The Nature and Extent of Species Interactions With the United States Gulf Menhaden Fishery.

I employed categorical techniques to explain patchy data on the releasable bycatch in the U.S. Gulf of Mexico menhaden fishery looking for species and areas of potential concern and potential solutions. For fishing grounds east of the Mississippi River, the odds of observing sets with high bycatch in spring and summer were greater than in the fall. Furthermore, spring bycatch rates were higher east of 89°W than in areas west of 93°W. Correspondence analysis indicated that the fate of the releasable bycatch could be classified into three major species-fate groupings. Two distinct bycatch species assemblages from April through August that separated the fishery at a longitude of 91°W were observed. From September through October there was a shift in the species assemblage. The assemblage west of 93°W appeared distinct from the rest of the fishery. From these analyses, bull sharks emerged as a species for potential concern. A shark-specific analysis of the bycatch revealed an annual take of approximately 30,000 sharks. Logit analysis indicated that the odds of observing shark bycatch were significantly greater in June--August than September--October. The odds of observing shark bycatch during April--May were also significantly different from September--October, however, these differences were only apparent east of 93°W. Stomach analyses of sharks and a consideration of size at age suggests that the fishery is impacting an important nursery ground for a complex assemblage of sharks, for which menhaden is an important forage base. I describe the spatial and temporal patterns of bottlenose dolphins and brown pelicans associated with the fishery. Dolphins were observed around 19% of fishing sets and diving and circling pelicans were observed in 23% of sets. These associations are described by a loglinear model with pelican-season-dolphin, dolphin-season-area, and prelican-season-area terms. Results suggest that while the incidental capture of dolphins in the fishery is extremely low, they are far more frequently observed in the immediate vicinity of the fishing operation. This suggests dolphins may have learned to avoid being captured. However, the extremely low rates of incidental capture may be biologically important given the low population estimates

Effects of dehydration on cricket specific skill performance in hot and humid conditions

The aim of the present study was to assess the effects of dehydration on cricket specific motor skill performance among fast-bowlers, fielders, and batsmen playing in a hot and humid environment. 10 fast-bowlers, 12 fielders and 8 batsmen participated in two field trials conducted 7 days apart: a fluid provision trial (FP) and a fluid restriction trial (FR). Each trial consisted of a 2-hour standardized training session and pre-training and post-training skill performance assessments. Bowling speed and accuracy (line and length), throwing speed and accuracy (overarm, sidearm and underarm) and timed running between wickets (1, 2, and 3 runs) was assessed pre to post-training in each trial. Mass loss was 0.6±0.3kg (0.9±0.5%) in FP, and 2.6±0.5kg (3.7±0.8%) in FR trials. Maintaining mass within 1% of initial values did not cause any significant skill performance decline. However, the dehydration on the FR trial induced a significant time and trial effect for bowling speed by 1.0±0.8% reduction (0.3±0.8% reduction in FP trial; p<0.01) and 19.8±17.3% reduction in bowling accuracy for line (3.6±14.2% reduction in FP trial; p<0.01), but no effect on bowling length. A significant decline was noted in the FR trial for throwing speed for overarm (6.6±4.1%; p<0.01; 1.6±3.4% reduction in FP trial) and sidearm (4.1±2.3%; p<0.01; 0.6±4.7% increase in FP trial) techniques, and for throwing accuracy for overarm (14.2±16.3%; p<0.01; 0.8±24.2% increase in FP trial) and sidearm (22.3±13.3%; p<0.05; 3.2±34.9% reduction in FP trial) techniques. Batsmen demonstrated significant performance drop in making three runs (0.8±1.2% increase in time in FP trial and 2.2±1.7% increase in time in FR trial; p<0.01). Moderate-severe dehydration of 3.7% body mass loss significantly impairs motor skill performance among cricketers, particularly bowlers and fielders, playing in hot and humid conditions. Fluid ingestion strategies maintaining mass loss within 1% prevented a decline in skill performance

Chronic health effects and cost of snakebite

The burden of disability among survivors and the socio-economic impact of snakebite have not been adequately researched. We reviewed original research articles, case reports and small case series relating to chronic physical, mental and psycho-social disability and economic burden of snakebite. Both physical and psychological health problems seem common in snakebite survivors and can lead to disability and loss of productivity. Chronic physical health effects, musculoskeletal disability being the commonest, can be largely attributed to limited and delayed access to optimal treatment of acute envenoming. The economic burden is considerable, and includes health system costs, out-of-pocket expenditure and opportunity costs, with regional variations. Health systems should be more responsive to needs and circumstances of bite victims, and a more holistic approach should be developed in the treatment of snakebite which incorporates the management of chronic health effects

