The cost of poor land use practices in Lake Nakivale Wetland in Isingiro District, Uganda

The land use practices around Lake Nakivale Wetland have over the last five decades changed from dominantly cattle keeping to crop farming, human settlement and urbanisation. This change, has increased food production and security, it has come at a cost to the natural environment in form of land degradation, wetland encroachment, loss of wildlife habitats and crucial wetland resources. Based on a research conducted in Lake Nakivale Wetland in Isingiro District in Uganda, this paper assessed the cost residents incur as wetland resources experience external disturbances from poor land use practices. Collection of data involved a household survey, interviews, focused group discussions and wetland resource ranking. The impact analysis approach was used to estimate the value of the affected wetland resources. This was based on the market price and the concept of willingness to either pay or accept compensation for wetland resources. The findings indicate that cost of poor land use practices on vital wetland resources is enormous, estimated to be worth US $ 2,943,960.3 per annum and is expected to continue to increase in the future, putting the livelihoods of residents in dilemma. Sustainable land use management based on sound land use planning and restoration program is proposed to minimise the negative effects of land use on the wetland.Key words: Land use practices, wetland resources, livelihoods, sustainable land use management, land use planning, wetland resource value

The last defence? Surgical aspects of gouty arthritis of hand and wrist

OBJECTIVE: To review the epidemiology, pathophysiology, clinical manifestations, diagnosis, and treatment of gouty arthritis of the hand and wrist, with a focus on the surgical aspects. DATA SOURCES AND EXTRACTION: Electronic databases including MEDLINE, PubMed, and the Cochrane library were searched with the key words of 'gouty arthritis', 'hand', 'wrist', and 'surgical'. STUDY SELECTION: A total of 55 articles were selected for inclusion in this review. DATA SYNTHESIS: There is no existing study for the overall prevalence of gout in Asia, though one study showed that it was 3.1% in Taiwan. Its pathophysiology entails hyperuricaemia, trauma, lower temperatures, and previous diseases. Gouty arthritis of hand and wrist presents as acute wrist pain, subcutaneous or peritendinous tophi, tenosynovitis, entrapment neuropathy, tendon rupture, or even bone destruction. Demonstration of negatively birefringent crystals in the absence of organisms and a normal white cell count in synovial fluid confirm the diagnosis. Medical treatment including non-steroidal anti-inflammatory drugs, colchicines, allopurinol, uricosuric agents, and lifestyle modifications remain the mainstay of treatment. Surgical treatment options for tophaceous gout involve decompression by aspiration, incision and drainage, tenosynovectomy, shaving procedures, and complex surgical approach. CONCLUSION. While medical treatment remains the mainstay of treatment for gouty arthritis of the hand and wrist, 5% of patients may not respond. In this group, surgery is often performed in advanced stages, but yields less-than-satisfactory outcomes. Gouty arthritis is difficult to treat when it starts to cause stiffness and deformities. Although more studies are needed to evaluate the outcomes, the authors suggest that one possible solution is pre-emptive surgery.published_or_final_versio

Cases of Mycobaterium Marinum Tenosynovitis of the hand and wrist: clinical features. management and results

Selected paper for 2010 APOA-Pfizer Best Scientific Paper Award for Orthopaedic InfectionOpen Access JournaleCM XII: Implant Infection Conference Main Focus: Orthopedic and trauma related infectionsAsia Pacific Orthopaedic Association SessionINTRODUCTION: Mycobacterium marinum infections followed an unpredictable clinical course and delay in definitive diagnosis was frequently encountered. Chow et al. found that the average duration of infection before patients were seen by the Orthopaedics unit was 3.3-3.7 months.1 The initial diagnosis was commonly found to be mistaken for conditions such as rheumatoid arthritis and trigger finger which may lead to inappropriate management like steroid injections. The objective of this study was to review our experience with treatment of Mycobacterium marinum tenosynovitis of the hand and wrist and to assess for any clinical parameters that were associated with poor functional outcome and also suggest a treatment algorithm for these …published_or_final_versio

Current Management Of Acute Scaphoid Fractures: A Review

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Another light in the dark: review of new method for the arthroscopic repair of triangular fibrocartilage complex

The triangular fibrocartilage complex (TFCC) is an anatomically and biomechanically important structure. Repair of radial-sided TFCC tear has previously been challenging. We designed a new method of radial-sided TFCC tear repair and found that it was also applicable for ulnar-sided TFCC tear repair. From October 2006 to December 2010, 10 patients underwent this operation and were reviewed: 9 men and 1 woman, with a mean age of 33.9 years. Average postoperative follow-up was 8 months. We graded results according to the Mayo modified wrist score. We rated 2 of the 10 patients (20%) as 'excellent,' 3 (30%) as 'good,' and 5 (50%) as 'fair.' The 5 patients who were rated as 'fair' returned to regular jobs or had restricted employment. Based on this small sample, we recommend that this technique be considered an alternative method for TFCC repair.postprin

