Transanal irrigation: best practice in the community.

Chronic constipation, which is common and often difficult to treat, has numerous origins, including neurological and other conditions, and adverse reactions to drugs, especially opioids. Chronic functional constipation lacks a clear underlying cause. Increasing evidence suggests that transanal irrigation (TAI) aids faecal evacuation and is well tolerated in many people with bowel dysfunction who do not adequately respond to first-line treatments. Recent papers offer insights that help nurses and other healthcare professionals implement best practice in the community, including discussing any need for assistance before starting TAI, agreeing the most appropriate device with patients and optimising the irrigation protocol. Training, careful follow-up and ongoing supervision improve adherence and success. Further studies are needed, however, and patients who do not respond adequately or are unable to tolerate TAI should be referred to a specialist service.

Outcomes of early versus late irrigation and debridement of pediatric open long bone fractures.

BACKGROUND: Open long bone fractures are a major concern for pediatric patients due to the risk of surgical site infection (SSI). Early studies have recommended irrigation and debridement of open fractures within 6 hours-8 hours for the prevention of SSI. According to the American College of Surgeons (ACS) Best Practice Guidelines, in 2015, irrigation and debridement should be done within 24 hours. AIM: To identify whether early irrigation and debridement, within 8 hours, vs late, between 8 hours and 24 hours, for pediatric open long bone fractures impacts rate of SSI. METHODS: Using retrospective data review from the National Trauma Data Bank, Trauma Quality Improvement Project (TQIP) of 2019. TQIP database is own by the ACS and it is the largest database for trauma quality program in the world. Propensity matching analysis was performed for the study. RESULTS: There were 390 pediatric patients with open long bone fractures who were included in the study. After completing propensity score matching, we had 176 patients in each category, irrigation and debridement within 8 hours and irrigation and debridement between 8 hours and 24 hours. We found no significant differences between each group for the rate of deep SSI which was 0.6% for patients who received surgical irrigation and debridement within 8 hours and 1.1% for those who received it after 8 hours [adjusted odd ratio (AOR): 0.5, 95%CI: 0.268-30.909, P > 0.99]. For the secondary outcomes studied, in terms of length of hospital stay, patients who received irrigation and debridement within 8 hours stayed for an average of 3.5 days, and those who received it after 8 hours stayed for an average of 3 days, with no significant difference found, and there were also no significant differences found between the discharge dispositions of the patients. CONCLUSION: Our findings support the recommendation for managing open long bone fractures from the ACS: Complete surgical irrigation and debridement within 24 hours.

Effect of the Irrigation Agitation Technique on Postoperative Pain in Teeth With Symptomatic Irreversible Pulpitis.

Introduction Irrigation of the root canal system is a vital step in endodontic treatment aimed at disinfecting the canal. The efficacy of irrigation can be improved by various irrigation agitation methods. One such novel method of interest is the manual dynamic agitation (MDA) technique. However, the effect of MDA on postoperative pain as compared to needle irrigation (NI) with sodium hypochlorite has been scarcely explored. This study aimed to compare the effects of NI and MDA techniques on postoperative pain in teeth with symptomatic irreversible pulpitis. Materials and methods This quasi-experimental study was conducted at the Department of Operative and Paediatric Dentistry, Fauji Foundation Dental Hospital, over four months after gaining ethical approval. One hundred and sixty-eight participants diagnosed with symptomatic irreversible pulpitis were enrolled in the study through the purposive sampling technique. The participants were divided into two groups based on the irrigation technique used: Group A (NI) and Group B (MDA). Postoperative pain was recorded after six hours, 24 hours, 48 hours, and seven days using the 0-100mm visual analog scale (VAS). The VAS scores were compared using an independent sample t-test. Results Out of 168 participants, 48.2% were in Group A and 51.2% in Group B. The study found that VAS pain scores for Group B (MDA) were significantly lower at six hours, 24 hours, 48 hours, and seven days as compared to Group A (NI), with a p-value less than 0.001. Conclusion This study shows that the MDA technique leads to decreased postoperative pain both immediately after endodontic treatment and a week later as compared to the NI technique. Hence, the use of MDA can aid in controlling postendodontic pain and, therefore, ensure smoother recovery and increased patient satisfaction.

