Perinatal testicular torsion: literature review and local experience

Introduction Perinatal testicular torsion includes intrauterine testicular torsion (IUTT) and postnatal testicular torsion (PTT). IUTT includes cases of vanished testis and testicular mass presenting at birth. Controversies exist regarding the need for urgent exploration and contralateral orchiopexy. The aim of this study is to review our local experience in the management of these cases.Patients and methods From May 2000 to May 2010, all files of patients with perinatal testicular torsion and operated cases of undescended testes (UDT) were reviewed retrospectively.Results Seven patients presented with a unilateral nonacute testicular mass at birth. Six of these patients required elective inguinal exploration and orchiectomy, whereas one was treated conservatively. All patients underwent urgent radiological investigations. None of the cases had synchronous or asynchronous contralateral involvement. Two patients with PTT presented acutely and required immediate bilateral scrotal exploration and testicular fixation without preoperative radiological investigations. Of 450 patients with UDT, there were 13 vanished testes (2.9%). Thirteen patients with torsion of the undescended testes (TUDT) presented acutely and required immediate inguinal exploration. Most of the TUDT cases (85%) presented between 5 weeks and 6 months. None of them could be saved.Conclusion Patients with IUTT did not present acutely, whereas patients with PTT presented acutely and required immediate bilateral scrotal exploration and fixation. The prognosis in TUDT is guarded and contralateral fixation was not practiced, except in a 5-week-old infant. Early orchiopexy at 3–6 months is recommended. Cooperation between surgeons, neonatologists, and parents is mandatory to avoid time delay. Keywords: intrauterine testicular torsion, postnatal testicular torsion, torsion of undescended testi

CURRENT STATUS AND OUTLOOK OF RENEWABLE ENERGY DEVELOPMENT IN NIGERIA

Over 80% of the current Nigerian primary energy consumption is met by petroleum. This overdependence on fossil fuels derived from petroleum for local consumption requirements should be a serious source of concern for the country in two ways – depletion of the resources and negative impact on the environment. This paper presents a critical review of the available renewable energy resources in Nigeria, namely; biomass, hydropower, solar and wind energy. It examines the current energy situation in the country and equally discusses the various energy policy documents developed by the government. Using the scenario-based International Atomic Energy Agency models, the projected energy demand and supply structure of the country through 2030 are presented and analysed. Overall, this study shows that Nigeria will overcome her present energy crisis if she explores the abundant renewable energy resources in the country.  The data presented in this paper is a crucial eye-opener for relevant government agencies towards developing these energy resources in tackling the present energy crisis in Nigeria.  http://dx.doi.org/10.4314/njt.v36i1.2

Efficient Photoelectrochemical Performance of Gamma Irradiated gC3N4 and its g-C3N4@BiVO4 Heterojunction for Solar Water Splitting

This is the author accepted manuscript. The final version is available from the American Chemical Society via the DOI in this recordComprehensive experimental and density functional theory simulations have been performed for the enhanced photoelectrochemical performance of gamma irradiated g-C3N4 and its heterojunction with BiVO4. The structure and morphology of g-C3N4@BiVO4 as a heterojunction were analyzed and verified from the correlation of experimental and theoretical data. It is found that gamma radiations have changed the bonding structure of g-C3N4 which ultimately reduces the optical bandgap energy. Moreover, the performance of gamma-irradiated g-C3N4 is two-fold, compared to that of non-irradiated one; increases from 3.59 to 5.86 µAcm-2 at 1.23 V versus Ag/AgCl in 0.5 M Na2SO4 electrolyte solution (pH 7). Finally, it is observed that the performance of gamma irradiated g-C3N4 in g-C3N4@BiVO4 heterojunction increased from 0.53 mA cm-2 to 1.38 mA cm-2, compared to that of the non–irradiated one. In summary, it has been concluded that gamma-irradiated g-C3N4 and its heterojunction is potentially be applied in PEC solar water splitting.National University of Malaysi

Design for safety in construction: a study of design professionals in Kuwait

Purpose: Design for safety (DfS), also known as prevention through design (PtD), is a concept that mitigates accidents and hazards through considerations during the design stage of building projects. The literature provides much information on this concept, but such information is only limited to a few developed countries such as the UK, the USA and Australia. There is limited insight into DfS implementation in the construction industry of several countries, including countries in the Gulf Cooperation Council (GCC) such as Kuwait. Therefore, this study investigates DfS implementation among design professionals in the Kuwait construction industry. Design/methodology/approach: The study used a questionnaire survey to obtain data from design professionals. The data were analysed using descriptive and inferential statistics (i.e. analysis of variance and t-test). Findings: The results revealed that DfS awareness among design professionals is very high; there is a very high willingness among design professionals to apply the concept, and design professionals generally view DfS implementation as important. Despite these, the frequency of implementation of DfS practices is generally moderate. In addition, the results revealed that though there is a high interest in DfS training among the design professionals, their actual engagement in training is low. The results also suggest some association between the frequency of engagement in the DfS practices and designers' DfS awareness, training and education. DfS related regulations, industry guidance, formal education and training are considered by design professionals to have the greatest influence on DfS implementation in Kuwait. Originality/Value: These emerging findings both mirror and contradict aspects of the outcomes of previous DfS studies in other countries. Furthermore, the findings from this study provide insights into a less investigated area regarding work-related health and safety in the GCC region. It offers new and additional information and insights into the current state-of-the-art DfS implementation in the construction industry in Kuwait. In view of the findings, joined-up efforts by government, industry and academia are needed to enhance DfS implementation by design professionals in Kuwait

Successful Suprainguinal Fascia Illiaca block for surgical anaesthesia of hip surgery

Introduction: Suprainguinal Fascia Illiaca Block is unpopular choice for anaesthesia of hip surgery. Deep nerve block such as neuroaxial and lumbar plexus nerve block are much more common due to difficulty to attain relief of selective hip pain. However, these nerve blocks might not be feasible in patients with certain comorbidities such as spine and cardiovascular disease. The nerve block result in blockade of femoral nerve, lateral femoral cutaneous nerve and obturator nerve. Suprainguinal approach may result in a more proximal spread, hence more efficacious analgesia for hip surgery. Case description: We reported three successful cases of suprainguinal fascia iliaca nerve block use as anaesthesia technique supplemented with monitored anaesthesia care. The patients in our report had multiple comorbidities at which general anaesthesia and neuraxial nerve block might not be feasible. All patients presented with neck of femur fracture and underwent proximal femoral nail insertion. The first patient had lung adenocarcinoma with spine metastases and the second patient had severe aortic stenosis. The third case was a patient with hypertensive heart disease and obesity. We perform the surgeries using fascia illiaca block by suprainguinal approach under ultrasound guidance using 40 mls of lignocaine 0.5%. Catheter was inserted during the procedure and further 10 mls of levobupivacaine were given after 1 hour. All surgeries were supplemented with dexmedetomidine infusion and boluses of ketamine. Postoperatively, all patients were started on levobupivacaine infusion 0.1% at 10 mls/h for the analgesia. The surgeries were performed successfully with adequate sensory block around the hip region, and we recorded good postoperative pain control. The benefit of this technique extends beyond adequate pain relief but also allow minimal cardiovascular and respiratory interference. We concluded that ultrasoundguided superficial fascia iliaca nerve block is an effective anesthetic technique for patients undergoing surgery for fracture of the neck of femur

Psychometric properties of the malay-language quality of life enjoyment and satisfaction scale: A confirmatory study on malaysian children

Data Availability Statement: The data is available upon request from the authors.Copyright © 2021 by the authors. The objective of this study was to validate the translated Malay version of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-M) scale among Malaysian primary school children using the confirmatory factor analysis (CFA). The Q-LES-Q-M measures the level of enjoyment and satisfaction experienced with relation to physical health, feelings, homework, and leisure. The participants were 607 Malay students, 240 (39.5%) boys and 367 (60.5%) girls, with an age range from 10 to 11 years old. The original version of the Q-LES-Q was translated into the Malay language by forward to backward translation procedures with consideration for the local culture and suitable vocabulary for primary school students. The participants then completed the Q-LES-Q-M. CFA was performed using Mplus 8 software. Using CFA, the initial model did not result in a good data fit. Further analysis of the CFA suggested some changes to the model to improve the fit indices. Model modification included the deletion of three problematic items and co-varying some error items. This resulted in improved fit indices and 40 items remained in the final model. The final model showed good reliability based on two indicators of composite reliability (CR) and Cronbach’s alpha (CA). The factors with their CR and CA were physical activity (CR = 0.857, CA = 0.854), feelings (CR = 0.808, CA = 0.813), homework (CR = 0.837, CA = 0.837) and leisure (CR = 0.742, CA = 0.737). The final measurement consists of 40 items. The retained items were deemed suitable for Malay primary school children. The revised Q-LES-Q-M with 40 items is suitable for measuring the levels of children’s involvement in determining the enjoyment and satisfaction of learning and physical activity.The research was partially supported by the Exercise Medicine Research Grant (EMRG/19004)

Lack of association of CTLA-4 +49 A/G polymorphism with predisposition to type 1 diabetes in a cohort of Egyptian families

Background: Type 1 diabetes is one of the most common chronic childhood illnesses. Interplay between genetic susceptibility and environmental factors is thought to provide the fundamental element for the disease. Apart from the Major Histocompatibility locus which is the main contributor to risk susceptibility, more than 40 loci are recognized. One among these is the CTLA-4, however data from the literature are controversial. The aim of our study was to investigate the role of CTLA4 49 A/G as a risk susceptibility factor for the development of type 1 diabetes in a cohort of Egyptian families.Subjects and methods: This is a case control study including 88 Egyptian families with one or more index cases (<18 years). The control group comprised 369 healthy unrelated subjects with no family history of diabetes or autoimmune disease. Using PCR-RFLP methodology, CTLA4 49 A/G was analyzed in 738 samples representing 88 families (88 patients, 125 siblings and 156 parents) and 369 control.Results: The age of onset was 6 days-12.5 years with a mean of 5.3± 3.6 and a median of 5 years. The mode of presentation was classic symptoms in 51 and diabetic ketoacidosis in 37 cases. Twenty-two cases had a history of viral infection or exanthematous disease and four had associated autoimmune diseases. No significant differences were encountered between the different groups with regard to CTLA4 +49 A/G genotype or allele frequencies. Neither was there a relation between the various genotypes and age of onset or the mode of presentation.Conclusions: CTLA4 49 A/G polymorphism was not recognized as a risk susceptibility factor in our cohort. This may be attributed to the low co-incidence of autoimmune diseases. Up to our best knowledge, this is the first study involving families. We recommend that all studies performed on risk susceptibility to type 1 diabetes should include proper investigation for other autoimmune diseases to exclude their confounding effect on data analysis.Keywords: Type 1 diabetes; CTLA-4; Risk susceptibilit