Management of twenty patients with neck trauma in Khartoum ENT Hospital

Background: Neck trauma is a great surgical challenge, because there are multi organ and systems involved.Objective: To study the clinical presentation, management and outcome of twenty patients presented to Khartoum ENT Hospital with neck trauma.Methods: This is a prospective study conducted in Khartoum ENT Hospital, Sudan during the period 1998- 2008. A total number of 20 patients presented to our unit with neck trauma were included in the study. All patients were admitted to the hospital, assessed and managed according to the magnitude of trauma.Results: The age varied from 5 to 40years, with mean age (±SD) 28 years (±9). Male to female ratio was 2:1. Most of the patients presented to the Hospital between 1-6 hours after trauma. The mechanism of neck trauma was blunt trauma in 16(80%) patients and penetrating wound in 4(20%) patients. The distribution of injuries in neck zones were 17(85%) patients in zone II, 2(10%) patients in zone III and one patient in zone I. Tracheal injury and pharyngeal injury were seen in 4(20%) patients each, laryngeal injury in 5(25%) patients, and salivary gland injury in 1(5%) patient.Surgical exploration and tracheostomy were done in 4(20%) patients. tracheostomy alone was performed in 7(35%) patients with blunt trauma. Conservative management without surgical intervention was done in 9(45%) patients. The common complications in this study were vocal cord paralysis and subglottic stenosis in 2(10%) patients each, while surgical emphysema and haemothorax was seen in one patient.Conclusion: Zone II injures were the commonest injuries. Early presentation and proper management of patients with neck trauma carry good prognosis.Key words: neck trauma, clinical presentation, management

The Attitudes of Qatari Nationals and White-Collar Resident Workers Towards the New Traffic Law in Qatar

In 2007 the government of Qatar enacted a new traffic law with the objectives of improving the traffic flow and reducing the road traffic-related death and accident rates in the country through policy interventions, mass media and national traffic campaigns. Three years have passed since then and Qatar is still among the countries with the highest death accident rates in the world. Using the 2011 Social and Economic Survey Research Institute (SESRI) Omnibus Survey, we ask Qatari nationals and white-collar resident workers about their level of knowledge and awareness of the national campaigns for the prevention of road accidents and their level of commitment to the new traffic law. Respondents were also asked about the main causes of traffic accidents in Qatar and their attitudes towards the new penalties for traffic violation associated with the new law. The purpose of this presentation is to highlight the results of this important study.http://www.trforum.org/forum/proceedings.php?year=201

Road traffic fatalities in Qatar Jordan and UAE

ABSTRACT Smeed’s equation is a widely used model for prediction of traffic fatalities but has been found inadequate for use in developing countries. We applied regression analysis to time-series data on vehicles, population and traffic fatalities in the United Arab Emirates (UAE), Jordan and Qatar. The data were fitted to exponential models for fatality prediction, producing an average absolute error of 20.9% for Qatar, 10.9% for Jordan and 5.5% for the UAE. We found a strong linear relationship between gross domestic product and fatality rate

Gastric Polyp: A rare cause of Chronic Volvulus in an Adult

Gastric volvulus is a rare but potentially life-threatening cause of upper gastrointestinal obstruction. It presents clinically with epigastric pain radiating to the back and or left thoracic area or left abdominal quadrant and retching. This is a case of a 60 years old woman, who had a six-years history of an episodic epigastric pain related to meals. The pain was equally brought about by recumbence and relieved by decumbency. Three months prior to admission, her pain got worse and it was associated with vomiting. Abdominal ultrasound showed a gastric outlet soft tissue mass. Barium meal revealed a huge filling defect at the pyloric antrum. Oesophagogastrodudenoscopy showed a twisted gastric mucosa, brought about by a huge pedunculated gastric polyp. She was labelled to have a gastric volvulus and showed a good response to the conservative management. Surgical opinion was sought with the possibility of polypectomy and gastropexy. Surgery was postponed because she went into a hypertensive cardiac failure. We concluded that by twisting and de-twisting, gastric polyp may cause gastric volvulus that runs a chronic course. Therefore it has to be included in the differential diagnosis of chronic abdominal pain.Key words: Gastric Volvulus, Gastric Polyp, Abdominal Pain, Sudan