Effect of continuous vs sequential chelation on the mechanical properties of root dentin: An ex vivo study.

OBJECTIVES: To evaluate the mechanical properties of root canal dentin treated with sodium hypochlorite (NaOCl) in combination with hydroxyethylidene diphosphonic acid (HEDP) or ethylenediaminetetraacetic acid (EDTA). METHODS: For testing fracture resistance, 45 single-rooted teeth were instrumented and irrigated with NaOCl/HEDP, NaOCl/EDTA, or distilled water. Fifteen untreated teeth served as control. After obturation, specimens from the experimental groups were thermocycled, dynamically-loaded, and then statically-loaded in a universal testing machine until failure. For flexural strength analysis, 15 teeth were instrumented and irrigated with NaOCl/HEDP or NaOCl/EDTA. Root segments were sectioned into dentin bars and tested for flexural strength using a universal testing machine. For microhardness evaluation, 20 teeth were instrumented and irrigated with NaOCl/HEDP or NaOCl/EDTA. Dentin disks from the coronal-third of each root segment were prepared, one before and one after irrigation, for microhardness testing with a Knoop hardness tester. RESULTS: The highest fracture resistance was recorded in the untreated group, and the lowest in the EDTA group. Although the HEDP group had higher fracture resistance than the EDTA group, the distilled water group demonstrated even greater fracture resistance than the HEDP group. Specimens treated with HEDP had significantly higher flexural strength and microhardness values when compared with those treated with EDTA. CONCLUSION: The fracture resistance, flexural strength, and microhardness of root canal dentin were higher when root canals were irrigated with NaOCl/HEDP, when compared with NaOCl/EDTA. CLINICAL SIGNIFICANCE: Irrigating root canals with NaOCl combined with HEDP significantly improves the mechanical integrity of root canal dentin compared to the use of NaOCl with EDTA.

Comparative clinical outcomes of irrigation techniques in burr-hole craniostomy for chronic subdural hemorrhage: a multicenter cohort study.

BACKGROUND: Chronic Subdural Hemorrhage(cSDH) is often treated with surgical blood drainage, but concerns about recurrence and outcomes persist. Surgical techniques, including irrigation, vary. This study compares the outcomes of irrigation in cSDH surgery. MATERIALS AND METHODS: From September 2020 to September 2022, 92 cSDH patients underwent surgery. Two different irrigation methods were used: extensive irrigation (IG) and non-irrigation (NIG). Method of irrigation was selected by each surgeon's preference. Parameters measured included volume of hematoma changes, midline shifting, complications, and basic demographics. Recurrence was defined as symptomatic or hematoma expansion more than double the volume before surgery. Factors predicting recurrence and irrigation method impact were analyzed. RESULTS: Eleven patients were excluded because of bilateral or related to other disease. We analyzed 81 patients (44 NIG, 37 IG). Recurrence occurred in 6 IG cases (16.2%) and 1 NIG case (2.3%). Irrigation method significantly affected recurrence (P = 0.043). Age, gender, medication, medical history, and preoperative measurements had no major impact on recurrence. NIG had unexpected cases of intracerebral hemorrhage. CONCLUSION: Extensive irrigation may increase recurrence in cSDH drainage. Non-irrigation drainage had fewer recurrences, but unexpected complications arose. Careful drainage in non-irrigated cases is crucial.

Assessment of Smear Layer Removal and Penetration Depth of Root Canal Irrigant Using Different Irrigation Activation Systems: A Comparative Study.

AIM: The aim of the current study was to evaluate the penetration depth and smear layer removal of root canal irrigant using various irrigation activation techniques. MATERIALS AND METHODS: In this investigation, sixty single-rooted premolars extracted for orthodontic purposes were chosen. Diamond burs were used to create an access cavity, and #10 K-file was used to determine the patency. About sixty samples were divided into the following three groups (20 samples in each group), group I: Irrigation with conventional needle, group II: Activation of EndoVac system, group III: Passive ultrasonic irrigation (PUI). The efficacy of the smear layer was assessed using a scanning electron microscopy at a ×2000 magnification. One-way ANOVA was used to record and analyze the data. All statistical analyses were performed with a significance level of p < 0.05. RESULTS: At coronal third, the maximum smear layer was removed in group II (1.26 ± 0.02) followed by group III (1.84 ± 0.16) and group I (2.89 ± 0.21). At middle third, smear layer removal was maximum in group I (1.18 ± 0.10) followed by group III (1.72 ± 0.09) and group I (2.66 ± 0.18). At apical third, the more smear layer was removed in group II (1.02 ± 0.01) followed by group III (1.58 ± 0.08) and group I (2.38 ± 0.06). There was a highly significant difference found between the three different irrigation systems at all three levels (p < 0.001). CONCLUSION: In conclusion, every irrigation device that was evaluated was successful in removing the smear layer from the root canal. However, the EndoVac system group removed a greater amount of smear layer compared with PUI and conventional needle group. CLINICAL SIGNIFICANCE: With the goal of promoting cleaning that is beyond the ability of mechanical devices, irrigation is a crucial part of root canal therapy. If an efficient irrigation delivery system is used, the irrigants can reach the working length (WL). This type of distribution system needs to provide a suitable amount of irrigants up to the WL, as well as have enough flow and be effective at debriding the entire canal system. How to cite this article: Pujari MD, Das M, Das A, et al. Assessment of Smear Layer Removal and Penetration Depth of Root Canal Irrigant Using Different Irrigation Activation Systems: A Comparative Study. J Contemp Dent Pract 2024;25(4):331-334.

Transfer of heavy metals from soil to vegetables: A comparative assessment of different irrigation water sources.

This study aimed to assess the transfer factor (TF) of heavy metals (HMs) from soil to commonly consumed vegetables irrigated with different water sources. The field study covered 36 m2 of agricultural land in Kermanshah province, Iran, divided into nine equal-sized plots. Coriander, basil, and radish were the three types of vegetables cultivated and subjected to irrigation over two months, utilizing three different water sources: treated wastewater effluent (TWE), river water (RW), and well water + nitrogen fertilizer (WWF). After the irrigation and harvesting stages, soil samples from the cultivation area and harvested vegetables were collected. These samples underwent analysis using the ICP-OES method to assess HM levels and subsequent calculation of the TF of HMs from soil to plants. The results revealed that the TF levels indicated plants' relatively weak response (TF < 1) to the absorption of HMs. For non-toxic elements (Mn, Fe, Zn, Cu, Ni), TF values were generally higher than those for toxic elements (Cd, As, Pb) across all three vegetable types and irrigation treatments. The study's findings suggest that the TF of HMs in the studied vegetables varied based on the irrigation source and vegetable type. Various factors, including the type of irrigation source and vegetable, influenced the TF of HMs, each having different impacts on the transfer rate of each HM. The study highlights the importance of monitoring irrigation water and soil quality to prevent the accumulation of HMs in cultivated vegetables, thereby mitigating potential risks to human health.

Randomized split-mouth clinical trial comparing osteoblastic activity and osteogenic potential of autogenous particle harvesting during implant surgery without irrigation and with irrigation.

OBJECTIVE: To compare the osteoblastic activity and osteogenic potential of autogenous particle harvesting during implant surgery using low-speed drilling without irrigation and high-speed drilling with irrigation. MATERIALS AND METHODS: Thirty patients with bilateral missing teeth of 3.6 and 4.6 were randomized into two groups (Group 1: low-speed drilling without irrigation and Group 2: high-speed drilling with irrigation) and 60 single dental implants were placed. The temperature at the tip of each drill was recorded and the harvested bone was weighed; particle size and Ca and P levels were also analyzed. After osteoblast culture, cell viability, cell cycle assay, cell migration, vascular endothelial growth factor (VEGF) concentration, and mineralized nodule formation were assessed. RESULTS: Although the temperature of the drills was slightly higher in Group 1, no statistically significant differences were observed (p ≤ 0.05); however, the amount of harvested bone was higher (p < 0.001) and the size of the particles was higher (p = 0.019). In relation to osteoblastic activity and osteogenic potential, higher cell proliferation, higher number of cells in G2/M and S phases, higher cell migration capacity, higher VEGF concentration, and higher amount of mineralized nodule formation were observed in Group 1. CONCLUSIONS: Low-speed drilling without irrigation does not result in a significant increase in bone temperature compared to conventional drilling. However, a greater amount of bone is obtained; in addition, osteoblastic activity and osteogenic potential are higher with this technique, but further clinical studies are necessary.

Improving the Antimicrobial Potency of Berberine for Endodontic Canal Irrigation Using Polymeric Nanoparticles.

To address the challenges posed by biofilm presence and achieve a substantial reduction in bacterial load within root canals during endodontic treatment, various irrigants, including nanoparticle suspensions, have been recommended. Berberine (BBR), a natural alkaloid derived from various plants, has demonstrated potential applications in dentistry treatments due to its prominent antimicrobial, anti-inflammatory, and antioxidant properties. This study aimed to produce and characterize a novel polymeric nanoparticle of poly (lactic-co-glycolic acid) (PLGA) loaded with berberine and evaluate its antimicrobial activity against relevant endodontic pathogens, Enterococcus faecalis, and Candida albicans. Additionally, its cytocompatibility using gingival fibroblasts was assessed. The polymeric nanoparticle was prepared by the nanoprecipitation method. Physicochemical characterization revealed spheric nanoparticles around 140 nm with ca, -6 mV of surface charge, which was unaffected by the presence of BBR. The alkaloid was successfully incorporated at an encapsulation efficiency of 77% and the designed nanoparticles were stable upon 20 weeks of storage at 4 °C and 25 °C. Free BBR reduced planktonic growth at ≥125 µg/mL. Upon incorporation into PLGA nanoparticles, 20 µg/mL of [BBR]-loaded nanoparticles lead to a significant reduction, after 1 h of contact, of both planktonic bacteria and yeast. Sessile cells within biofilms were also considered. At 30 and 40 µg/mL, [BBR]-loaded PLGA nanoparticles reduced the viability of the sessile endodontic bacteria, upon 24 h of exposure. The cytotoxicity of BBR-loaded nanoparticles to oral fibroblasts was negligible. The novel berberine-loaded polymeric nanoparticles hold potential as a promising supplementary approach in the treatment of endodontic infections.

Sealing of pulp chamber dentin in endodontics: Influence of bond strategy and time-point application.

Context: Seal the dentin of the pulp chamber during endodontic treatment to avoid interfering with the restorative treatment performed afterward. Aims: The aim was to evaluate the effect of three adhesive systems applied in different bonding strategies (etch-and-rinse, self-etch, and universal adhesive) and time-point application (immediately after the cavity access preparation or after endodontic obturation) on the hybrid layer formation and dentinal penetrability. Materials and Methods: Forty-eight sound molars were randomly distributed into six groups (n = 10) according to the adhesive system used: Forty-eight sound molars were randomly distributed into six groups (n = 10) according to the adhesive system used and the time-point application: Adper Scotchbond Multi-purpose (AS), Clearfil SE (CF) and Scotchbond Universal (SU) in strategy of immediate endodontic sealing (IES) or delayed endodontic sealing (DES). In IES-AS, IES-CF, and IES-SU groups, dentin sealing was performed immediately after the cavity access, while in DES-AS, DES-CF, and DES-SU, after root canal obturation. The specimens were sectioned in the long axis, in a buccal-lingual direction, and the dentinal penetrability of the adhesive systems was evaluated using confocal microscopy images. Hybrid layer formation was analyzed by scanning electron microscopy images. Statistical Analysis Used: Dentinal penetrability data were analyzed with the ANOVA test and the Kruskal-Wallis test was performed for hybrid layer data (α = 0.05). Results: IES-CF showed the lowest dentinal penetrability (P < 0.05), while the other protocols were similar to each other (P > 0.05). No significant differences were found between groups regarding the hybrid layer formation (P > 0.05). Immediate and DES protocols do not influence the hybrid layer formation, regardless of the bond strategy used. Conclusions: Sealing the pulp chamber dentin before endodontic treatment can improve the bond strength of the final restoration but the formation of the hybrid layer was not influenced by the bond strategy.

Enhancement in Tomato Yield and Quality Using Biochar Amendments in Greenhouse under Salinity and Drought Stress.

