Levels and Trends of Occupational Hazards among Surgical Residents at Tikur Anbessa Hospital, Addis Ababa Ethiopia

Background: A previous study conducted four years ago among surgeons-in-training at the Addis Ababa University revealed that work-related  accidents among surgical trainees were enormous, and there was huge under reporting to the occupational health unit (OHU) of the hospital. The aim of this study was to evaluate the impact of the strengthened OHU of the hospital and what the current status of work-related accidents is like at the same hospital three years later.Methods: A cross-sectional study was conducted to investigate the  prevalence and context of all work-related accidents that resulted in contamination with blood and blood products inside the operating theatre, among surgical residents at the Tikur Anbessa teaching specialized referralhospital, in Addis Ababa University, Ethiopia. Data was collected from all 76 surgical residents who were at different stages of their specialty training in 2011.Results: Seventy- two (94.7%) of the residents were males and 26  (34.2%) were in their 3rd and 4th year of training. Of the 76 respondents, 53 (69.8%) had sustained a needle-stick injury inside the operating theatre at least once during their residency (Range=1-15 times). For 20 (26.3%), the accidents involved a high risk patient at least once. Cut with a sharp object, contact of blood to an unprotected skin and splash of blood to the eyes and face were reported by 9 (11.7%), 39(51.3%) and 28(36.9%) of the respondents respectively. Information concerning the most recent injuries inside the operating theatre revealed that 46(69.7%) of the residents sustained accidents in the 6 months preceding the survey, 7(9.2%) of which involved a high risk patient. All of the 7 (100%) of the recent high risk injuries and 10(27.7%) of the low-risk injuries were  reported to the OHU and all the high risk injury victims were commenced on HIV prophylaxis.Conclusions and Recommendations: Overall, the study revealed that work-related accidents among surgical trainees are still unacceptably high, even though there is a decline in the number of sharp object cut, and blood splash accidents. However, there is a positive trend towards reporting of injuries, particularly those which are high risk. More is expected from the hospital to create a safe working environment and to encourage reporting of all form of injuries

Aspergilloma of the lungs: Operative experience from Tikur Anbessa Hospital, Ethiopia

Background: Pulmonary aspergilloma represents a potentially life-threatening disease caused by saprophytic growth of Aspergillus fumigates in pulmonary cavities. This is the first report of its operative treatment from Ethiopia.The aim of this study was to determine the clinical presentations, operative treatments and post operative outcome of patients with pulmonary aspergilloma.Methods: This was a retrospective review of patients’ record with post operative diagnosis of pulmonary aspergilloma treated over a period of three years between April 2005-March 2008 at The Tikur Anbessa hospital which is a teaching and referral hospital in Addis Ababa.Results: Eleven patients were included, 81.8% of whom were males. Cough and hemoptysis were the two most common presenting symptoms, occurring in 11(100%) and 10(90.9%). The chest x-ray features typical for aspergilloma was seen in only 4(36.4%). The left lung was involved in 8(72.75%) and the upper lobes were the most commonly affected lobes occurring in 10 (90.9%). The most frequent clinical indication for surgery was severe hemoptysis in 8 (72.75%). Left upper lobectomy was the most frequently performed surgery in 4(36.4%) and left pneumonectomy in 3(27.3%). Four significant complications occurred in the postoperative period and one patient died, making the postoperative mortality 9.1%. Histopathologic confirmation of the fungal ball was possible in 10 patients and the most common underlying cavitary disease was tuberculosis in 9(90%).Conclusion: Aspergilloma is not an uncommon disease in Ethiopia and the diagnosis should be considered in patients who present with hemoptysis or chronic non-resolving cough. Surgery for pulmonary aspergilloma accounted for 5.8% of all thoracotomies done at the hospital and we have adopted the policy of early surgical treatment for all cases. In our series, the commonest lung pathology behind the aspergillus lesions was cavitary pulmonary tuberculosis, similar to many reports. Since the typical x/ray finding is not present in all patients, we believe that a supportive x/ray finding is sufficient enough an investigation to decide on early surgery in patients who present with suggestive symptoms

Habitat preference of the endangered Ethiopian walia ibex (Capra walie) in the Simien Mountains National Park, Ethiopia

