Obstructive urolithiasis in a 11/2 – year old Ouda–Yankasa ram: case report

Obstructive urolithiasis is the retention of urine subsequent to the lodgement of calculi in the urinary tract from the kidney up to the urethral orifice. This report describes the post-mortem and chemical analysis findings of the calculi in an 18-month old Ouda-Yankasa cross ram presented at the Large Animal Clinic of the Veterinary Teaching Hospital, Usmanu Danfodiyo University, Sokoto. The patient was presented on 20th of March, 2013 with reports of anorexia, disinclination to drink water and anuria that developed four days before presentation at the clinic. On clinical examination, urethral blockage and mild ascites were observed. Cystocentesis was performed to relieve the patient and plain radiograph taken but was not diagnostic. The patient died before definitive diagnosis was made for rational treatment. The post - mortem findings include frothy exudate in the trachea and bronchial airways, congestion of the lungs, hydroperitoneum with recovered fluid measuring 2,350 ml, splenomegaly, hydronephrosis, distended urinary bladder, severe haemorrhagic cystitis, urinary calculi in the bladder and throughout the urethral length and urethral stricture. The urinary calculi recovered were white, friable and amorphous, ranging from small particles to 5mm in diameter. Histopathologic section of the kidney showed atrophied glomeruli. It can thus be concluded that the atrophied glomeruli in turn impaired glomerular filtration which invariably pre-disposed the patient to uraemia leading to its death. The chemical analysis of the calculi showed that the calculi was either oxalate, phosphate or silicate, or any of these mixtures.Keywords: calculi, obstruction, phosphate, uraemi

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden