Uncommon Cause of Acute Pelvic Pain: Isolated Torsion of Hydrosalpinx

Isolated torsion of hydrosalpinx is a rare cause of acute pelvic pain. Pre-operative diagnosis is very difficult because of non specific clinical presentation. Definitive diagnosis is always made at surgicalexploration performed for suspected adnexal torsion and salpingectomy is performed in the majority of cases. A 34-year-old woman was admitted for acute pelvic pain with nausea and vomiting. Vaginal examination revealed a right adnexal tender mass and ultrasound revealed a well circumscribed right adnexal cystic mass. Surgical exploration has revealed torsion of a right hydrosalpinx and right salpingectomy was performed. Differential diagnosis between adnexal and tubal torsion is very difficult, however both should be managed by rapid surgical exploration which an allow precocious diagnosis and conservative treatment(Afr J Reprod Health 2009; 13[4]:147-150)

Arbuscular mycorrhizal fungi species associated with rhizosphere of Phoenix dactylifera L. in Morocco

A survey of arbuscular mycorrhizal fungi (AMF) diversity and date palm (Phoenix dactylifera L.) tree root colonization in arid areas was undertaken in ten palm groves located along the Ziz valley (Tafilalet, south-west Morocco). The frequency and the mean intensity of root colonization reached 72 and 43% respectively and the spore population varied from 238 to 1840 spores/10g of soil. The AMF colonization levels of field date palm roots were found to be negatively correlated with soil phosphorus content (r2 =-0,64). A total of ten AMF species were trapped from the 10 studied sites with a population of 4 to 7 species per sites. The isolated species included: Glomus mosseae, G. fasciculatum, G. constrictum, G. aggregatum, G. macrocarpum, 3 undescribed species of Acaulospora and two of Scutellospora genera. The latter two species were trapped only at the second trapping cycle.Keywords: AMF, diversity, Morocco, palm grove, Phoenix dactylifer,

Electron impact double ionization of helium from classical trajectory calculations

With a recently proposed quasiclassical ansatz [Geyer and Rost, J. Phys. B 35 (2002) 1479] it is possible to perform classical trajectory ionization calculations on many electron targets. The autoionization of the target is prevented by a M\o{}ller type backward--forward propagation scheme and allows to consider all interactions between all particles without additional stabilization. The application of the quasiclassical ansatz for helium targets is explained and total and partially differential cross sections for electron impact double ionization are calculated. In the high energy regime the classical description fails to describe the dominant TS1 process, which leads to big deviations, whereas for low energies the total cross section is reproduced well. Differential cross sections calculated at 250 eV await their experimental confirmation.Comment: LaTeX, 22 pages, 10 figures, submitted to J. Phys.

Guidance for evaluating integrated surveillance of antimicrobial use and resistance

Antimicrobial resistance (AMR) resulting from antimicrobial use (AMU) is an emerging threat to global health. One of the key elements for a better understanding and management of AMU and AMR is to develop effective and efficient integrated surveillance systems that consider the complex epidemiology of these issues and the impacts of resistance on humans, animals and the environment. Consequently, for this project, an international consortium of experts from multiple fields called CoEvalAMR was formed with the objectives to study user needs, characterise and compare existing tools for the evaluation of integrated AMU and AMR surveillance, apply them to case studies, and elaborate guidance on the purpose-fit selection and the use of the tools. For the comparison of evaluation tools, questions were extracted from existing tools and attributed to themes, to assess the user needs, interviews were conducted with national key stakeholders, and we applied a series of different evaluation tools to understand and document their strengths and weaknesses. The guidance was refined iteratively. From 12 evaluation tools, 1117 questions/indicators were extracted and attributed to seven emerging themes. Twenty-three experts were interviewed, who suggested to increase the ease-of-use, grant open access, provide web-based interfaces and allow results to be automatically generated. Respondents also wished for tools providing the flexibility to conduct a rapid review, or an in-depth analysis of the surveillance system, depending on the evaluation objectives. The case studies emphasised that proper evaluations require adequate resources, typically requiring the involvement of several assessors and/or stakeholders, and can take weeks or months to complete. The resulting web-based guidance comprises six main sections: 1. Introduction to surveillance evaluation, 2. Evaluation of surveillance for AMU and AMR, 3. Evaluation tools, 4. Support for selecting an evaluation tool, 5. Case studies and 6. Directory of existing tools. The audience for the guidance is personnel working in public, private, and non-governmental organisations, from public health, animal health, plant health and environmental health, at local, national and international levels. We conclude that the field is challenged by opposing user needs for reduction and simplicity versus system approaches allowing the synthesis of that knowledge to sufficiently reflect the complexity of AMU and AMR ecology for real-world decisions. The CoEvalAMR web platform allows a better understanding of the different evaluation tools and assists users in the selection of an approach that corresponds to their evaluation needs. The CoEvalAMR consortium continues to address remaining gaps and consolidate evaluation tools and approaches in the future

Successful transureteropyelostomy after heminephrectomy of a bilateral hydronephrotic horseshoe kidney: a case report

<p>Abstract</p> <p>Introduction</p> <p>Horseshoe kidney is a rare congenital malformation that is found in approximately 0.25% of the general population and usually remains asymptomatic.</p> <p>Case presentation</p> <p>We report a successful transureteropyelostomy after heminephrectomy of the non-functional right moiety in a 25-year-old man with horseshoe kidney who had a combined 50% functional loss and hydronephrosis due to multiple distal ureteral strictures on the functionally remaining left side. Continuous ureteral stenting of the remaining part of the former horseshoe kidney was avoided during a follow-up of 2 years.</p> <p>Conclusion</p> <p>Urologists are often faced with technically difficult cases that are not responsive to standard operative procedures, and this case illustrates an individual surgical approach in a clinical situation.</p

An insight into the suspected HbA2' cases detected by high performance liquid chromatography in Pakistan

Background:Hemoglobin A2\u27 (delta 16 Gly Arg) is globally the commonest delta chain variant of HbA2. It is clinically and hematologically silent but its sole importance lies in the underestimation of HbA2 quantity during the workup of beta-thalassaemia trait. High performance liquid chromatography (HPLC) identifies it as a small S-window peak with a mean retention time of 4.59 0.03 minutes. This study aims at describing the frequency of detection of HbA2\u27 by HPLC in Pakistan and its confirmation at a molecular level. Potential HbA2\u27 cases were identified by a retrospective review of 10186 HPLC chromatograms in year 2006. Prospective samples were collected for polymerase chain reaction (PCR) amplification, restriction digestion and nucleotide sequencing. Findings: One hundred and ninety two potential cases (1.89%) of HbA2\u27 were detected on HPLC, having mean retention time of 4.59 0.05 minutes. Sixty four (0.6%) new cases were suspected of having co-existing beta-thalassaemia trait when the quantity of S-window peaks was taken into account. Thirteen samples with presumed HbA2\u27 on HPLC were subjected to molecular analysis and the said mutation (delta 16 GGC CGC) was not detected in any sample. Conclusion: It is concluded that diagnosis of HbA2\u27 on HPLC alone is not justified, as evidence of the presence of this delta chain variant in Pakistani population is yet to be proven. Such small S-window peaks should be either disregarded or confirmed at molecular level, and only then should influence the diagnosis of beta-thalassaemia trait. Further studies are required to determine the true nature of these peaks