Receptors for immunoglobulin G and complement on human eosinophil leucocytes

This dissertation is concerned with (1) the identification of surface membrane markers for immunoglobulin G and complement on human eosinophils; (2) how certain pharmacological mediators, which stimulate eosinophil locomotion, influence the expression of these receptors; and (3) the susceptibility of schistosomula coated with antibody and/or complement to killing by human eosinophils, neutrophils and mononuclear leucocytes.By the rosette technique and immunofluorescence it was shown that human eosinophils and neutrophils bear membrane receptors for rabbit and human IgG and the human complement components, C3b, C3d and C4. There was a significantly reduced percentage of eosinophils bearing receptors for C4 and C3b when patients with eosinophilia of various aetiology were compared to controls. However, no differences were found with IgG receptors.The ECF-A tetrapeptides (Val-Gly-Ser-Glu and Ala-GlySer-Glu) and histamine, agents previously shown to be preferentially chemotactic for the eosinophil, markedly enhanced the expression of human eosinophil receptors for C3b. The enhancement appeared to be highly selective for the eosinophil since there was no evidence that C3b receptors on neutrophils or monocytes were altered by these pharmacological agents. The mediators similarly enhanced receptors for C4 but under the same conditions C3d and IgG (Fc) receptors were unaffected. A number of other pharmacological mediators including bradykinin and the prostaglandins PGE₁, E₂ and F₂α, had no apparent effect on eosinophil C3b receptors. However, a major histamine catabolite, imidazoleacetic acid, also recognised as an anaphylaxis-associated eosinophilotactic agent, enhanced eosinophil C3b receptors to a degree comparable to that of histamine.These results suggested that pharmacological mediators of hypersensitivity may regulate certain eosinophil dependent biological reactions and that there may be a direct relationship between the cell surface 'recognition unit' for eosinophil locomotion and some of the membrane receptors which promote the adhesion of eosinophils to opsonized particles.Studies were also undertaken to determine the susceptibility of schistosomula coated with antibody (Ab) and/or complement (c), to destruction by human eosinophils, neutrophils and mononuclear leucocytes. It was shown that (1) damage to schistosomula in vitro can be mediated by human eosinophils, neutrophils or mononuclear leucocytes in the presence of either 'Ab alone', 'C alone' or 'Ab + C'; (2) the efficiencies of the three experimental systems were Ab + C > C > Ab irrespective of whether effector cells were granulocytes or mononuclear leucocytes; and (3) preferential killing of schistosomula by the human eosinophil, as compared to the neutrophil, was not demonstrable with Ab alone but only when complement was present either alone or in combination with antibody.These studies indicate that the regulation of various eosinophil-associated biological events may be dependent on surface membrane markers, especially those for complement

Use of CAPI in surveys data collection SESRI experience

In this presentation, we explained the technical challenges and how SESRI solved them to conduct successful CAPI surveys; also, we showed how SESRI dealt with the Qatari society in particular to make the interviewing experience more welcomed to the Qatari families and expatriates

Measurement of ocular component contributions to residual astigmatism in adult human eyes

The aim of this study was to determine whether an ophthalmophakometric technique could offer a feasible means of investigating ocular component contributions to residual astigmatism in human eyes. Current opinion was gathered on the prevalence, magnitude and source of residual astigmatism. It emerged that a comprehensive evaluation of the astigmatic contributions of the eye's internal ocular surfaces and their respective axial separations (effectivity) had not been carried out to date. An ophthalmophakometric technique was developed to measure astigmatism arising from the internal ocular components. Procedures included the measurement of refractive error (infra-red autorefractometry), anterior corneal surface power (computerised video keratography), axial distances (A-scan ultrasonography) and the powers of the posterior corneal surface in addition to both surfaces of the crystalline lens (multi-meridional still flash ophthalmophakometry). Computing schemes were developed to yield the required biometric data. These included (1) calculation of crystalline lens surface powers in the absence of Purkinje images arising from its anterior surface, (2) application of meridional analysis to derive spherocylindrical surface powers from notional powers calculated along four pre-selected meridians, (3) application of astigmatic decomposition and vergence analysis to calculate contributions to residual astigmatism of ocular components with obliquely related cylinder axes, (4) calculation of the effect of random experimental errors on the calculated ocular component data. A complete set of biometric measurements were taken from both eyes of 66 undergraduate students. Effectivity due to corneal thickness made the smallest cylinder power contribution (up to 0.25DC) to residual astigmatism followed by contributions of the anterior chamber depth (up to 0.50DC) and crystalline lens thickness (up to 1.00DC). In each case astigmatic contributions were predominantly direct. More astigmatism arose from the posterior corneal surface (up to 1.00DC) and both crystalline lens surfaces (up to 2.50DC). The astigmatic contributions of the posterior corneal and lens surfaces were found to be predominantly inverse whilst direct astigmatism arose from the anterior lens surface. Very similar results were found for right versus left eyes and males versus females. Repeatability was assessed on 20 individuals. The ophthalmophakometric method was found to be prone to considerable accumulated experimental errors. However, these errors are random in nature so that group averaged data were found to be reasonably repeatable. A further confirmatory study was carried out on 10 individuals which demonstrated that biometric measurements made with and without cycloplegia did not differ significantly

Efficiency of Different Phosphate Fertilizer Sources in Two Hawaiian Soils With Contrasting Phosphate Fixing Tendencies