Preferencia de hábitat del íbice de Etiopía (Capra wallie), en peligro de extinción, en el Parque Nacional de las Montañas Simien, en Etiopía El íbice de Etiopía (Capra wallie) es una especie en peligro de extinción endémica del Parque Nacional de las Montañas Simien, en Etiopía. La reciente expansión de las poblaciones humanas y el pastoreo de ganado en el parqque han suscitado preocupación por que los límites y los hábitats utilizados por el íbice de Etiopía hayan cambiado. Se realizaron observaciones del íbice de Etiopía y conteos de excrementos de íbice y de ganado, asimismo, se describió la vegetación y se clasificaron las características del hábitat en los puntos muestrales durante las estaciones seca y húmeda, desde octubre de 2009 hasta noviembre de 2011. Se evaluó la influencia de las características del hábitat en la presencia de excrementos de íbice y posteriormente se utilizó un modelo espacial para crear un mapa predictivo de las zonas con mayor probabilidad de albergar a esta especie. Los hábitats preferidos fueron los rocosos y arbustivos en comparación con los herbáceos. La distribución de los excrementos indicaba que el ganado y el íbice de Etiopía no solían encontrarse en el mismo punto muestral (el 70% de los cuadrados que contenían excrementos de íbice carecían de defecaciones de ganado y el 73% de los cuadrados con defecaciones de ganado no contenían excrementos de íbice). El mejor modelo para describir la probabilidad de presencia del íbice tomaba en consideración el efecto de la cubierta herbácea (β = 0,047), la cubierta arbustiva (β = 0,030), la distancia a un acantilado (β = –0,001), la distancia a una carretera (β = 0,001) y la altitud (β = 0,004). Los íbices de Etiopía se han trasladado hacia las zonas más orientales y abruptas del parque, lo que parece estar relacionado con la concentración de actividades humanas más intensas en las tierras bajas. Nuestro estudio pone de manifiesto la complejidad de gestionar zonas habitadas por poblaciones humanas y que a la vez constituyen un hábitat fundamental para las especies en conservación

Duration of low temperature storage, clove topping and gibberellic acid on garlic sprouting and seedling vigor

Dormancy of garlic (Allium sativum L.) creates a problem in use of freshly harvested garlic bulbs. Thus, pre-planting treatment of garlic cloves is an important agronomic concern for inducing and improving sprouting behavior of garlic. Glasshouse experiment was conducted at Haramaya University to evaluate the effect of cold storage (7°C) durations (10, 20, 30 days and one stored at room temperature that is 21°C for 30 days), clove topping (whole and cut) and gibberellic acid concentrations (0, 125, 250 and 375 mg/l) and distilled water treatment as second control on sprouting behavior of improved garlic variety (‘Tseday’). The treatments were laid out in factorial arrangement with three replications using completely randomized design (CRD). For cloves stored at ambient temperature (0 day) and non-topped, gibberellic acid application (250 and 375 mg/l) showed a significant increase in sprouting percentage, speed of sprouting and shoot dry mass of garlic as compared to 125mg/l GA3 treated and the controls. On the other hand, for topped cloves stored at ambient temperature (0 day), 10 and 20 days cold storage, gibberellic acid treatment did not show a significant influence on these characteristics as compared to the controls. The interaction effect of 30 days cold stored and topped cloves significantly increased pseudo-stem height (40.51%) compared to the lowest values recorded for the non-cold treated and non-topped cloves. The 30 days cold stored and topped cloves soaked in water significantly increased sprouting percentage over the period of 19 days after planting, speed of sprouting (four fold) and above ground shoot dry mass (79.41%) compared to the lowest values recorded for the non-cold treated and non-topped cloves not soaked in water and gibberellic acid (GA3). Hence, it can be concluded that 30 days cold storage, topping and soaking in water could enhance early sprouting of the garlic variety tested under glasshouse condition.Keywords: Clove topping, Dormancy, Garlic, Gibberellic acid, Sprouting percentage, Storage condition

The initial Mayo Clinic experience using high-frequency oscillatory ventilation for adult patients: a retrospective study

BACKGROUND: High-frequency oscillatory ventilation (HFOV) was introduced in our institution in June 2003. Since then, there has been no protocol to guide the use of HFOV, and all decisions regarding ventilation strategies and settings of HFOV were made by the treating intensivist. The aim of this study is to report our first year of experience using HFOV. METHODS: In this retrospective study, we reviewed all 14 adult patients, who were consecutively ventilated with HFOV in the intensive care units of a tertiary medical center, from June 2003 to July 2004. RESULTS: The mean age of the patients was 56 years, 10 were males, and all were whites. The first day median APACHE II score and its predicted hospital mortality were 35 and 83%, respectively, and the median SOFA score was 11.5. Eleven patients had ARDS, two unilateral pneumonia with septic shock, and one pulmonary edema. Patients received conventional ventilation for a median of 1.8 days before HFOV. HFOV was used 16 times for a median of 3.2 days. Improvements in oxygenation parameters were observed after 24 hours of HFOV (mean PaO(2)/FIO(2 )increased from 82 to 107, P < 0.05; and the mean oxygenation index decreased from 42 to 29; P < 0.05). In two patients HFOV was discontinued, in one because of equipment failure and in another because of severe hypotension that was unresponsive to fluids. No change in mean arterial pressure, or vasopressor requirements was noted after the initiation of HFOV. Eight patients died (57 %, 95% CI: 33–79); life support was withdrawn in six and two suffered cardiac arrest. CONCLUSION: During our first year of experience, HFOV was used as a rescue therapy in very sick patients with refractory hypoxemia, and improvement in oxygenation was observed after 24 hours of this technique. HFOV is a reasonable alternative when a protective lung strategy could not be achieved on conventional ventilation

