Digestive Surgical Emergencies at Analankininina Toamasina Madagascar University Hospital during the Covid-19 Pandemic

During the period of total containment during the Covid-19 pandemic; our department became the sole treatment center for all surgical emergencies. The influx of many patients made the task very difficult for the surgeon. This is a 3-month descriptive prospective study in the visceral surgery department at the Analankininina Toamasina University Hospital Center. Of the 81 patients hospitalized during the study, 32 patients were admitted for digestive surgery emergency, i.e. 39.50%. The mean age was 34.87 years with a sex ratio of 1.66, predominantly male. Abdominal pain occupied 43.75% of the reason for consultation, the most frequent pathologies were acute intestinal obstruction (18.75%) and acute appendicitis (18.75%). An exploratory laparotomy is performed on 40.62% of patients. Many patients were operated on for proctologic emergency (18.75%). The average length of hospitalization is 4.18 days. The visceral emergencies are present despite the presence of the Covid-19 pandemic and the activities of the health personnel are uninterrupted.

Comprehensive Study of Trace Elements in Juices and Soft Drinks and Their Impact on Human Health

A comprehensive study carried out for determination of heavy metals including trace (Cr, Fe, Zn, Ni, Mn, Co, Cu) and toxic (Pb, Cd) metals in variety of fruit juices and soft drinks and also studies the impact of these on human health. These heavy metals were determined by atomic absorption technique. Statistical analysis (ANOVA) was also done for heavy metals of a variety of juices and soft drinks of different packing material and also determined various physicochemical parameters like (PH, Conductivity, TDS, Salinity, DO, Specific gravity) as well as isolation of fungal species and microbial load in variety of fruit juices and soft drink. The results of heavy metal were compared with permissible limit in drinking water imposed by the United State Environmental Protection Agency (US-EPA), World Health Organization (W.H.O) both for fruit juices and soft drinks and recommended dietary allowances (RDA) only for fruit juices. Isolated fungal species compared with literature review both in fruit juices and soft drinks and microbial load with Gulf standard (only in fruit juices) as well as these were correlated with physicochemical parameters. Present study shows that order range of concentration for Cr was not permissible above within the standards sets by the organization and also dietary intake It was found that upper limit of Fe in tetra pack and plastic bottle also range was found in sachet pack was not safe within limits but if compared with dietary intake order and concentration range below the standards. It was found that Mean (range) of Zn was below the US-EPA also dietary intake of trace element. Range of concentration and order for Ni (T> B >S) was above within the standards also was not permissible with dietary intake Upper limit of Mn in all packing was not lies within standards except range of Mn in plastic bottle permissible by W.H.O recommendation. Range of Mn in tetra pack and plastic bottle was below within in daily intake level but upper level in sachet pack was high. Mean range of Cu and Co in all packaging was within in all standards was also small within a dietary intake. In the present work range of Pb was measured in all packing was within US-EPA but not safe according to W.H.O recommendation. Upper limit of range of Cd in tetra pack and plastic bottle and range was found in sachet pack was not safe within standards. Mean of heavy metals (ppm) in soft drinks was accessible. In present work it was found that means value of Cr and Ni in both packaging (plastic pack and tin pack) was not permissible and above within standards Mean value of Fe in both packaging was high and not safe within 0.3 ml/L. It was observed that range of Zn (plastic pack and tin pack) was low as compared to standards Mean concentration of Mn, Co and Cd was approximate within standards Mean concentration of Pb in (plastic pack and tin pack) was expectable within US-EPA, but obove within W.H.O. Statistical analysis (ANOVA) Result showed that null hypothesis for Zn and Ni was rejected for fruit juices as well in soft drinks Zn, Cu, and Cd were rejected synthetic chemicals used in the packaging, storage, and processing of food stuffs. This is because most of these substances are not inert and can leach into the foods, harmful to human health over the long period. For identification of fungi in the juices, direct plating technique was applied and the species were recovered in a variety of tetra pack fruit juices and plastic bottle soft drinks. A.flavus, A.niger, Penicillium sp, Rhizopus sp, Mucor saccromyces, Fusarium, A. Fumigate, Monilia, A. Wentii and Candida albicans. In present study genus Aspergillus was most frequent in juices. None fungal contamination was observed in plastic bottle and sachet pack of a variety of fruit juices and tin pack of soft drink Furthermore present work showed that presence of fungi was frequently observed in tetrapacks of fruit juices may be due to permeability of packing by which they are made cartons was more risk than plastic bottle carton are bent and hot filled in vacuum condition this process causes a depression within the carton which may lead to the entry of air and consequently favors mould(fungi) production. For the evaluation of total viable count (TVE) total coliform count (TCC) fecal coliform (FCC) and total staphylococcal count (TSC) Standard cultural techniques were applied. In the present work observed bacterial load in tetra pack and plastic bottle of a variety of juices and soft drinks but none bacterial load was seen in sachet pack of fruit juices and tin pack of soft drinks. Present work observed that Total viable count (TVC) in Apple, Mango, Punch and strawberry juice was below the standard while in orange and grape was found within the standard (TCC.) Total coliform count in Apple, Mango, Orange, Grape, Punch and strawberry juices was above the standard. Fecal coliform count (FCC) in Mango, Grape, Punch and strawberry was above the standard while they were absent in Apple and Orange. Staphylococcal count was found in Apple, Mango, Punch juices was within the standard while in Orange was above the standard, they were absent in grape and strawberry. But in present work presence of coliform, fecal coliform and staphylococci in fruit juices and soft drinks of different packing materials indicate that they were contaminated. Fruits become contaminated with microorganism during preharvest, harvest and post harvest period of time all the way through fecal material harvesting equipment, domestic animals and wild animal human use, transport container, wild and domestic animals, ice or water. Many microorganisms was found as natural contaminants in soft drink, but moderately the minority be able to cultivate inside the acidic and little oxygen atmosphere All assessment it was determined that fruits juices and soft drinks might cause serious hazards to human health. It was concluded that care and caution should be taken to improve the quality of consumer product in every as pact on the basis of may research work for health view do not use ready to eat drinks like juices and soft drinks should be utilize fruits and homemade juices since they are actually favorable for our health and life.