We need to talk about Charlie: putting the brakes on unlawful act manslaughter

Following a recent high-profile case in which a regulatory, strict liability offence was utilised to provide the "unlawful act" in unlawful act manslaughter, this article examines what is a sufficiently "unlawful" act to underpin that offence. It argues that the breadth of offences that can now be used to found an unlawful act manslaughter charge has led to a departure from the fair-labelling principle and traditional notions of culpability. Even the traditional argument, that the requirement of dangerousness sufficiently circumscribes those offences that qualify, has been weakened as that requirement has been diluted, and no longer provides adequate protection. Considering the legal position when a death resulted from a collision with a bike which did not comply with a Regulation, this article argues that trying to use unlawful act manslaughter to fill a lacuna in the law relating to fatal collisions involving cyclists risks unfairness to defendants through the unwarranted expansion of liability. New legislation is likely to be the most appropriate way properly to criminalise riding falling below the standard of a reasonable cyclist, but not amounting to gross negligence, that causes death.Non

Paediatrics pain management

Pain is one of the most common symptoms experienced the world over. It has always received the needed attention and care in the adult but not until recently among children. Several erroneous beliefs contributed to the inadequate attention among children such as assumption that children did not experience pain to the extent that adults do, because of the immaturenervous system, or that children would not remember the pain. A paediatrician is expected to be knowledgeable about pediatric painmanagement principles, provide a calm environment for painful procedures, use appropriate assessment tools and techniques, anticipatepainful experiences, use a multimodal approach (pharmacologic, cognitive,behavioral, and physical) to pain management, use a multidisciplinaryapproach when possible and involve families in creating solutions for their child’s pain. Studies have shown that the most common reason for unrelieved pain is failure to routinely assess pain and provide pain relief. The theories, pathways, transmission, regulations, classifications, assessment scales and the treatment of paediatric pain and practical issues that arise from the use of pharmacologic analgesic in the children were also reviewed and highlighted

Retinoblastoma - a clinico - pathological study in Ilorin, Nigeria

Retinoblastoma is the commonest childhood primary malignant intraocular neoplasm that is often characterized by spontaneous regression. They display photoreceptor differentiation. This study provides the clinical presentations and histological profiles of retinoblastoma in Ilorin, Kwara – State, in the North Central geo-political zone of Nigeria. A retrospective study of clinically and histologically verified retinoblastoma at the University of Ilorin Teaching Hospital, Ilorin, Kwara – State, Nigeria from January 1989 to December 2000 was undertaken. The clinical and histological features were analyzed using the patient\'s case folder and surgical pathology records. There were 20 patients, 9 males and 11 females (M:F ratio 1: 1.2), age range from 5 1/2 months to 6 years with 23 eyeball tumours histologically confirmed retinoblastoma during the study period. Proptosis with chemosis was the most common clinical presentation (84.6%). Bilaterality was 15% in this study. Enucleation and Exenteration combined with chemotherapy were offered to 15 (75%) and 5 (25%) patients respectively. A poorly differentiated type with extensive areas of tumour necrosis was the commonest histological pattern. Thirteen (65%) of the patients died before completing the course of chemotherapy. African Journal of Health Sciences Vol. 13 (1-2) 2008: pp. 117-12

Linking metabolic dysfunction with cardiovascular diseases: Brn-3b/POU4F2 transcription factor in cardiometabolic tissues in health and disease.

Metabolic and cardiovascular diseases are highly prevalent and chronic conditions that are closely linked by complex molecular and pathological changes. Such adverse effects often arise from changes in the expression of genes that control essential cellular functions, but the factors that drive such effects are not fully understood. Since tissue-specific transcription factors control the expression of multiple genes, which affect cell fate under different conditions, then identifying such regulators can provide valuable insight into the molecular basis of such diseases. This review explores emerging evidence that supports novel and important roles for the POU4F2/Brn-3b transcription factor (TF) in controlling cellular genes that regulate cardiometabolic function. Brn-3b is expressed in insulin-responsive metabolic tissues (e.g. skeletal muscle and adipose tissue) and is important for normal function because constitutive Brn-3b-knockout (KO) mice develop profound metabolic dysfunction (hyperglycaemia; insulin resistance). Brn-3b is highly expressed in the developing hearts, with lower levels in adult hearts. However, Brn-3b is re-expressed in adult cardiomyocytes following haemodynamic stress or injury and is necessary for adaptive cardiac responses, particularly in male hearts, because male Brn-3b KO mice develop adverse remodelling and reduced cardiac function. As a TF, Brn-3b regulates the expression of multiple target genes, including GLUT4, GSK3β, sonic hedgehog (SHH), cyclin D1 and CDK4, which have known functions in controlling metabolic processes but also participate in cardiac responses to stress or injury. Therefore, loss of Brn-3b and the resultant alterations in the expression of such genes could potentially provide the link between metabolic dysfunctions with adverse cardiovascular responses, which is seen in Brn-3b KO mutants. Since the loss of Brn-3b is associated with obesity, type II diabetes (T2DM) and altered cardiac responses to stress, this regulator may provide a new and important link for understanding how pathological changes arise in such endemic diseases

