Predicting the pathogen of diabetic toe osteomyelitis by two consecutive ulcer cultures with bone contact

In this study, we investigate the accuracy of two consecutive ulcer cultures with bone contact compared to bone biopsy for the diagnosis of diabetic toe osteomyelitis. The same nurse and orthopaedic surgeon obtained all samples: sample A-1: bone contact swabbing through the ulcer; sample A-2: a second culture swabbing from the bone surface within 24 h; sample B: surgical bone biopsy in the operating theatre. The kappa statistic measure between samples A-1 and A-2 (bone contact swabs) indicated 82.35% agreement. The sensitivity, specificity, positive and negative predictive values of the two samples A compared to B were 96%, 79%, 92% and 88%, respectively, for the causative pathogen. These results were similar with prior antibiotic treatment, discordant bone surface swabs or with monomicrobial infections. As a conclusion, two consecutive diabetic toe cultures with bone contact accurately predict the pathogen of diabetic toe osteomyelitis in 90% of case

Hallux valgus, ankle osteoarthrosis and adult acquired flatfoot deformity: a review of three common foot and ankle pathologies and their treatments.

The pathogenesis of hallux valgus deformity is multifactorial. Conservative treatment can alleviate pain but is unable to correct the deformity. Surgical treatment must be adapted to the type and severity of the deformity. Success of surgical treatment ranges from 80% to 95%, and complication rates range from 10% to 30%.Ankle osteoarthrosis most commonly occurs as a consequence of trauma. Ankle arthrodesis and total ankle replacement are the most common surgical treatments of end stage ankle osteoarthrosis. Both types of surgery result in similar clinical improvement at midterm; however, gait analysis has demonstrated the superiority of total ankle replacement over arthrodesis. More recently, conservative surgery (extraarticular alignment osteotomies) around the ankle has gained popularity in treating early- to mid-stage ankle osteoarthrosis.Adult acquired flatfoot deformity is a consequence of posterior tibial tendon dysfunction in 80% of cases. Classification is based upon the function of the tibialis posterior tendon, the reducibility of the deformity, and the condition of the ankle joint. Conservative treatment includes orthotics and eccentric muscle training. Functional surgery is indicated for treatment in the early stages. In case of fixed deformity, corrective and stabilising surgery is performed. Cite this article: Crevoisier X, Assal M, Stanekova K. Hallux valgus, ankle osteoarthrosis and adult acquired flatfoot deformity: a review of three common foot and ankle pathologies and their treatments. EFORT Open Rev 2016;1:58-64. DOI: 10.1302/2058-5241.1.000015

Posttraumatic ankle arthritis due to a novel Nocardia species

Introduction: Nocardial arthritis in immunocompetent patients is rare, and the optimum duration of antimicrobial therapy is unknown, although several months of antibiotic treatment is often recommended. Case report: We here report the first case of human infection with a novel Nocardia sp., summarise the epidemiology of nocardial arthritis and outline the feasibility of relatively short antibiotic treatments after careful surgical drainag

ADC mapping of the aging frontal lobes in mild cognitive impairment

Normal aging, leukoaraiosis (LA) and vascular disease particularly involve the human frontal lobes. We decided to investigate a population of elderly patients referred for neuroimaging because of progressive minor cognitive deficits but no dementia. They underwent conventional Magnetic resonance imaging (MRI) using axial T1 and T2-weighted imaging as well as coronal FLAIR sequences in addition to the axial diffusion-weighted MRI. MRI allowed us to differentiate patients with leukoaraïosis (LA+) from those without it (LA-) and mapping of the apparent diffusion coefficient (ADC) to investigate local tissular water motion.We observed an increase in the ADC in all investigated patients with increasing age (r=0.326, p=0.002). This increase was observed in both patients groups (LA+ and LA-) . In addition, the LA+ group had significant higher ADC values than the LA- group after controlling for age (p<0.0001

Nationality and citizenship questions in Sudan after the Southern Sudan referendum vote

The Comprehensive Peace Agreement (CPA) of 2005 provided southern Sudanese with the right to self-determination through a referendum vote that took place January 9–15, 2011. Formal results will be announced at the end of January, but reliable reports indicate an overwhelming vote for independence. While the CPA provides a six-month transition period following the referendum, and negotiations have begun on post-referendum issues, a great many contentious issues remain to be settled. Central among them is the question of how nationality and citizenship will be defined and handled in a future North Sudan and South Sudan

Civil society and peace building in Sudan: A critical look

Abstract The role of civil society organizations in peace making and peace building is often valorized, especially in countries that witness protracted conflicts. The assumption underlying this valorization is that while conflicting parties sign peace deals, it is civil society organizations that undertake the implementation of such peace deals. A significant requirement for the success of civil society organizations in peace building is their inclusion in peace making in the first place. Such inclusion is indicative of the recognition accorded to civil society organizations and, conversely, their exclusion means that those who broker peace deals are not cognizant of the roles of these organizations. While civil society organizations may have negative roles or may even be party to conflicts, it is important to highlight the instances in which they are excluded from partaking in peace-making and peace-building engagements. The conceptualization of civil society is yet another challenge that bears on how these organizations contribute to peace making and building. Sudan represents a case that requires scrutiny. The peace process that culminated in signing the Comprehensive Peace Agreement (CPA) in 2005 started in 2002. Peace negotiations spanned over almost three years, with a notable absence of civil society organizations. Peace talks were an exclusive affair between the Sudan Government and Sudan Peoples’ Liberation Army/Movement (SPLA/M). Civil society organizations in Sudan had to deal with the peace agreement as a product of bilateral negotiations between the two signatories, but were keen to contribute to the success of the agreement. Different was the case of the Doha peace talks on Darfur where civil society organizations from Darfur were present during the peace negotiations that culminated in the Doha Peace agreement of 2009. Taking the examples of Darfur civil society organizations, and two Khartoum-based ones, this research closely looks a

Sudan’s popular uprising and the demise of Islamism

This Sudan Brief is concerned with the fractionalization of Islamism during Bashir&rsquo;s rule (1989-2019). It does not focus on the details of Bashir&rsquo;s brutal rule, rather, it is about the emerging disunity from within which eventually led to the removal of Bashir from power. I analyze factors that led to the Islamists adopting a more pragmatic stand, especially after the main ideologue of the Islamist movement was kicked out into the cold in 1999. The Brief argues that although the Islamists have successfully created a parallel or deep state the last three decades, the political shift of power away from the Islamists which the 2018 popular uprising represent, makes the political future of Islamism bleak

Is it the Fault of NGOs Alone? Aid and Dependency in Eastern Sudan

Scholars of development studies have long debated the efficacy of humanitarian assistance in the Sudan, especially in eastern Sudan, where humanitarian agencies have been working for more than two decades. Questions about the importance of humanitarian assistance to recovery and, hence, development, are central in the debate. Does humanitarian assistance end up creating dependence, not development? This study suggests that humanitarian assistance, often carried out in contexts of complex emergencies and fragile livelihoods, has little chance of achieving recovery and eventual development. Using qualitative data from the Red Sea State in eastern Sudan, this article argues that the failure to achieve recovery and development is not the fault of NGOs alone. Chronic susceptibility to droughts and famines, wars, and lack of coordination among NGOs and between NGOs and local authorities are some of the local level problems that negatively affect humanitarian work in eastern Sudan. The local level problems that impede achieving self-reliance are entangled with the discursive national and international politics of humanitarian assistance in ways that cast doubts about the positive role of aid agencies. The presence of NGOs certainly led to changes in many structures, but this is not reflected positively in people's livelihoods. Instead of achieving recovery, communities in eastern Sudan are moving from positive coping strategies to negative adaptive vulnerabilities, exemplified by dependence on NGOs. The recently signed peace agreement in eastern Sudan offers opportunities for more inclusive planning, but without national commitment and international support it might accelerate conflict and vulnerability and hence deepen dependency

Automatic Identity Recognition Using Speech Biometric

Biometric technology refers to the automatic identification of a person using physical or behavioral traits associated with him/her. This technology can be an excellent candidate for developing intelligent systems such as speaker identification, facial recognition, signature verification...etc. Biometric technology can be used to design and develop automatic identity recognition systems, which are highly demanded and can be used in banking systems, employee identification, immigration, e-commerce…etc. The first phase of this research emphasizes on the development of automatic identity recognizer using speech biometric technology based on Artificial Intelligence (AI) techniques provided in MATLAB. For our phase one, speech data is collected from 20 (10 male and 10 female) participants in order to develop the recognizer. The speech data include utterances recorded for the English language digits (0 to 9), where each participant recorded each digit 3 times, which resulted in a total of 600 utterances for all participants. For our phase two, speech data is collected from 100 (50 male and 50 female) participants in order to develop the recognizer. The speech data is divided into text-dependent and text-independent data, whereby each participant selected his/her full name and recorded it 30 times, which makes up the text-independent data. On the other hand, the text-dependent data is represented by a short Arabic language story that contains 16 sentences, whereby every sentence was recorded by every participant 5 times. As a result, this new corpus contains 3000 (30 utterances * 100 speakers) sound files that represent the text-independent data using their full names and 8000 (16 sentences * 5 utterances * 100 speakers) sound files that represent the text-dependent data using the short story. For the purpose of our phase one of developing the automatic identity recognizer using speech, the 600 utterances have undergone the feature extraction and feature classification phases. The speech-based automatic identity recognition system is based on the most dominating feature extraction technique, which is known as the Mel-Frequency Cepstral Coefficient (MFCC). For feature classification phase, the system is based on the Vector Quantization (VQ) algorithm. Based on our experimental results, the highest accuracy achieved is 76%. The experimental results have shown acceptable performance, but can be improved further in our phase two using larger speech data size and better performance classification techniques such as the Hidden Markov Model (HMM)

Predicting the pathogen of diabetic toe osteomyelitis by two consecutive ulcer cultures with bone contact

In this study, we investigate the accuracy of two consecutive ulcer cultures with bone contact compared to bone biopsy for the diagnosis of diabetic toe osteomyelitis. The same nurse and orthopaedic surgeon obtained all samples: sample A-1: bone contact swabbing through the ulcer; sample A-2: a second culture swabbing from the bone surface within 24 h; sample B: surgical bone biopsy in the operating theatre. The kappa statistic measure between samples A-1 and A-2 (bone contact swabs) indicated 82.35% agreement. The sensitivity, specificity, positive and negative predictive values of the two samples A compared to B were 96%, 79%, 92% and 88%, respectively, for the causative pathogen. These results were similar with prior antibiotic treatment, discordant bone surface swabs or with monomicrobial infections. As a conclusion, two consecutive diabetic toe cultures with bone contact accurately predict the pathogen of diabetic toe osteomyelitis in 90% of cases