of cases were tertiary referrals. ERCP was completed successfully in 95% of cases. Anaesthetic and endoscopic complications were comparable between the two groups (5% and 7% vs 3% and 5%). Where sedERCP had been unsuccessful due to patient intolerance, the procedure was completed successfully using propofol. CONCLUSIONS: PropERCP is safe and is associated with high endoscopic success. The need for propERCP is likely to increase given patient preference and the high proportion of complex procedures being undertaken. All endoscopy units should look to incorporate propofol-assisted endoscopy into aspects of their services.

Risk factors profile of shoulder dystocia in oman: a case control study.

OBJECTIVE: This study aimed to assess the risk factor profile of shoulder dystocia and associated neonatal complications in Oman, a developing Arab country. METHODS: A retrospective case-control study was conducted among 111 cases with dystocia and 111 controls, identified during 1994-2006 period in a tertiary care hospital in Oman. Controls were randomly selected among women who did not have dystocia, and were matched to cases on the day of delivery. Data related to potential risk factors, delivery, and obstetric complications were collected. RESULTS: Dystocia was significantly associated with older maternal age, higher parity, larger BMI, diabetes, and previous record of dystocia. In addition, dystocia was associated more with vacuum and forceps deliveries. Routine traction (51%) was the most used manoeuvre. Among dystocia cases, 13% were associated with fetal complications of which Erb's Palsy was the most prevalent (79%). CONCLUSION: Our finding of significant associations with risk factors lays out the ground to develop a predictability index for shoulder dystocia, which would help in making it preventable. Further p rospective studies are required to confirm the obtained results.

SU-E-T-237: Leading 25 in 25: A Bibliometric Analysis of Classics Articles in IMRT.

PURPOSE: Scientific publication in IMRT has experienced significant development since its introduction. Bibliometric analyses allow an understanding of how this publication trend is organized at an aggregated level. Citation analysis is one of the most widely used bibliometric tools of scientometrics. Analysis of classics, defined as an articles with 100 or more citations, is common in the biomedical sciences as it reflects an article's influence and the recognition it receives in its professional and scientific community. Our objective was to identify the 25 most frequently cited classic articles in IMRT in the past 25 years. METHODS: The 25 most-cited IMRT articles were identified by searching ISI's Web of Knowledge and Pubmed databases for all related publications from 1986 through 2011. Articles were evaluated for several characteristics such as author(s), institution, country of origin, publication year, type, and number of citations. An unadjusted categorical analysis was performed to compare all articles published in the search period. RESULTS: Our search yielded a cumulative total of 37,197 entries for the publication period. Original research and clinical trial articles accounted for 25,827 and 312, respectively, for a total of 25,719 entries. The 25 most-cited articles were identified from the latter sum and selected out of 123 classics. The number of citations per article ranged from 203 to 504. IMRT classics appeared in one general and five core journals. CONCLUSIONS: This study analyzed publication patterns focused on IMRT, its most influential classic articles, journals that published them, their authors and other salient characteristics. Such information is of importance to researchers and those who wish to study the history and development of the field.