Aetiology, pattern and management of oral and maxillofacial injuries at Mulago National Referral Hospital

Objective: To establish the aetiology, pattern and methods of  management of oral and Maxillofacial injuries (OMFIs) seen at the Oral and Jaw injuries unit of Mulago National Referral Hospital (MNRH) Kampala, Uganda, over a ten year period.Design: A descriptive retrospective study.Setting: Oral and jaw injury unit of Mulago National Referral Hospital, Kampala, Uganda.Results: One thousand two hundred and three patient records met the inclusion criteria. The age range was 1-90 years with a male: female ratio of 4.5:1. The age-group most affected was the 21-30-year-olds. Road traffic injuries (RTIs) were responsible for 61% (n=735 of the injuries, interpersonal violence27.6% (n=332), accidental falls 12% (n=142) and firearm injuries 2.2% (n=27). Of the maxillofacial fractures (n=1069)isolated mandibular fractures were 62%, isolated mid-facial fractures 24% whereas Pan-facial fractures accounted for 14% .Conclusion: The victims of OMFIs were mostly young men between 21 and 30 years of age. The main aetiological factors were road traffic injuries (RTIs) and interpersonal violence (IPV), while the lower third of the face was most often involved. Consistent with findings in other studies, RTI and IPV remain the two main causes of Maxillofacial injuries and public health measures targeting prevention should focus on these areas

Cigarette Smoking And Oral Health Among Healthcare Students

Background: The knowledge, attitudes and practices of cigarette smoking and health risks among health workers has been found to be predictive of their efficiency as agents for tobacco cessation campaigns.Objective: To describe the knowledge, attitudes and practices of cigarette smoking and oral health risks among healthcare professional students.Design: A cross sectional multi-level study.Setting: College of Health Sciences, University of Nairobi.Subjects: Two hundred and eighty one students.Results: Thirty four (12.1%) of the students were current smokers, 174 (61.95%) had never smoked, while 73 (26%) were former smokers. Seventy nine point four per cent of the current smokers were males and 20.6% were females. Pharmacy students had the highest smokingprevalence at 11 (32.4%), while dental and nursing students had the lowest percentages of current smokers. Differences observed in smoking status of students in the constituent schools of the College of Health Sciences were statistically significant (p = 0.008). Apart fromknowledge levels on the association between tobacco consumption and lung cancer (p = 0.142), there were statistically significant differences in the awareness of the severe oral and systemic effects of smoking amongst the four student groups.Conclusions: There is a need for harmonisation of teaching of oral and systemic effects of smoking so as to impact on the smoking habits and effectiveness of healthcare professional students as agents of smoking cessation programmes

Impact of organic and inorganic fertilizers on growth, fruit yield, nutritional and lycopene contents of three varieties of tomato (Lycopersicon esculentum (L.) Mill) in Ogbomoso, Nigeria

