Abstract Introduction Historically, concerns about complications following parathyroid surgery, such as airway compromise, bleeding and hypocalcemia, have precluded its consideration as a short-stay surgical procedure. Recent advancements in perioperative care have resulted in several publications demonstrating that parathyroidectomy can be safely performed as a short-stay procedure. Objectives The aim of the present study was to describe the process of implementing a short-stay protocol focusing on preoperative patient education and postoperative calcium management for those undergoing surgery for primary hyperparathyroidism (PHP). Method A retrospective audit of consecutive parathyroidectomies performed for PHP over the period between 2010 and 2013 was performed. A short-stay protocol (SSP) was introduced focusing on postoperative calcium management. Results were reaudited over the period between 2013 and 2015. Results Consecutive parathyroidectomies in 76 patients were included in the study. A total of 42 patients underwent parathyroidectomy prior to the introduction of the protocol. A total of 26.2% of these patients were symptomatic from hypercalcemia. A total of 40 out of 42 (95.2%) patients had a biochemical cure. A total of 36 out of 42 (85.7%) cases were due to parathyroid adenomas. A total of 34 patients underwent surgery following the introduction of the protocol. A total of 13 out of 34 (38.2%) of the patients had symptomatic hypercalcemia. A total of 33 out of 34 (97.1%) had a biochemical cure. A total of 32 out of 34 (94.1%) cases were due to parathyroid adenomas. The length of stay decreased from a median of 3 days (range 2–9 days; mean 3.32) preprotocol to a median of 2 days (range 2–3 days; mean 2.16) postprotocol (p< 0.0001) with no difference in the 30-day unplanned readmission rate (4.8 versus 2.9%; p= 0.999). Conclusions The postoperative length of stay after parathyroidectomy for PHP can be safely reduced through patient education and by rationalizing postoperative calcium management without adversely affecting outcomes.

Abstract The structural characterization and bioactivities of a polysaccharide from the stalk residue of Pleurotus eryngii were investigated. Firstly the stalk residue of P. eryngii was collected from the top portion of spent mushroom substrate and processed to yield water-soluble polysaccharide. Subsequently this crude polysaccharide was purified by DEAE Sepharose CL-6B ion exchange chromatography and Sepharose CL-6B size-exclusion chromatography. Then its structural features were investigated by gas chromatography (GC), gel permeation chromatography (GPC), methylation analysis, and Fourier Transform Infrared Spectrum (FT-IR). The results showed that it was heteropolysaccharide and mainly composed of glucose (82.4%). The backbone of P-2a mainly consisted of 1, 3-linked (42.7%) and 1, 6-linked (35.5%) glucose residues. Besides, in vitro antioxidant assay showed that P-2a exerted a high scavenging effects on hydroxyl radical and in vitro antitumor assay showed it had a dose-dependent antiproliferative effect against human gastric MGC-803 cancer cells & human epithelial Hela cancer cells. The findings of this study suggested that the polysaccharide extracted from the stalk residue has the similar structure and bioactivities as that from fruit-body of the mushroom. It could be potentially used as a natural source for the development of health-care food.

Under rainfed conditions, farmers rarely use micro-nutrients for crop production, due to which soils become deficient especially in zinc (Zn) and boron (B). Secondly, farmers apply nutrients through soil application but scarcity/less availability of moisture make the nutrients unavailable for crop plants. Under such circumstances, foliar application of Zn and B may play a key role for better crop growth and yield. Therefore this field study was conducted to investigate the role of Zn and B application alone and in combination through seed, soil and foliar application methods on growth, yield and net returns of maize grown under rainfed conditions. Results showed that combined application of Zn and B on foliage improved relative water contents, SPAD chlorophyll values, leaf area index (LAI), crop growth rate (CGR), and grain yield due to substantial expansion in entire yield related traits. Combined foliar application of Zn and B harvested 12% and 45% more yield compared with seed priming and control treatments, respectively. The foliar application of Zn and B in combination counteracted the low rainfall effect by producing higher relative water contents that helped in improving SPAD-chlorophyll values, LAI and CGR. Higher net returns and benefit: cost ratio was also obtained by foliar application of Zn and B in combination. In conclusion, combined foliar application of B and Zn improved maize yield due to significant expansion in allometric and yield related traits and thus improved net returns of maize grown under rainfed conditions of Pothwar plateu in Pakistan.