INTRODUCTIONSevere symptomatic aortic stenosis is associated with a poor prognosis, with most patients dying 2–3 years after diagnosis. We analysed the proportion of patients with severe aortic stenosis not referred for aortic valve replacement (AVR) in a UK-based population and the clinical factors contributing to this.METHODSRetrospective analysis of patients with echocardiographic evidence of severe aortic stenosis was performed at a university teaching hospital.RESULTSA total of 178 consecutive patients with severe aortic stenosis (AVA: <1cm2, mean pressure gradient: ≥40mmHg, or visually severe on echocardiography) were included in the study. Eighty-three patients did not have AVR (95% confidence interval: 39–54%). The cohort included 146 symptomatic patients (82%) and 32 (18%) who were asymptomatic. The most common reason for non-referral in symptomatic patients was ‘high operative risk’ and in asymptomatic patients ‘no symptoms’. Of the patients who did not have AVR, only 19% (n=16) were referred for a surgical opinion. None of the patients in the asymptomatic group underwent echocardiographic stress imaging. The thirty-day operative mortality rate in the AVR group was 2.3%. Symptomatic patients who underwent AVR had superior survival, even after adjusting for co-morbidities (p<0.001).CONCLUSIONSA considerable proportion of patients with severe aortic stenosis are not referred for surgery although they have a clear indication for AVR. Patients are often estimated as being too high risk or having prohibitive co-morbidities. Among asymptomatic patients, stress imaging was rarely used despite its useful role prognostically and in deciding the best time for intervention.

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The journal of Toxicology and pest control is one of the series issued twice by the Egyptian Academic Journal of Biological Sciences, and is devoted to publication of original papers related to the interaction between insects and their environment. The goal of the journal is to advance the scientific understanding of mechanisms of toxicity. Emphasis will be placed on toxic effects observed at relevant exposures, which have direct impact on safety evaluation and risk assessment. The journal therefore welcomes papers on biology ranging from molecular and cell biology, biochemistry and physiology to ecology and environment, also systematics, microbiology, toxicology, hydrobiology, radiobiology and biotechnology. www.eajbs.eg.net

Experiments were conducted in the experimental Horticulture Research Station at Qaha, Qalubiya governorate under greenhouse conditions during two successive seasons (2016-2017 and 2017-2018). The study aims to evaluate some pest control methods on cucumber, Cucumis sativus L. and their effect on total yield. Population density of Bemisia tabaci (Geen.), Frankliniella occidentalis (Pergande) and Phenacoccus solenopsis Tinsley determined on cucumber plants. Blue and yellow sticky traps were settled in first greenhouse in rate of 13 traps (10 blue and 3 yellow). The second greenhouse was treated in foliar spray by (closer SC24% "Sulfoxaflor" at 10cm 3 /20L plus 13 traps (10 blue and 3 yellow). The third greenhouse without treatments (untreated). Results indicated that, the activity period of B. tabaci, F. occidentalis and P. solenopsis on cucumber plants during both seasons was expressed by two and three peaks. The effects of different treatments of pest control methods (traps, pesticides + traps) were high significantly in reducing pests` population and increase yield. Where, in untreated plots, B. tabaci, F. occidentalis and P. solenopsis were responsible for 98% and 99%, reduction in yield respectively. Maximum and minimum temperature were showed that significant negative effect on the population in first season conversely, in the second season cleared significant positive on B. tabaci, F. occidentalis and P. solenopsis population. The relative humidity had significant positive effect on first season however in the second season found insignificant. The combined effect (E.V) of these ecological factors on B. tabaci, F. occidentalis and P. solenopsis showed that these factors were responsible as a group for 94 %, 90 %, 92 during 2016-2017 and 98, 98, 99 during 2017-2018 effects on the population density of insects throughout both seasons, respectively. The obtained results revealed that, the treatment of pesticide with traps (yellow and blue) reduced effectively population of whitefly, thrips and mealy bugs and increase the yield during the two seasons of the study.

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