Enhancing saline water productivity in arid regions is essential for sustainable agriculture. Adding biochar can improve the quantity and quality of tomato yield under higher levels of salinity and lower levels of irrigation. The experiment aimed to evaluate the effects of biochar on enhancing tomato fruit quality and yield under salinity and drought stress. The experiment combines two treatments for irrigation water quality (0.9 and 2.3 dS m-1), four irrigation levels (40, 60, 80, and 100%) of crop evapotranspiration (ETc), and the addition of 5% of biochar to treated soil (BC5%) and untreated soil (BC0%). The results showed that the decrease in the water quality and irrigation levels negatively impacted the yield and properties of tomato fruit, while 5% of biochar application positively improved the yield. Adding biochar decreased the tomato yield by 29.33% and 42.51% under lower-saline-irrigation water than the control, negatively affecting the fruit's physical parameters and mineral content. In contrast, adding biochar and irrigating with saline water at 60% of ETc improved the firmness and quality characteristics of the fruit by 56.60%, 67.19, 99.75, and 73.57% for vitamin C (VC), total titratable acidity (TA), total soluble solids (TSS), and total sugars (TS), respectively, compared to the control, and also reduced the sodium content of the fruits under all irrigation levels compared to untreated plants by biochar. Generally, biochar with saline water under deficit irrigation with 80 and 60% of ETc could be an excellent strategy to enhance the qualitative characteristics of tomato fruits and save approximately 20-40% of the applied water.

Synergistic Effects of Soil-Based Irrigation and Manure Substitution for Partial Chemical Fertilizer on Potato Productivity and Profitability in Semiarid Northern China.

Soil-based irrigation and the partial substitution of chemical fertilizers with manure are promising practices to improve water and nitrogen (N) use efficiency. We hypothesize that their combination would simultaneously benefit potato production, tuber quality and profitability. A two-year experiment was conducted in semiarid northern China to investigate the combined effects of three water treatments [rainfed (W0), soil-based irrigation (W1), conventional irrigation (W2)] and three N treatments [no N (N0), chemical N (N1), 25% manure substitution (N2)] on these indicators, and to perform a comprehensive evaluation and correlation analysis. The results showed that water and N treatments separately affected all indicators except vitamin C content. Compared to W2, W1 significantly increased water productivity by 12% and irrigation water use efficiency (IWUE) by 30% due to 10% lower evapotranspiration and 21% lower water use. However, W1 and W2 negatively affected crude protein content. Conversely, this was compensated by the combination with N1 and N2. There were slight differences between N1 and N2 for all indicators on average across water treatments, while under W1, N2 significantly increased leaf area index (LAI) and N recovery efficiency (REN) by 18% and 29.4%, respectively, over N1. Also, comprehensive evaluations showed that W1N2 performed best, with the highest tuber yield, profit and acceptable quality. This can be explained by the increase in LAI, IWUE and REN due to the positive correlations with tuber yield and net return. Consequently, soil-based irrigation combined with 25% manure substitution had complementary effects on tuber quality and synergistic effects on potato productivity and profitability.

Increasing Hybrid Rice Yield, Water Productivity, and Nitrogen Use Efficiency: Optimization Strategies for Irrigation and Fertilizer Management.

Water and fertilizer are crucial in rice growth, with irrigation and fertilizer management exhibiting synergies. In a two-year field study conducted in Yiyang City, Hunan Province, we examined the impact of three irrigation strategies-wet-shallow irrigation (W1), flooding irrigation (W2), and the "thin, shallow, wet, dry irrigation" method (W3)-in combination with distinct fertilizer treatments (labeled F1, F2, F3, and F4, with nitrogen application rates of 0, 180, 225, and 270 kg ha-1, respectively) on rice yield generation and water-fertilizer utilization patterns. The study employed Hybrid Rice Xin Xiang Liang you 1751 (XXLY1751) and Yue Liang you Mei Xiang Xin Zhan (YLYMXXZ) as representative rice cultivars. Key findings from the research include water, fertilizer, variety, and year treatments, which all significantly influenced the yield components of rice. Compared to W2, W1 in 2022 reduced the amount of irrigation water by 35.2%, resulting in a 42.0~42.8% increase in irrigation water productivity and a 25.7~25.9% increase in total water productivity. In 2023, similar improvements were seen. Specifically, compared with other treatments, the W1F3 treatment increased nitrogen uptake and harvest index by 1.4-7.7% and 5.9-7.7%, respectively. Phosphorus and potassium uptake also improved. The W1 treatment enhanced the uptake, accumulation, and translocation of nitrogen, phosphorus, and potassium nutrients throughout the rice growth cycle, increasing nutrient levels in the grains. When paired with the F3 fertilization approach, W1 treatment boosted yields and improved nutrient use efficiency. Consequently, combining W1 and F3 treatment emerged as this study's optimal water-fertilizer management approach. By harnessing the combined effects of water and fertilizer management, we can ensure efficient resource utilization and maximize the productive potential of rice.

