A case report on an unusual elongation of the Sustentaculum tali

The sustentaculum tali, as a horizontal shelf of the calcaneus serves as an attachment point for the ligamentous support of the foot. Any variations  on it has therefore been linked to instability factors of the ankle joint. Studies have explored on the possible variations of this bony projection, but  none have been documented on an unusually long elongation of the same. This study examined an unusually elongated sustentaculum tali found located on the left calcaneus of an adult Kenyan calcaneus. The right pair did not bear the same variation. This elongation on the calcaneus revealed that it had a length of 11.68mm, height of 7.68mm and thickness of 2.83mm. This elongated sustentaculum tali, even though a rare case should be considered in the cases of idiopathic subtalar joint instability. Keywords: Sustentaculum tali, calcaneu

A Systematic Literature Review of Path-Planning Strategies for Robot Navigation in Unknown Environment

The Many industries, including ports, space, surveillance, military, medicine and agriculture have benefited greatly from mobile robot technology.  An autonomous mobile robot navigates in situations that are both static and dynamic. As a result, robotics experts have proposed a range of strategies. Perception, localization, path planning, and motion control are all required for mobile robot navigation. However, Path planning is a critical component of a quick and secure navigation. Over the previous few decades, many path-planning algorithms have been developed. Despite the fact that the majority of mobile robot applications take place in static environments, there is a scarcity of algorithms capable of guiding robots in dynamic contexts. This review compares qualitatively mobile robot path-planning systems capable of navigating robots in static and dynamic situations. Artificial potential fields, fuzzy logic, genetic algorithms, neural networks, particle swarm optimization, artificial bee colonies, bacterial foraging optimization, and ant-colony are all discussed in the paper. Each method's application domain, navigation technique and validation context are discussed and commonly utilized cutting-edge methods are analyzed. This research will help researchers choose appropriate path-planning approaches for various applications including robotic cranes at the sea ports as well as discover gaps for optimization

Anomalous origin of the ulnar nerve from the lateral cord of the brachial plexus: A case report

Background:  The ulnar nerve has been noted to bear variations as concerns its origin such as that of its communication with the median nerve via nerve branches and sharing of common sheath with the medial cutaneous nerve of the forearm. However, only a few studies have reported on the ulnar nerve receiving a communicating branch from the lateral cord. Case:  We report a case in which the ulnar nerve was noted to originate from branches of the lateral cord of the brachial plexus, during routine dissection. Discussion and conclusion:  This study adds data on such a rare scenario in a Kenyan setting.   French title: Origine anormale du nerf ulnaire du cordon lateral du plexus brachial : A propos d’un cas. Introduction: Des variations de l’origine du nerf ulnaire telles que celle de sa communication avec le nerf médian via des branches nerveuses et le partage de la gaine commune avec le nerf cutané médial de l'avant-bras ont été décrites. Cependant, seules quelques études ont rapporté que le nerf ulnaire recevait une branche communicante du faisceau latéral. Observation: Nous rapportons une observation dans laquelle le nerf ulnaire provenait des branches du cordon latéral du plexus brachial, lors d’une dissection de routine. Discussion et conclusion: Cette étude ajoute des données sur un scénario rare dans un contexte kenyan

Unusually low arcuate artery in a Kenyan cadaver

The arcuate artery is one of the two major branches of the dorsalis pedis artery that supply the dorsum of the foot including interdigital spaces. The artery’s origin varies but in almost all cases it branches in the proximal third of the dorsum of the foot. During routine dissection of the right foot in a black Kenyan, we encountered a case where the artery was located and branched in the distal third of the dorsum of the foot, at the level of the metatarsophalangeal joint. This is much more distal than previously reported in prevailing literature. This artery did not give off any dorsal metatarsal arteries but gave the digital arteries directly. The dorsalis pedis artery, lateral and medial tarsal arteries had normal course in this foot.Keywords: Translational research; Dorsalis pedis artery; Integration; Arcuate arter