The efficiency of fused magnesium phosphate, treble superphosphate, and treble superphosphate with calcium silicate was studied in a Gibbsihumox, and the efficiency of fused magnesium phosphate and treble superphosphate was studied in a Chromustert. Sudax was the indicator crop in this pot experiment. Also, the efficency of three granule sizes (normal size, coarse fraction, and fine fraction) of fused magnesium phosphate in a Gibbsihumox was studied in the same experiment. In both studies the plant and first ratoon crops of Sudax were analyzed for P,Si, Mg, Ca, K, and Mn. The two soils were analyzed for extractable P, sorbed P, extractable Si, Mg, Ca, K, Mn, Fe, Cu, Zn, and soil pH. Samples from the Halii soil were also analyzed for extractable Al. The dry matter yields of the plant and first ratoon crops of Sudax increased significantly with increasing levels of applied P in both soils. Treble superphosphate gave significantly higher average dry matter yields than fused magnesium phosphate in the two soils in the plant crop. However, in the ratoon crops average dry matter yields were nearly identical for the two phosphate sources. The application of calcium silicate with treble superphosphate to the Halii soil increased dry matter yields of both plant and ratoon crops, but the increase was not significant. The three granule sizes of fused magnesium phosphate applied to the Halii soil produced similar dry matter yields. Plant P concentrations were similar for fused magnesium phosphate, treble superphosphate and treble superphosphate with calcium silicate in the Halii soil; and for fused magnesium phosphate and treble superphosphate in the Lualualei soil. Plant Mg concentrations in the Halii soil were significantly higher for fused magnesium phosphate than for treble superphosphate with and without calcium silicate. In the Lualualei soil, however, plant Mg levels were similar with the two phsophate fertilizers. Plant Si concentrations were highest with fused magnesium phosphate in the Halii soil. Extractable soil P was significantly higher for treble superphosphate than fused magnesium phosphate in both soils. The addition of calcium silicate with treble superphosphate to the Halii soil increased soil P significantly. The phosphorus requirement of the soil was decreased by the application of calcium silicate. The amount of soil P extracted from the Halii soil for the three granule sizes of fused magnesium phosphate increased in the order fine fraction < normal size < coarse fraction. Phosphorus sorption studies showed that P sorbed by the Halii soil with the three phosphate sources was in the order treble superphosphate with silicate < treble superphosphate < fused magnesium phosphate. In the Lualualei soil the order was treble superphospate < fused magnesium phosphate. Fused magnesium phosphate increased soil pH from 4.1 to 5.6 in the Halii soil with the application of 800 Kg P/ha, and from 7.5 to 7.7 in the Lualualei soil with the application of 200 Kg P/ha. The same amount of fertilizer material reduced the level of soil Al in the Halii soil from 0.7 to 0.2 me/100 g soil. Fused magnesium phosphate appears to be a suitable source of P for highly weathered soils with high P fixing capacity and low pH, Ca, Mg and Si

Entrepreneurial Action in the Pre-Export Phase of SMEs: A Cognitive Approach

The purpose of this study is to advance the theoretical knowledge of internationalisation of small and medium-sized firms from an individual perspective. In particular, the research takes a cognitive approach in understanding how experiential knowledge shapes entrepreneurs’ uncertainty perception and thus their willingness to recognise and act upon export opportunities. Six in-depth, semi-structured interviews were conducted with three exporters and non-exporters in the Swedish beverage sector. The comparative analysis allowed understanding how individuals on each group recognise, evaluate and act upon export opportunities within their milieu. Empirical findings show differences in the underlying uncertainty perception amongst both groups. Key to these differences is entrepreneurs’ individual motives, which wrought the type of experiences they engage in and accordingly the experiential knowledge they accumulate. Given the empirical observations, five propositions were developed to refine the understanding of entrepreneurs’ decision making process in the pre-export phase. This led to the construction of an empirical framework. Lastly, theoretical and practical implications were delineated

Supply Response of Sudan's Cotton Industry: Implications of Government Intervention

Sudan's cotton industry has assumed a key role since the mid 1920's in its national economic development both on economic and social grounds. This study addresses the issues of government intervention on Sudan's cotton industry. Control measures in the cotton industry which span area determination, cotton producers' price determination, cotton exchange rate and cotton tax rate, are believed to have negative impacts on the cotton industry supply response. The major objective of this study is to investigate the implications of government intervention on cotton industry. The study employs an econometric approach to examine the behavior of the cotton supply response. The study uses time series data over the period 1969 - 1998. The long and medium staple cotton models incorporate five equations, namely area, yield, export supply, producers' price and export demand The model equations have been structured to allow for a balanced representation of both price and nonprice factors. The models have been estimated using the auto--regressive distributed lag technique and error correction model The study employs Theil's inequality and root mean square percentage error as validation techniques to ascertain model performance. A simulation of alternative policy scenarios with regard to cotton exchange rate and cotton tax rate was carried out to assess the impact of policy reforms on the magnitude of the endogenous variables. In addition, a simulation of the policy scenario with regard to food self-sufficiency as a policy objective was also conducted. The findings of the study support the view that government interventions on Sudan's cotton industry have had negative implications on the cotton supply function components, namely, area and yield The various forms of government intervention have had, on the whole, undermined the provision of adequate incentives to cotton producers and as such have resulted in the lack of responsiveness on part of the cotton producers to changes in the cotton world market. Such a situation has deprived the country of its inherent comparative advantage as cotton producer. The study recommends corrective policy reforms in relation to producers' price determination mechanism and its associate variables mainly cotton exchange rate and cotton taxation. Moreover, non-price policy variables, which are mainly of technological nature, have to be appropriately considered in cotton production planning process in order to elucidate positive supply response