One year audit of surgical admissions at Gondar university medical college

Background: The new University of Gondar enrolled surgeons for post graduate training in November 2003. A new surgical curriculum was designed in partnership with the Leicester Gondar Link. Admissions to the Department of Surgery over twelve months were subject to audit. The objectives of the audit study were to introduce a new concept, to review the surgical experience of the Department, to support organizational change, to integrate audit into post graduate training, and to measure and improve the quality of the service.Method: Social, medical and administrative data on inpatients was recorded on a discharge summary sheet. The data was coded using a six letter descriptive code and transferred to a computer for presentation on a spread sheet.Results: The results list the social and the demographic distribution of patients; the surgical details including diagnosis, operation and outcome; and administrative data of patient numbers and duration of stay.Conclusion: The discussion is related the objectives of the study. The concept of audit was successfully introduced. Although data was incomplete, trends were apparent. The surgical experience of the Department was documented. The results supported the argument for organizational change including a move to sub-specialization. Audit has become an integral part of the postgraduate curriculum underwriting the monthly morbidity and mortality meetings and providing data for clinical research. The data has provided a baseline mortality rate and exposed quality issues for example, demographic restrictions on access to surgery, and the high mortality rate among patients with head injury

Tuberculous dactylitis—an easily missed diagnosis

The prevalence of tuberculosis (TB) continues to rise worldwide. Current migration patterns and increased travel to high-prevalence TB countries will result in more frequent presentations of less common forms of TB. Tuberculous dactylitis, a form of tuberculous osteomyelitis, is well recognised in countries with a high prevalence of TB. We provide a systematic review of all published cases of tuberculous dactylitis in children and adolescents and describe a case to illustrate the typical features of the disease. Our review revealed 37 cases of tuberculous dactylitis in children and adolescents, all reported in the last 17years. Children less than 10 years of age are most frequently affected and the hand is the most commonly affected site. Concurrent pulmonary TB is present in a fifth of cases and systemic symptoms are usually absent. Positive TST and IGRA support the presumptive diagnosis, but cannot be used as rule-out tests. The definitive diagnosis relies on the detection M. tuberculosis by PCR or culture. Treatment should comprise of a standard three to four drug anti-tuberculous regimen. The optimal treatment duration remains unknown. Surgery has a limited role in the treatment in general but may play a supportive role, and curettage of the cavity has been recommended for avascular lesion

What does a universal IMF imply about star formation?

We show that the same initial mass function (IMF) can result from very different modes of star formation from very similar underlying core and/or system mass functions. In particular, we show that the canonical IMF can be recovered from very similar system mass functions, but with very different mass ratio distributions within those systems. This is a consequence of the basically log-normal shapes of all of the distributions. We also show that the relationships between the shapes of the core, system, and stellar mass functions may not be trivial. Therefore, different star formation in different regions could still result in the same IMF.Comment: 6 pages, 4 figures. MNRAS, in pres

Chandra imaging of the X-ray core of Abell 1795

We report the discovery of a 40 arcsec long X-ray filament in the core of the cluster of galaxies A1795. The feature coincides with an Halpha+NII filament found by Cowie et al in the early 1980s and resolved into at least 2 U-band filaments by McNamara et al in the mid 1990s. The (emission-weighted) temperature of the X-ray emitting gas along the filament is 2.5-3 keV, as revealed by X-ray colour ratios. The deprojected temperature will be less. A detailed temperature map of the core of the cluster presented. The cD galaxy at the head of the filament is probably moving through or oscillating in the cluster core. The radiative cooling time of the X-ray emitting gas in the filament is about 3x10^8 yr which is similar to the age of the filament obtained from its length and velocity. This suggests that the filament is produced by cooling of the gas from the intracluster medium. The filament, much of which is well separated from the body of the cD galaxy and its radio source, is potentially of great importance in helping to understand the energy and ionization source of the optical nebulosity common in cooling flows.Comment: 5 pages, 5 figures, accepted by MNRAS, high resolution version available at http://www-xray.ast.cam.ac.uk/papers/a1795_chandra.pd

The hot core towards the intermediate mass protostar NGC7129 FIRS 2: Chemical similarities with Orion KL

NGC 7129 FIRS 2 (hereafter FIRS 2) is an intermediate-mass (2 to 8 Msun) protostar located at a distance of 1250 pc. High spatial resolution observations are required to resolve the hot core at its center. We present a molecular survey from 218200 MHz to 221800 MHz carried out with the IRAM Plateau de Bure Interferometer. These observations were complemented with a long integration single-dish spectrum taken with the IRAM 30m telescope. We used a Local Thermodynamic Equilibrium (LTE) single temperature code to model the whole dataset. The interferometric spectrum is crowded with a total of ~300 lines from which a few dozens remain unidentified yet. The spectrum has been modeled with a total of 20 species and their isomers, isotopologues and deuterated compounds. Complex molecules like methyl formate (CH3OCHO), ethanol (CH3CH2OH), glycolaldehyde (CH2OHCHO), acetone (CH3COCH3), dimethyl ether (CH3OCH3), ethyl cyanide (CH3CH2CN) and the aGg' conformer of ethylene glycol (aGg'-(CH2OH)_2) are among the detected species. The detection of vibrationally excited lines of CH3CN, CH3OCHO, CH3OH, OCS, HC3N and CH3CHO proves the existence of gas and dust at high temperatures. In fact, the gas kinetic temperature estimated from the vibrational lines of CH3CN, ~405 K, is similar to that measured in massive hot cores. Our data allow an extensive comparison of the chemistry in FIRS~2 and the Orion hot core. We find a quite similar chemistry in FIRS 2 and Orion. Most of the studied fractional molecular abundances agree within a factor of 5. Larger differences are only found for the deuterated compounds D2CO and CH2DOH and a few molecules (CH3CH2CN, SO2, HNCO and CH3CHO). Since the physical conditions are similar in both hot cores, only different initial conditions (warmer pre-collapse phase in the case of Orion) and/or different crossing time of the gas in the hot core can explain this behavior.Comment: 30 pages, 9 figure

Electroencephalographic patterns in Ethiopian patients with epilepsy: A retrospective review

Background: Epilepsy is a common problem throughout sub-Saharan Africa, including Ethiopia. Electroencephalography (EEG) is useful for the diagnosis and proper treatment of this condition. However, the literature is scanty of reports describing EEG patterns in Ethiopian patients with epilepsy. This study attempts to bridge that gap and provide a baseline for further research into the etiological basis of specific epileptiform abnormalities.Objective: To review EEG patterns in Ethiopian patients with epilepsy.Methods: We retrospectively reviewed EEG records of patients with epilepsy presenting to a specialized referral hospital (Addis Ababa University Tikur Anbessa Teaching Hospital) and a private clinic (Yehuleshet Higher Clinic) between September 2008 and August 2010.Results: Two hundred and fifty one patients with mean age of 26 years (SD 14.8) and 1.2:1 male: female ratio was included in the study. One hundred and forty nine patients (59.4%) harbored EEG abnormalities. The majority of these abnormalities 61.1% were epileptiform discharges; the remainder 38.9% being nonspecific patterns. The most common epileptiform discharges were focal, with or without secondary generalization in 63.7%. These focal discharges originated from the left cerebral hemisphere in 43.1% cases and the right in 39.7%; 17.2% were bilateral. Multifocal cerebral and temporal lobe discharges accounted for 43.1% and 39.7% of all focal discharges, respectively.Conclusion: The most common EEG abnormalities in Ethiopian patients with epilepsy are focal interictal epileptiform discharges, typically originating from multifocal cerebral loci and the temporal lobe, without hemispheric lateralization. It provides a foundation for prospective studies to address the etiological basis of focal abnormalities

Fringe Fields and Dynamic Aperture in the FNAL Muon Storage Ring

Quadrupole fringe fields can limit the dynamic aperture of muon storage rings.Using the computer code COSY INFINITY for particle tracking and normal-form analysis, we evaluate the importance of fringe fields in the FNAL muon storage ring, and identify the regions of the machine where they are most critical. Dynamic aperture and linear tune shifts with amplitude are calculated considering an ideal machine without any errors or misalignments. We also explore the efficiency of various nonlinear correction schemes, study the momentum acceptance, and evaluate the spin decoherence over the transverse phase space

Conceptual design of a nonscaling fixed field alternating gradient accelerator for protons and carbon ions for charged particle therapy

Published by the American Physical Society under the terms of the Creative Commons Attribution 3.0 License. Further distribution of this work must maintain attribution to the author(s) and the published article’s title, journal citation, and DOI.The conceptual design for a nonscaling fixed field alternating gradient accelerator suitable for charged particle therapy (the use of protons and other light ions to treat some forms of cancer) is described.EPSR