Field experiments were carried out to assess the impact of 100% NPK fertilizer recommendation (300 kg NPK 20:10:10), 100% Tithonia compost (TC), 75% NPK + 25% TC, 50% NPK + 50% TC, 25% NPK + 75% TC and control (non-fertilized plant) on the growth, fruit yield, nutritional and lycopene contents of three tomato varieties (Raoma VF; Ogbomoso local and Califonia wonder). The experiment was a split plot fitted into a randomized complete block design replicated three times. Data were collected on growth and reproductive parameters, fruit and seed attributes, and fruit proximate and nutritional contents. Data collected were subjected to analysis of variance to determine significant means. Significant varietal  differences were observed among the tomato varieties in terms of growth, fruit yield and nutritional  attributes. The plant dry matter yield was highest in Ogbomoso local and least in Roma VF. Fruit yield  obtained with Ogbomoso local was 45 and 56% higher than what was obtained for Roma VF and Califonia  wonder, respectively. In terms of vitamin C content, Roma VF fertilized with 50% NPK + 50% TC gave  the highest value which is 23 to 67% higher than values obtained from the other treatment combinations.  Again, irrespective of variety, organically grown tomato contains higher content of lycopene. It was also observed that the higher the proportion of TC compost in the treatments, the better the lycopene content. It could be concluded that the use of organic fertilizer has potential in improving the growth, fruit yield and nutritional contents of any of the three tomato varieties studied. Key words: Lycopersicon esculentum, compost, inorganic fertilizers, fruit yield, nutritional quality, lycopene content.Abbreviation: TC, Tithonia compost; WAT, week after transplanting; TSS, total soluble solid

Clinico-histopathologic types of maxillofacial malignancies with emphasis on sarcomas: A 10-year review

Background: Sarcomas are malignant neoplasms that occur anywhere in the human body. Though their occurrence in the head and neck region is rare vis-a-vis other malignancies, their presence is of tremendous concern due to their often grave prognosis.Objective: To determine the pattern of occurrence, histopathologic types of maxillofacial sarcomas and their proportion to other malignant neoplasms of this region based on archival material accumulated over 10 years (2000-2009).Design: A combined retrospective and prospective cross-sectional study.Setting: The University of Nairobi Dental Hospital (UNDH).Subjects: All cases with a diagnosis of sarcoma registered between 2000-2009 were evaluated.Results: Of the 528 malignancies recorded over the ten-year period, 427 (80.9%) were of epithelial origin while 101 (19.1%) were sarcomas. Patients with epithelial malignancies were older (54.16 ± 15.94 years) than patients with sarcomas (31.73 ± 16.78) with the differences having been statistically significant. Osteosarcoma was the most commonlyoccurring sarcoma (29.7%), followed by Kaposi’s sarcoma (KS) (28.7%), fibrosarcoma (FBS) (18.8%), and rhabdomyosarcoma (RMS) (9.9%). Sarcomas peaked in the third decade with 70% occurring below the age of 40 years. The maxilla and the mandible were the most afflicted sites in the maxillofacial region accounting for 52%. The patients on averagepresented to medical personel about nine months after noticing the lesion with the most frequent complaint having been swelling.Conclusion: The present study confirms the relative rarity of maxillofacial sarcomas. It also provides data on the histopathologic types and demographic characteristics of maxillofacial sarcomas in a select Kenyan population. This information is a contribution to the comprehensive documentation of sarcomas that occur globally and is useful in theprovision of baseline data upon which future prospective analytical protocols may arise

Occupational Predisposition to Dermatophytes and other Agents of Human Dermatitis in Jos, Nigeria

Five hundred and twenty human samples were collected from patients with dermatitis, who visited the Dermatophilosis research laboratory in Jos, Plateau  State, Nigeria. This was in order to determine occupational predisposition to dermatophytes and other agents of human dermatitis. Samples collected were skin scrapping, nails, hair and pus exudates. They were processed according to standard procedure. Four hundred and thirty-three (83.3%) of the collected samples were positive for dermatophytes and other agents of dermatitis. The breakdown of the result along occupational categories were; Students (38.10%), Civil servants (31.64%), Self-employed (12.93%), Housewives (9.24%), Unemployed (4.16%) and Farmers (3.93%). The dermatophyte Trichophyton mentagrophytes had the highest frequency of occurrence in Civil servants (28), Students (26) House wives (8) and Unemployed (5). While Aspergillus niger had the highest frequency with the Farmers (4) and Self-employed (11). The students’ were noticed to be more predisposed to dermatophytes and other agents of dermatitis than any other category as a result of poor environmental hostel conditions that facilitate easy spread of infections and their unhealthy habit of sharing clothing and personal items. A vigorus public awareness on the risk involved in unhealthy and unhygienic habits could reduce the spread of these organisms. @JASEMJ. Appl. Sci. Environ. Manage. December, 2010, Vol. 14 (4) 97 - 10