Applications of Virus Induced Gene Silencing (VIGS) in Plant Functional Genomics Studies

Virus induced gene silencing (VIGS) is an effective technology that exploits an antiviral defense mechanism in plants. It is a recently developed gene transcript suppression technique for characterizing the function of plant genes. VIGS is rapid, efficient and specific system for transient gene silencing. The major steps in VIGS includes; engineering viral genomes to the appropriate viral vector to incorporate fragments of host genes that are targeted to be silenced, infecting the appropriate plant hosts and silencing the target genes as part of the defense mechanism of the plant against virus infection. The VIGS vector is a recombinant virus engineered to be able to carry a piece an endogenous gene from the host. During infection with the modified vector, the host’s defense reaction will be induced against the cloned host gene; a loss of function phenotype makes it possible to identify the function of the gene. The recombinant virus is introduced into plant cells through Agrobacterium tumefaciens mediated transient expression or in vitro transcribed RNA inoculation or direct DNA inoculation. The Trans gene is amplified along with the viral RNA by RNA dependent RNA polymerase generating dsRNA molecules. dsRNA is the triggering molecule of Post transcriptional gene silencing. VIGS as a reverse genetics tool for functional genomics studies presenting several advantages. Despite its great potential, many limitations remain to be overcome. In this review, the molecular mechanism in VIGS technology, its advanced application in plant functional genomics studies and the major limitation and potential future prospects were briefly discussed

Recent Developments in Genomic Selection for Minor Gene Quantitative Disease Resistance Plant Breeding

To speed up the development of improved crop varieties, genomics assisted plant breeding is becoming an important tool. With traditional breeding and marker assisted selection, there have been several achievements in breeding for diseases resistance. Most research for disease resistance has been focused on major disease resistance genes which are highly effective although very vulnerable to breakdown with rapid changes in pathogenic races. In contrast, breeding for minor gene quantitative resistance can produce more durable plant varieties although it is very slow and challenging breeding. As the genetic architecture of the plant disease resistance shifts from single major R genes to many minor quantitative genes, the most appropriate approach for molecular plant breeding is genomic selection (GS) than marker assisted selection or conventional breeding. With the advent of new genomic tools, GS has emerged as one of the most important approaches for predicting genotype performance to improve genetically complex quantitative traits. Consequently, GS helps to accelerate the rate of genetic gain in breeding by using whole genome sequence data to predict the breeding value of offspring. GS breeding for quantitative resistance will therefore necessitate whole genome prediction models and selection methodology as implemented for classical complex traits. With the implementation of GS for yield and other economically important traits, whole genome marker profiles are available for the entire set of breeding lines, enabling genomic selection for disease resistance with no additional direct cost. Therefore, recent developments in GS including a two stream GS + de novo GWAS models (GS+) and GS for combined highest level of quantitative resistance with R genes (QR +R gene) individuals are expected to further advance disease resistance plant breeding and briefly discussed

Relaxation oscillations and negative strain rate sensitivity in the Portevin - Le Chatelier effect

A characteristic feature of the Portevin - Le Chatelier effect or the jerky flow is the stick-slip nature of stress-strain curves which is believed to result from the negative strain rate dependence of the flow stress. The latter is assumed to result from the competition of a few relevant time scales controlling the dynamics of jerky flow. We address the issue of time scales and its connection to the negative strain rate sensitivity of the flow stress within the framework of a model for the jerky flow which is known to reproduce several experimentally observed features including the negative strain rate sensitivity of the flow stress. We attempt to understand the above issues by analyzing the geometry of the slow manifold underlying the relaxational oscillations in the model. We show that the nature of the relaxational oscillations is a result of the atypical bent geometry of the slow manifold. The analysis of the slow manifold structure helps us to understand the time scales operating in different regions of the slow manifold. Using this information we are able to establish connection with the strain rate sensitivity of the flow stress. The analysis also helps us to provide a proper dynamical interpretation for the negative branch of the strain rate sensitivity.Comment: 7 figures, To appear in Phys. Rev.