Mucinous adenocarcinoma of the rectum with breast and ocular metastases

We present the case of a 32-year-old woman who, 10 months after abdominoperineal resection and total mesorectal excision for a locally advanced mucinous adenocarcinoma of the rectum, presented with local recurrence and metastases to the breast, spine, the left eye and orbit. Following surgery, due to the patient's personal reasons, adjuvant chemoradiation was not given. The patient died 2 months later, with disseminated cancer. To the best of our knowledge, breast as well as ocular metastasis in a patient with mucinous adenocarcinoma of the rectum has never been reported and, therefore, needs to be documented

Growth, osmoregulation and ion accumulation in the coastal halophyte Arthrocnemum indicum under field conditions

Life cycle and population biology of a perennial halophyte Arthrocnemum indicum Willd, was studied from February 1992 to January 1993. During the 12 months, the population was exposed to great variations in soil salinity from 35 to 58 ms/cm2 and soil moisture ranging from flood to drought levels. Seasonal changes in dry weight are directly related to soil salinity stress. When salinity levels become low, the dry matter production increases. A little increase in dry weight from April to July indicates that more negative soil water potentials were limiting plant growth. Proline content increased considerably during the dry season with a corresponding increase in salinity. Water soluble oxalate did not vary much with changes in salinity

Mucinous adenocarcinoma arising from chronic perianal fistula

Perianal mucinous adenocarcinoma is a rare tumour which may be associated with long-standing chronic perianal sepsis. Early diagnosis is challenging and is based on a high index of clinical suspicion and specific histological features. Definitive treatment is surgical, in the form of an abdomino-perineal resection. We hereby describe a case of a perianal mucinous adenocarcinoma arising from long-standing recurrent perianal fistula and complement this with a brief review of the literature pertaining in particular to the management of this condition

Creating enabling environment for student engagement: Faculty practices of critical thinking

Critical thinking (CT) is considered an important attribute in practice disciplines and faculty members in nursing, medicine, and education are expected to facilitate the development of CT in their graduates so that these individuals can be critical, reflective, competent, and caring professionals and service providers (Distler, 2007; Shiau & Chen, 2008; Worell & Profetto-McGrath, 2007). When students are actively engaged in their learning, and classrooms have an enabling environment, critical thinking is promoted. Teachers must reflect upon their teaching pedagogy when students do not participate in stimulating discussions, or asks questions in class. Research suggests that lack of understanding of CT affects teachers’ CT practices in the classroom. Literature supports that teaching learning activities and opportunities that emphasize encouragement of students’ participation in classroom fosters communication, student engagement, creativity, self – directedness and critical thinking (Choy & Cheah, 2009). Thus it is vital to explore what CT practices can be performed by educators to influence students’ CT. The present study aimed to identify perceptions and practices of CT among educators from the disciplines of nursing, medicine, and education in higher education in Karachi, Pakistan. A descriptive exploratory design was used where 12 multidisciplinary educators participated in semi structured interviews and allowed classroom observations. Four major themes were identified, but this paper will explore multidisciplinary educators’ practices of CT in a classroom setting. The faculty needs to be aware of how their practices of critical thinking can create an enabling learning environment, and what factors in its physical, psychological and intellectual environment can affect critical thinking in students

EVALUATION OF APPARENT DIGESTIBILITY COEFFICIENTS OF DIFFERENT DIETARY PROTEIN LEVELS WITH AND WITHOUT FISH MEAL FOR LABEO ROHITA

The apparent digestibility coefficients of three protein levels of reference diets (without fish meal) and test diets (with fish meal) were estimated for Labeo rohita. Three test diets (test diet-I, test diet-II and test diet-III) and three reference diets (reference diet-I, reference diet-II and reference diet-III) having 28, 30 and 32% protein levels were prepared. Chromic oxide was used as an internal marker in the experimental diets for the evaluation of digestibility of protein levels. The differences in apparent digestibility for dry matter, crude protein, crude fat and gross energy of reference and test diets were highly significant (P<0.01). The apparent digestibility coefficients (ADCs) of dry matter were 32.10 ± 0.30 and 35.30 ± 0.30% for reference and test diets -III. The ADCs of crude protein and crude fat were 77.92 ± 0.10, 69.23 ± 0.06 and 75.77 ± 0.05, 70.40 ± 0.22% for reference and test diets-III, respectively. The values of ADCs of gross energy were maximum for reference diet-III (52.28 ± 0.25%) and test diet-III (48.65 ± 0.78%). The ADCs of dry matter were 19.80 ± 1.40 and 18.15 ± 0.05% for reference and test diet-I. The ADCs of crude protein and crude fat were 73.93 ± 0.05, 68.43 ± 1.58 and 59.49 ± 1.13, 57.02 ± 2.42% for reference and test diet-I respectively. The ADCs values of gross energy were for reference diet-I (42.43 ± 0.36%) and test diet-I (39.09 ± 1.35%). The better ADCs for dry matter, crude protein, crude fat and gross energy were at 32% protein level

Prospects for the sustainability of delivering the basic package of Health Services in Afghanistan: a stakeholder analysis

This study explored the readiness of stakeholders in Afghanistan for sustaining delivery of the Basic Package of Health Services (BPHS) without external technical and financial assistance. A stakeholder analysis was applied using qualitative methods. Fifteen stakeholders were purposively drawn from the Afghanistan ministries of public health and finance, political representatives, development partners, nonprofit organizations and public health experts. Data were collected through in-depth interviews with the stakeholders and desk review of pertinent documents. We found that sustainability of the BPHS in Afghanistan is questionable as stakeholders are sub optimally organized to come up with effective alternatives. Uneven ownership and divisive positioning are bottlenecks to the evolution of a realistic continuation plan. Those with the most significant influence are lukewarm, while those who are most supportive have the least influence. Sustainability needs to be tackled at the start in designing the BPHS rather than in the wake of eventual donor withdrawal