Assessment of heavy metals concentration in water, soil sediment and biological tissues of the lesser flamingos in four eastern rift valley lakes

The term heavy metal refers to any metallic chemical element that has a relatively high density and is toxic at low concentrations. This study was conducted in four eastern Rift Valley lakes which included Lakes Oloidien, Crater, Elementaita and Nakuru, to determine the presence and levels of lead, arsenic, cadmium and chromium concentration in water, soil sediments and biological tissues of the Lesser Flamingos (Phoeniconaias minor) and compare with the set standards. As these lakes catchments fall directly within a combination of agricultural and industrial regions, the run-offs and the resulting effluents will make the waters highly prone to chemical contamination. The methodology involved collection of water samples (n=40), sediments samples (n=51) and the Lesser Flamingos (live n= 6; dead n=2) for qualitative and quantitative toxicological analysis. The analysis was done using Graphite Furnace Atomic Absorption Spectrophotometer (GFAAS) model-Specter AA-10 Varian. Lead and arsenic were found to be in high concentration in soil sediments in all four lakes while chromium and cadmium were in low concentration. Soil sediments analysed from the inflow of the Nakuru sewerage drain (1754±22.81 ppb) and rivers to Lake Nakuru (1129±107 ppb) had the highest mean ± SD lead concentration. Arsenic, cadmium, chromium and lead were also observed in bird tissues. Metals in the Lesser Flamingo tissues were below the toxicological levels that are reported in literature to be harmful, except lead which was above the level recommended by the US Environmental Protection Agency.Keywords: Heavy metals, lesser flamingo, environmen

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran