Evaluation of respiratory function using blood gas parameters in Yucatan minipigs following Spinal Cord Injury

There are approximately 17,810 new spinal cord injuries (SCI) in the U.S. each year [1]. Physical damage to the spinal cord has the potential to interfere with normal motor, sensory, and/or autonomic function, such as impairment of the respiratory system. In fact, respiratory insufficiency is the number one cause of mortality and morbidity after SCI. The more rostral the injury, the more likely there will be disruption to normal ventilation (generally rostral to T6) [2]. To conduct relevant preclinical research, it has been shown that large animal models, such as the Yucatan minipig, have a better success rate of translating to the clinical setting when compared to rodent or other small animal models [3]. While trying to optimize this animal model to specifically target deficits in mobility, it was important to narrow the injury site, which would isolate mobility and not affect the respiratory system. In this study, 18 Yucatan minipigs were randomized into groups of 6 and received either a mild, moderate, or severe level of a T9/T10 SCI. Blood gases PO2, PCO2, HCO3, and pH were recorded hourly prior to, during, and immediately post injury to evaluate stability of the animal during anesthesia, as well as closely monitor respiratory function following SCI. Parameters were monitored one hour prior to anesthetic induction and up to 4 hours post anesthesia recovery. None of the groups showed significant deficits in respiratory function post-injury. It was concluded that a T9/T10 injury could be used to isolate motor function independent of respiratory deficits

Knowledge and Uses of African Pangolins as a Source of Traditional Medicine in Ghana

Traditional medicine has been practised in Ghana for centuries with the majority of Ghanaians still patronising the services of traditional healers. Throughout Africa a large number of people use pangolins as a source of traditional medicine, however, there is a dearth of information on the use of animals in folk medicine in Ghana, in particular the use of pangolins. The aim of this study was to determine the prevalent use of pangolins and the level of knowledge of pangolin use among traditional healers in Ghana for the treatment of human ailments. Data was gathered from 48 traditional healers using semi-structured interviews on the traditional medicinal use of pangolin body parts in the Kumasi metropolis of Ghana. The cultural importance index, relative frequency of citation, informant agreement ratio and use agreement values were calculated to ascertain the most culturally important pangolin body part as well as the level of knowledge dissemination among traditional healers with regards pangolin body parts. Our study revealed that 13 body parts of pangolins are used to treat various medicinal ailments. Pangolin scales and bones were the most prevalent prescribed body parts and indicated the highest cultural significance among traditional healing practices primarily for the treatment of spiritual protection, rheumatism, financial rituals and convulsions. Despite being classified under Schedule 1 of Ghana's Wildlife Conservation Act of 1971 (LI 685), that prohibits anyone from hunting or being in possession of a pangolin, our results indicated that the use of pangolins for traditional medicinal purposes is widespread among traditional healers in Ghana. A study on the population status and ecology of the three species of African pangolins occurring in Ghana is urgently required in order to determine the impact this harvest for traditional medical purposes has on their respective populations as current levels appear to be unmonitored and unsustainable

Impact of Mass Drug Administration (MDA) on the Transmission of Lymphatic Filariasis in Tono Irrigation Area in Navrongo, Ghana

Lymphatic filariasis is ranked as one of the leading causes of permanent and long-term disability and also oldest and most debilitating neglected tropical disease worldwide. Filariasis is caused by nematode endoparasitic worms transmitted to humans by various mosquito vectors.  World Health Organization established Global Programme to Eliminate Lymphatic Filariasis as a public health problem by the year 2020. The strategies employed are to interrupt transmission through mass drug administration (MDA) and to alleviate suffering and disability via morbidity management; and vector control. It is expected that after implementation of the strategies above, transmission assessment surveys are required to ascertain their progress, impact and efficacies. As MDA was the main strategy, this work therefore determined impact of mass drug administration on the transmission of lymphatic filariasis in Tono Irrigation area in Navrongo following more than nine years of its implementation. Human landing and pyrethrum spray monthly collections of mosquitoes in Wuru and Saboro were dissected to determine the transmission level in the study area. The mosquitoes collected in the study comprised 90.22% (3,650) Anopheles species and 9.78% (386) Culex species with no Aedes or Mansonis species. The man biting rate computed from (Human Landing Catch) HLC was 162.25 bites/man/night in Wuru and 143.75bites/man/night in Saboro. Only 3An. species were infected with filarial parasites; 2 in Saboro with 2mf, and 1L2 in a mosquito in Wuru. However, there was no L3 stage recorded in any of the 3,560 mosquitoes macerated implying that there was no ongoing transmission of LF in the study sites since no infective bites were encountered. However, a follow up survey is required to assess the level of transmission since one survey is inadequate to declare the place free of LF. Keywords: Anopheles species, Wuchereria bancrofti, Mass Drug Administration, Lymphatic filariasis, Ghan