Dorsal Morphology of the Calcaneus—An Osteological Study

Background: The calcaneus exhibits variations in articular facets and calcaneal sulcus width. These variations influence occurrence of osteoarthritic conditions, whose prevalence is significant in our setting, and are essential during surgeries involving the foot. Despite this, local data on calcaneal facets remain scarce. Methods: Sixty calcanei were obtained from the National Museum of Kenya. The number, type and shapes of their facets were documented and calcaneal sulcus width measured. Images were taken and collected data were represented in tables and figures. Results: The calcanei had 1–3 articular facets. The common calcanei type noted was type 1B on the right calcaneus and 1B on the left. The least was type 4 on the right and 2C on the left. In terms of shape, types 1 and 4 calcanei had non-rounded facets while type 2 had rounded facets. The width of the sulcus calcanei was narrowest among type 1 calcanei in the right foot at 0.53 cm. On the left foot, type 2 calcanei had narrower (0.455 cm, range 0.35–0.60) calcaneal sulcus width. Conclusion: Our findings may aid in surgeries of the foot and in providing a link between local calcaneal variations and prevalence of osteoarthritic foot conditions. Keywords: Calcaneal-facets, Sinus tarsi, Arthriti

Role of heterogeneous astrocyte receptor expression in determining astrocytic response to neuronal disorders

Following neuronal disorders, astrocytes carry out either neuroprotection or neurodegeneration. Previous authors suggest that favoring of neurodegeneration or neuroprotection by astrocytes can be due to many factors such as the influence of cytokines following their binding on their receptors on astrocytes. These receptors have however been shown to be region specific and heterogeneous. Further, research exploiting their role and influence in determining astrocytic response remains partly elucidated. A review of previous and ongoing research on these receptors would be helpful in the disclosure of astrocytic responses to neuronal disorders.Keywords: Astrogliosis, Heterogenous astrocyte expression, Antagonistic astrocyte reaction, Nervous injury, Astrocyte mediated neurodegeneratio

Conventional and variant origin of the transverse cervical artery in a select kenyan population

Data from previous studies have highlighted on the use of transverse cervical artery (TCA) flaps as posterior neck musculocutaneous flaps in  reconstructive surgeries. General preference of flap selection relies heavily on the neurovascular supply of the flap in question and even though known, the transverse cervical artery has been shown to vary among populations, therefore affecting its use as a potential flap. Additionally, variant points of origin of the trans-cervical artery have been shown to predispose to brachial plexus compression. Our data on the same, however, remains partly elucidated and therefore a study aimed at describing the conventional and variant origin of the TCA in a Kenyan population would aid in deciding on its use as musculocutaneous flaps and determining the possible prevalence of brachial plexus compression because of its variant origin. The origin of the transverse cervical artery was studied bilaterally in 26 adult Kenyan cadavers in the Department of Human Anatomy, University of Nairobi. As regards their origin, the different types were photographed and grouped into five: Types I to V relative to its origin. The data collected was then analysed using SPSS version 21 and findings presented as percentages. The findings were presented in a bar graph and pie chart. The TCA was present in all the 26 cadavers studied. Type I origin of the TCA was the most common (71.15%) while type V was the least (1.92%). While type I origin occurred mostly on the left limbs, the other types were more prevalent on the right side. The significant variant origin of the TCA and its resultant aberrant course should be important considerations during the planning of posterior neck musculocutaneous flaps as well as in understanding brachial plexus compression associated with its variant origin. Key Words: Anatomy, Transverse cervical artery

Perception and challenges of health science students toward e-learning in a Sub-Saharan African country: a multi-institutional study

Background: E-learning is important in improving access to quality health sciences education. This study aimed to determine the perspectives of Kenyan health science students toward e-learning in a bid to enhance effective learning during the COVID-19 pandemic and beyond. Methods: This descriptive cross-sectional study targeted 294 Kenyan health science students. Approval was obtained from the Kenyatta National Hospital–University of Nairobi Ethics Research Committee, and informed consent was obtained from participants. Data were collected using Google Forms and analyzed using SPSS version 27.0. A p value ≤0.05 was considered significant at 95% confidence interval. Results: Most students had good knowledge of online learning; 74.9% reported having received training on the same by their universities and 74.5% further reported to have taken tests on the same. Almost half (45.5%) were knowledgeable of the use of the internet to access materials. Most (79.6%) portrayed a positive attitude toward online learning, agreeing to its use as an integral part of learning. However, 70.2% noted a decrease in concentration and changes in reading habits (44.7%). Regarding challenges faced, unreliable internet connection (56.9%) and lack of motivation (73.7%) were common. Conclusion: The majority of the Kenyan health science students portrayed good knowledge, attitude, and practice toward e-learning amidst challenges