Potential microemboli formation risk and its management during the heated saline-enhanced radiofrequency needle-tip catheter ablation.

BACKGROUND: The potential risk of embolic events during ablation in the left ventricle (LV) with a heated saline-enhanced radiofrequency (SERF) needle-tip ablation catheter has not been characterized. OBJECTIVE: This study aimed to investigate the formation of microemboli or other untoward events during SERF ablation. METHODS: Ninety-three radiofrequency (RF) ablation procedures were performed in the LV of 14 pigs by using a SERF catheter (35 W, 70 seconds, and 60°C; normal or degassed saline [NS or DS] irrigation with a flow rate of 10 mL/min) vs a standard irrigated-tip radiofrequency (S-RF) catheter (30 or 50 W, 30 seconds, and 17 mL/min). Microbubble formation was graded on the basis of intracardiac echocardiography. Microbubbles, microembolic signals, and microparticles were monitored using our established model. RESULTS: There was no significant difference in microbubble volume among SERF-NS, SERF-DS, and S-RF 30 W with "grade 1" intracardiac echocardiography microbubbles (median [quartiles] 0.201 [0.011-3.13], 0.455 [0.06-2.66], and 0.004 µL [0.00-0.16 µL], respectively). There was no significant difference in microembolic signals among SERF-NS, SERF-DS, and S-RF 30 W with grade 1 bubbles (n = 8.0 ± 5.8, n = 7.6 ± 4.2, and n = 6.1 ± 6.1, respectively). Both SERF-NS and SERF-DS created larger lesions than did both S-RF 30 W and S-RF 50 W deliveries (mean 1241.5 ± 658.6, 1497.7 ± 893.4, 75.0 ± 24.8, and 184.0 ± 93.8 mm3; P < .001). There was no significant difference in microparticle incidence among groups (P = .675). No evidence of embolic events was found in the brain and other organs at the histology assessment. CONCLUSION: In the setting of SERF ablation, significantly large LV lesions can be created without any increment in embolic microbubble or particle events. Grade 1 microbubble is related to the efficacy and safety.

Modeling Al-Qaraqoul canal before and after rehabilitation using HEC-RAS.

The Egyptian Ministry of Water Resources and Irrigation launched in 2020 the national project to rehabilitate the canals network to rationalize the use of water resources to face the scarcity problems. The aim of study is to evaluate the impact of canal rehabilitation on the performance of irrigation water delivered laterally to Mesqa's and longitudinally to the end of canal. Qaraqoul Canal et al.-Mallah Area, Alexandria, Egypt, was modeled using Hydrologic Engineering Center's-River Analysis System (HEC-RAS) to simulate water levels in the canal before and after rehabilitation using four discharge scenarios: 1.82, 3.7, 2.2, 7.87 m3/s. The calibration before rehabilitation shows that HEC-RAS simulated water levels corresponding to a discharge of 2.2 m3/s were in a good agreement with the actual field measured water levels. HEC-RAS results demonstrated that rehabilitation hydraulically improved the efficiency and performance of water conveyed by the canal. On the other hand, second scenario can be considered as suitable to keep water to reach the canal downstream with minimum suitable discharge, providing the need of two emergency pumps at last two branch canals called Mesqa's. An ideal cross-section is also simulated using HEC-RAS which produced an efficient alternative with 40% less cost than the constructed alternative.

Efficacy and Safety of Xylitol Nasal Irrigation after Functional Endoscopic Sinus Surgery: A Randomized Controlled Study.

Xylitol is considered a naturally occurring antibacterial agent. It is generally believed to enhance the body's own innate bactericidal mechanisms. It also provides anti-adhesive effects against both Streptococcus pneumoniae and Haemophilus influenza. This study was performed to evaluate the efficacy and safety of xylitol nasal irrigation in the postoperative care of functional endoscopic sinus surgery (FESS). Patients with chronic rhinosinusitis who received FESS were recruited and randomly assigned to two groups at one month post-surgery. Thirty-five patients in the xylitol group received 400 mL of 5% xylitol nasal irrigation daily for 2 months, while another 35 in the normal saline (NS) group received 400 mL of NS nasal irrigation daily for 2 months. Prior to FESS, as well as before and after nasal irrigation, sinonasal symptoms were assessed through the 22-item Sino-Nasal Outcome Test Questionnaire. The patients also underwent an endoscopic examination while undergoing nasal function tests, and a cytokine measurement of the nasal lavage and a bacterial culture from the middle meatus were performed. The safety of the nasal irrigation was assessed through any self-reported adverse events, the Eustachian Tube Dysfunction Patient Questionnaire and the eustachian tube function test. The endoscopic scores and olfactory threshold significantly decreased after xylitol irrigation when compared with those before irrigation. The prevalence of Staphylococcus aureus in the nasal secretions also decreased significantly after xylitol irrigation. The amounts of Interleukin-5 and Interleukin-17A were significantly increased in the nasal lavage after xylitol irrigation. No side effects, including those related to eustachian tube function, were seen after nasal irrigation in both groups. Our results showed that xylitol nasal irrigation was both beneficial and safe during the postoperative care of FESS.

Sinus irrigation as an adjunctive therapy for odontogenic maxillary sinusitis - an in-depth analysis.

BACKGROUND: Odontogenic maxillary sinusitis (OMS) is widely acknowledged in both the dentistry and otolaryngology fields. Recently, iatrogenic odontogenic maxillary sinusitis cases can be encountered frequently. The purpose of this study was to evaluate the effect of intraoral sinus irrigation using the small lateral window approach in patients with odontogenic maxillary sinusitis by comparing pre- and postoperative volumetric measurement of CBCT and symptoms. We surveyed 21 patients who visited the Oral and Maxillofacial Surgery Department at PNUDH from 2016 to 2022. All the patients' information was extracted from an electronic database. The patients with a follow-up period of 2 months or more were included. The three-dimensional volumetric measurement was performed using the ImageJ program (National Institute of Health, University of Wisconsin). RESULTS: Among 21 patients, 16 (76.1%) were male, and 5 (23%) were female. The most common type of surgery was general anesthesia (16 cases) in which oroantral fistula was present in 7 cases. In the causes of maxillary sinusitis, there were seven implant-related patients, five patients of tooth extraction, seven patients of bone grafting, and two patients in other groups. Radiographic opacity decreased by 40.15% after sinus irrigation especially in bone graft and tooth extraction cases. Clinically, symptoms improved in 17 patients (80.9%). CONCLUSION: By this study, it can be concluded that maxillary sinus irrigation using the small lateral window approach is a clinically and radiologically effective treatment method for odontogenic maxillary sinusitis.

Optimizing wheat productivity through integrated management of irrigation, nutrition, and organic amendments.

Enhancing wheat productivity by implementing a comprehensive approach that combines irrigation, nutrition, and organic amendments shows potential for collectively enhancing crop performance. This study examined the individual and combined effects of using irrigation systems (IS), foliar potassium bicarbonate (PBR) application, and compost application methods (CM) on nine traits related to the growth, physiology, and yield of the Giza-171 wheat cultivar. Analysis of variance revealed significant (P ≤ 0.05) main effects of IS, PBR, and CM on wheat growth, physiology, and yield traits over the two growing seasons of the study. Drip irrigation resulted in a 16% increase in plant height, leaf area index, crop growth rate, yield components, and grain yield compared to spray irrigation. Additionally, the application of foliar PBR at a concentration of 0.08 g/L boosted these parameters by up to 22% compared to the control. Furthermore, the application of compost using the role method resulted in enhanced wheat performance compared to the treatment including mix application. Importantly, the combined analysis revealed that the three-way interaction between the three factors had a significant effect (P ≤ 0.05) on all the studied traits, with drip irrigation at 0.08 g PBR rate and role compost application method (referred as Drip_0.08g_Role) resulting in the best performance across all traits, while sprinkle irrigation without PBR and conventional mixed compost method (referred as sprinkle_CK_Mix) produced the poorest results. This highlights the potential to synergistically improve wheat performance through optimized agronomic inputs.

Optimized sand tube irrigation combined with nitrogen application improves jujube yield as well as water and nitrogen use efficiencies in an arid desert region of Northwest China.

Efficient water-saving irrigation techniques and appropriate nitrogen (N) application are keys to solving the problems of water scarcity and irrational fertilization in jujube cultivation. In this study, first, the effects of sand tube irrigation (STI) on surface and subsurface wetted characteristics were investigated using in-situ infiltration tests in a jujube garden. Compared with surface drip irrigation (SD), STI reduced surface wetted area by 57.4% and wetted perimeter of the surface wetted circle by 37.1% and increased subsurface maximum infiltration distance of wetting front by 64.9%. At the optimal sand tube depth of 20 cm, surface wetted area of the surface wetted circle decreased by 65.4% and maximum infiltration distance of the wetting front increased by 70.9%, compared with SD. Two-year field experiments then investigated the effects of STI and SD on soil water storage, jujube leaf chlorophyll, net photosynthetic rate, actual water consumption, fruit yield, and water (WUE) and N (NUE) use efficiencies at four levels of N (pure nitrogen: N1, 0; N2, 286 kg ha-1; N3, 381 kg ha-1; N4, 476 kg ha-1) at the same irrigation amount (45 mm irrigation-1, total of 8). Compared with SD, STI increased soil water storage 18.0% (2021) and 15.6% (2022) during the entire growth period and also chlorophyll content, nitrogen balance index, and net photosynthetic rate, with both increasing and then decreasing with increasing N. Compared with SD, STI increased yields by 39.1% and 36.5% and WUE by 44.3% and 39.7% in 2021 and 2022, respectively. Nitrogen use efficiency was 2.5 (2021) and 1.6 (2022) times higher with STI than with SD. STI combined with N3 had the highest yield, WUE, NUE, and net income and is thus recommended as the optimal water-N combination. In conclusion, STI combined with appropriate N application can be an effective water-saving irrigation technology alternative to SD in jujube cultivation in arid areas.

Relating microtensiometer-based trunk water potential with sap flow, canopy temperature, and trunk and fruit diameter variations for irrigated 'Honeycrisp' apple.

Instrumentation plays a key role in modern horticulture. Thus, the microtensiomenter, a new plant-based sensor that continuously monitors trunk water potential (Ψtrunk) can help in irrigation management decisions. To compare the response of the Ψtrunk with other continuous tree water status indicators such as the sap flow rate, the difference between canopy and air temperatures, or the variations of the trunk and fruit diameter, all the sensors were installed in 2022 in a commercial orchard of 'Honeycrisp' apple trees with M.9 rootstocks in Washinton State (USA). From the daily evolution of the Ψtrunk, five indicators were considered: predawn, midday, minimum, daily mean, and daily range (the difference between the daily maximum and minimum values). The daily range of Ψtrunk was the most linked to the maximum daily shrinkage (MDS; R2 = 0.42), the canopy-to-air temperature (Tc-Ta; R2 = 0.32), and the sap flow rate (SF; R2 = 0.30). On the other hand, the relative fruit growth rate (FRGR) was more related to the minimum Ψtrunk (R2 = 0.33) and the daily mean Ψtrunk (R2 = 0.32) than to the daily range of Ψtrunk. All indicators derived from Ψtrunk identified changes in tree water status after each irrigation event and had low coefficients of variation and high sensitivity. These results encourage Ψtrunk as a promising candidate for continuous monitoring of tree water status, however, more research is needed to better relate these measures with other widely studied plant-based indicators and identify good combinations of sensors and threshold values.