Ethnomedicinal use of African pangolins by traditional medical practitioners in Sierra Leone

BACKGROUND: Pangolins (Manidae) have long been used for traditional medicinal purposes in most parts of sub-Saharan Africa. However, very little is known about the extent of this use, the body parts that are used and the ailments these practices are attempting to cure or alleviate. Pangolin body parts are used extensively and frequently by traditional medical practitioners in Sierra Leone. METHODS: A total of 63 traditional medical practitioners consented and were interviewed using semi-structured questionnaires on the traditional medicinal use of pangolin body parts. The use value, informant agreement ratio and use agreement value for each pangolin part was calculated to ascertain the most sought after body part, the level of knowledge dissemination among traditional medical practitioners about body parts and the most culturally significant body part. RESULTS: It was found that 22 pangolin parts are used to treat various ailments and conditions under 17 international categories of diseases. The highest use value was recorded for scales while eyes had the highest level of consensus among the traditional medical practitioners. The highest use value and informant agreement ratio for scales were recorded for spiritual ailments. Scales were the most culturally significant body part according to the use agreement value. CONCLUSION: This study indicates a high importance value for pangolins as part of these communities’ spiritual, cultural and medicinal beliefs. However, the numbers of individuals harvested from the wild remains unknown and unregulated even though pangolins have been listed under Schedule 2 of the Wildlife Conservation Act, 1972, of Sierra Leone, which prohibits any person from hunting or being in possession of pangolins. It is likely that this unregulated harvesting and poaching of this threatened species, for medicinal purposes, is unsustainable and there is an urgent need to determine pangolin population abundance within this region to ensure their sustainable harvesting for cultural use and conservation

Risk of transmission of viral haemorrhagic fevers and the insecticide susceptibility status of aedes aegypti (linnaeus) in some sites in Accra, Ghana

Background: Dengue is one of the emerging diseases that can mostly only be controlled by vector control since there is no vaccine for the disease. Although, Dengue has not been reported in Ghana, movement of people from neighbouring countries where the disease has been reported can facilitate transmission of the disease. Objective: This study was carried on the University of Ghana campus to determine the risk of transmission of viral haemorrhagic fevers and the insecticide susceptibility status of Ae. aegypti in some sites in Accra, Ghana. Design: Larval surveys were carried to inspect containers within households and estimate larval indices and adult Aedes mosquitoes were collected using human landing collection technique. WHO tube assays was used to assess the insecticide susceptibility status of Aedes mosquitoes. Results: Ae. aegypti were the most prevalent species, 75.5% and followed by Ae. vittatus, 23.9 %. Ae. albopictus and Ae. granti were in smaller numbers. Household index (HI), Breteau index (BI), and container index were calculated as 8.2%, 11.2% and 10.3% respectively with man-vector contact rate of 0.67 bites/man-hour estimated for the area. The mortalities recorded for Ae. aegypti from WHO tube assays was 88%, 94%, 80% and 99% for DDT (4%), deltamethrin (0.05%), lambdacyhalothrin (0.05%) and permethrin (0.75%) respectively.Conclusion: The survey results indicated that the density of Aedes mosquitoes was considered to be sufficient to promote an outbreak of viral haemorrhagic fevers on Legon Campus. Aedes mosquitoes were found to be resistant to DDT, deltamethrin and lamdacyhalothrin, but susceptible to permethrin. Funding: This study was supported in part by Japan Initiative for Global Research Network on Infectious Diseases(J-Grid).Keywords: Mosquitoes, Aedes aegypti, insecticide, risk, VHF transmission, Ghan

Spinal cord epidural stimulation for motor and autonomic function recovery after chronic spinal cord injury: A case series and technical note

Background: Traumatic spinal cord injury (tSCI) is a debilitating condition, leading to chronic morbidity and mortality. In recent peer-reviewed studies, spinal cord epidural stimulation (scES) enabled voluntary movement and return of over-ground walking in a small number of patients with motor complete SCI. Using the most extensive case series (n = 25) for chronic SCI, the present report describes our motor and cardiovascular and functional outcomes, surgical and training complication rates, quality of life (QOL) improvements, and patient satisfaction results after scES. Methods: This prospective study occurred at the University of Louisville from 2009 to 2020. scES interventions began 2–3 weeks after surgical implantation of the scES device. Perioperative complications were recorded as well as long-term complications during training and device related events. QOL outcomes and patient satisfaction were evaluated using the impairment domains model and a global patient satisfaction scale, respectively. Results: Twenty-five patients (80% male, mean age of 30.9 ± 9.4 years) with chronic motor complete tSCI underwent scES using an epidural paddle electrode and internal pulse generator. The interval from SCI to scES implantation was 5.9 ± 3.4 years. Two participants (8%) developed infections, and three additional patients required washouts (12%). All participants achieved voluntary movement after implantation. A total of 17 research participants (85%) reported that the procedure either met (n = 9) or exceeded (n = 8) their expectations, and 100% would undergo the operation again. Conclusion: scES in this series was safe and achieved numerous benefits on motor and cardiovascular regulation and improved patient-reported QOL in multiple domains, with a high degree of patient satisfaction. The multiple previously unreported benefits beyond improvements in motor function render scES a promising option for improving QOL after motor complete SCI. Further studies may quantify these other benefits and clarify scES’s role in SCI patients

Ethnomedicinal use of African pangolins by traditional medical practitioners in Sierra Leone

Abstract Background: Pangolins (Manidae) have long been used for traditional medicinal purposes in most parts of sub-Saharan Africa. However, very little is known about the extent of this use, the body parts that are used and the ailments these practices are attempting to cure or alleviate. Pangolin body parts are used extensively and frequently by traditional medical practitioners in Sierra Leone. Methods: A total of 63 traditional medical practitioners consented and were interviewed using semi-structured questionnaires on the traditional medicinal use of pangolin body parts. The use value, informant agreement ratio and use agreement value for each pangolin part was calculated to ascertain the most sought after body part, the level of knowledge dissemination among traditional medical practitioners about body parts and the most culturally significant body part. Results: It was found that 22 pangolin parts are used to treat various ailments and conditions under 17 international categories of diseases. The highest use value was recorded for scales while eyes had the highest level of consensus among the traditional medical practitioners. The highest use value and informant agreement ratio for scales were recorded for spiritual ailments. Scales were the most culturally significant body part according to the use agreement value

Comparison of Vertebroplasty, Kyphoplasty, and Nonsurgical Management of Vertebral Compression Fractures and Impact on US Healthcare Resource Utilization

Study DesignRetrospective propensity score-matched cohort analysis of the Thomson Reuters MarketScan database.PurposeTo compare the outcomes of vertebral compression fracture (VCF) treatment options, with an emphasis on reoperation, complications, costand overall healthcare resource use between 2005 and 2009 in the United States.Overview of LiteratureOptions for the treatment of VCFs include conservative management, kyphoplasty, and vertebroplasty. The cost-effectiveness of surgical intervention for VCF has been criticized, and some suggest their outcomes to be similar to placebo.MethodsPatients 18 years of age and older who developed a VCF were identified and separated into three treatment cohorts: vertebroplasty, kyphoplasty, and non-surgical. Propensity score matching was performed to match patients between cohorts. Main outcomes assessed included reoperation, complications, healthcare resource use and associated cost. Outcomes were compared at three separate time intervals (patients at index hospitalization; patients with at least 2-year follow-up data; and those with at least 4-year follow-up data).ResultsTwenty thousand seven hundred forty patients were identified with VCFs, yielding 7,290 after propensity score matching. The mean age of the patients was 78±12 years; and 5,507 (75.5%) were female. All reoperation rates ranged from 6%-17%, while complication rates ranged from 7%-10%, which did not differ significantly among the three cohorts at all follow-up periods. Overall costs were noted to be significantly greater in both the kyphoplasty and vertebroplasty groups at 1-year follow-up, not at 2-year and 4-year follow-up.ConclusionsOur data suggests that the treatment of a VCF patient will likely be associated with similar long-term operative and complication rates regardless of treatment modality