Working practices and incomes of health workers : evidence from an evaluation of a delivery fee exemption scheme in Ghana

Background: This article describes a survey of health workers and traditional birth attendants (TBAs) which was carried out in 2005 in two regions of Ghana. The objective of the survey was to ascertain the impact of the introduction of a delivery fee exemption scheme on both health workers and those providers who were excluded from the scheme (TBAs). This formed part of an overall evaluation of the delivery fee exemption scheme. The results shed light not only on the scheme itself but also on the general productivity of a range of health workers in Ghana. Methods: A structured questionnaire was developed, covering individual and household characteristics, working hours and practices, sources of income, and views of the exemptions scheme and general motivation. After field testing, this was administered to 374 respondents in 12 districts of Central and Volta regions. The respondents included doctors, medical assistants (MAs), public and private midwives, nurses, community health nurses (CHNs), and traditional birth attendants, both trained and untrained. Results: Health workers were well informed about the delivery fee exemptions scheme and their responses on its impact suggest a realistic view that it was a good scheme, but one that faces serious challenges regarding financial sustainability. Concerning its impact on their morale and working conditions, the responses were broadly neutral. Most public sector workers have seen an increased workload, but counterbalanced by increased pay. TBAs have suffered, in terms of client numbers and income, while the picture for private midwives is mixed. The survey also sheds light on pay and productivity. The respondents report long working hours, with a mean of 54 hours per week for community nurses and up to 129 hours per week for MAs. Weekly reported client loads in the public sector range from a mean of 86 for nurses to 269 for doctors. Over the past two years, reported working hours have been increasing, but so have pay and allowances (for doctors, allowances now make up 66% of their total pay). The lowest paid public health worker now earns almost ten times the average gross national income (GNI) per capita, while the doctors earn 38.5 times GNI per capita. This compares well with average government pay of four times GNI per capita. Comparing pay with outputs, the relatively high number of clients reported by doctors reduces their pay differential, so that the cost per client – $1.09 – is similar to a nurse's (and lower than a private midwife's). Conclusion: These findings show that a scheme which increases demand for public health services while also sustaining health worker income and morale, is workable, if well managed, even within the relatively constrained human resources environment of countries like Ghana. This may be linked to the fact that internal comparisons reveal Ghana's health workers to be well paid from public sector sources.This work was undertaken as part of an international research programme – IMMPACT (Initiative for Maternal Mortality Programme Assessment) – funded by the Bill & Melinda Gates Foundation, the Department for International Development, the European Commission and USAID

NIR-II fluorescence microscopic bioimaging for intrahepatic angiography and the early detection of Echinococcus multilocularis microlesions

Hepatic alveolar echinococcosis (HAE) is caused by the metacestode of Echinococcus multilocularis, which shows characteristics of malignant tumors with high mortality. However, traditional diagnostic imaging methods are still not sufficient for the recognition of HAE microlesions in the early stages. Near-infrared-II (900–1700 nm, NIR-II) fluorescence microscopic imaging (NIR-II-FMI) has shown great potential for biomedical detection. A novel type of negative target imaging method based on NIR-II-FMI with the assistance of indocyanine green (ICG) was explored. Then, NIR-II-FMI was applied to the early detection of HAE for the first time. The negative targeting NIR-II fluorescence imaging of HAE-infected mice at different stages with the assistance of ICG under 808 nm of laser irradiation was obtained. Especially, HAE microlesions at the early stage were detected clearly. Moreover, clear intrahepatic angiography was achieved under the same NIR-II-FMI system