Lateral tibial condyle reconstruction by pedicled vascularized fibular head graft: Long-term result

The technique of pedicled vascularized fibular graft for lateral tibial condyle reconstruction after en bloc resection of aggressive giant cell tumours was described by SP Chow et al. Early follow-up of two patients was presented in 1986. We present the 25 years follow-up of one patient with a literature review of alternative present day treatment options. The patient maintained community ambulant status despite developing late stage osteoarthritis. Although this procedure is performed rarely, it remains an alternative to the more sophisticated treatment options making it a useful method in centres with limited facilities and expertise. © 2011 The Author(s).published_or_final_versio

Epidemiology of occupational hand injury in Hong Kong

OBJECTIVES: To study the epidemiology of occupational hand injuries and associated social and industrial factors. DESIGN. For this retrospective case series of patients with occupational hand injuries, case records were retrieved to gather data. In addition, all the subjects were interviewed by a single interviewer using a predesigned questionnaire. SETTING: Division of Hand Surgery, Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong. PATIENTS: A total of 250 patients with occupational hand injuries were treated during the period from 1999 to 2001. This period was chosen to obtain 10 years of follow-up data to assess return to work and any secondary injuries. MAIN OUTCOME MEASURES: Personal particulars (gender, age, marital status, education level, length of stay in Hong Kong, type of employment, wage system, personal habits, family size, number of breadwinners, income), type of industry and mode of injury, causes of injury according to the worker, work conditions, type of injury, and treatment given. RESULTS: Two groups of workers in our study had more occupational hand injuries, namely those with less than 1 year of experience on a new job and immigrants from China. Factors associated with a large proportion of occupational hand injuries were male gender with personal risk factors (smoking and regular consumption of alcohol, long working hours), and in the case of machine operators, inadequate training and use of safety devices. CONCLUSION: Occupational hand injuries lead to loss of working hours and compensation. For prevention, the workplace should be made into a safer and work-friendly environment. Workers should also have sufficient training.published_or_final_versio

Progressive Trends in Electronic Resources Management Among Academic Libraries in Hong Kong

Due to recent technology advancement and particularly ubiquity of smart devices, user needs and habits of using library materials are also changed towards electronic resources, which facilitate anytime anyplace access as well as easier information search. For library management, digital resources facilitate long-term preservation together with savings of space and human costs. This lead to a trend of rapid development of digitization and electronic resources, leading to lots of changes in academic libraries. However, there are few studies providing a holistic view of this important trend, especially in metropolis of the East. To explore this trend, we interviewed four librarians in different departments from different universities in Hong Kong for a qualitative analysis on various aspects such as digital versus print, user expectation changes, and new management problems. Emerging issues of e-resources highlighted by the libraries includes acquisitions policies, budget implication, copyright, and access restrictions, consortium collaboration, manpower issues, workflow, and library system changes. We further discuss the practical implications of our findings, which are supportive to those disparate in other literature.postprin

How to obtain and identify the acetabular anterior column axial view projection in patients?

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Epidemiology of occupational hand injury in Hong Kong

OBJECTIVES: To study the epidemiology of occupational hand injuries and associated social and industrial factors. DESIGN. For this retrospective case series of patients with occupational hand injuries, case records were retrieved to gather data. In addition, all the subjects were interviewed by a single interviewer using a predesigned questionnaire. SETTING: Division of Hand Surgery, Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong. PATIENTS: A total of 250 patients with occupational hand injuries were treated during the period from 1999 to 2001. This period was chosen to obtain 10 years of follow-up data to assess return to work and any secondary injuries. MAIN OUTCOME MEASURES: Personal particulars (gender, age, marital status, education level, length of stay in Hong Kong, type of employment, wage system, personal habits, family size, number of breadwinners, income), type of industry and mode of injury, causes of injury according to the worker, work conditions, type of injury, and treatment given. RESULTS: Two groups of workers in our study had more occupational hand injuries, namely those with less than 1 year of experience on a new job and immigrants from China. Factors associated with a large proportion of occupational hand injuries were male gender with personal risk factors (smoking and regular consumption of alcohol, long working hours), and in the case of machine operators, inadequate training and use of safety devices. CONCLUSION: Occupational hand injuries lead to loss of working hours and compensation. For prevention, the workplace should be made into a safer and work-friendly environment. Workers should also have sufficient training.published_or_final_versio