Delayed Psychological Morbidity Associated with Snakebite Envenoming

Introduction The psychological impact of snakebite on its victims, especially possible late effects, has not been systematically studied. Objectives To assess delayed somatic symptoms, depressive disorder, post-traumatic stress disorder (PTSD), and impairment in functioning, among snakebite victims. Methods The study had qualitative and quantitative arms. In the quantitative arm, 88 persons who had systemic envenoming following snakebite from the North Central Province of Sri Lanka were randomly identified from an established research database and interviewed 12 to 48 months (mean 30) after the incident. Persons with no history of snakebite, matched for age, sex, geograpical location and occupation, acted as controls. A modified version of the Beck Depression Inventory, Post-Traumatic Stress Symptom Scale, Hopkins Somatic Symptoms Checklist, Sheehan Disability Inventory and a structured questionnaire were administered. In the qualitative arm, focus group discussions among snakebite victims explored common somatic symptoms attributed to envenoming. Results Previous snakebite victims (cases) had more symptoms than controls as measured by the modified Beck Depression Scale (mean 19.1 Vs 14.4; p<0.001) and Hopkins Symptoms Checklist (38.9 vs. 28.2; p<0.001). 48 (54%) cases met criteria for depressive disorder compared to 13 (15%) controls. 19 (21.6%) cases also met criteria for PTSD. 24 (27%) claimed that the snakebite caused a negative change in their employment; nine (10.2%) had stopped working and 15 (17%) claimed residual physical disability. The themes identified in the qualitative arm included blindness, tooth decay, body aches, headaches, tiredness and weakness. Conclusions Snakebite causes significant ongoing psychological morbidity, a complication not previously documented. The economic and social impacts of this problem need further investigation

Usefulness of Routine Terminal Ileoscopy and Biopsy during Colonoscopy in a Tropical Setting: A Retrospective Record-Based Study

Introduction. Available evidence for routine terminal ileoscopy during colonoscopy is equivocal. We investigated the place of routine terminal ileoscopy and biopsy during colonoscopy, in a tropical setting. Materials and Methods. All consenting adults undergoing colonoscopy had routine TI and biopsy. Patients with right iliac fossa (RIF) pain, diarrhoea, anaemia, suspected inflammatory bowel disease (IBD), and raised inflammatory markers were defined as Group A and all others undergoing colonoscopy as Group B. Results. Caecal intubation and TI were achieved in 988/1096 (90.15%) and 832/1096 (75.9%) cases, respectively. 764/832(91.8%) patients were included in final analysis. 81/764 (10.6%) patients had either macroscopic (34/81) or microscopic (47/81) abnormalities of terminal ileum; 20/81 had both. These were CD (28/47), tuberculosis (TB) (6/47), ileitis due to resolving infection (8/47), and drug-induced ileitis (5/47). 27/81 with macroscopically normal ileum had CD (18/27), ileitis due to resolving infection (5/27) and drug-induced ileitis (4/27) on histology. 12/764 (1.57%) patients with macroscopically normal colon had ileal CD (8/12), drug-induced ileitis (2/12), and resolving ileal infection (2/12) on histology. 47/764 (6.15%) patients had ileal pathology that influenced subsequent management. These were significantly higher in Group A (43/555 (8%)) than in Group B (4/209 (1.9%)) (P=0.0048, χ2=7.968). Conclusion. TI and biopsy improve diagnostic yield of colonoscopy in patients with RIF pain, diarrhoea, anaemia, suspected IBD, and raised inflammatory markers

A mechanistic model of snakebite as a zoonosis: Envenoming incidence is driven by snake ecology, socioeconomics and its impacts on snakes.

Snakebite is the only WHO-listed, not infectious neglected tropical disease (NTD), although its eco-epidemiology is similar to that of zoonotic infections: envenoming occurs after a vertebrate host contacts a human. Accordingly, snakebite risk represents the interaction between snake and human factors, but their quantification has been limited by data availability. Models of infectious disease transmission are instrumental for the mitigation of NTDs and zoonoses. Here, we represented snake-human interactions with disease transmission models to approximate geospatial estimates of snakebite incidence in Sri Lanka, a global hotspot. Snakebites and envenomings are described by the product of snake and human abundance, mirroring directly transmitted zoonoses. We found that human-snake contact rates vary according to land cover (surrogate of occupation and socioeconomic status), the impacts of humans and climate on snake abundance, and by snake species. Our findings show that modelling snakebite as zoonosis provides a mechanistic eco-epidemiological basis to understand snakebites, and the possible implications of global environmental and demographic change for the burden of snakebite

Should colloid boluses be prioritized over crystalloid boluses for the management of dengue shock syndrome in the presence of ascites and pleural effusions?

<p>Abstract</p> <p>Background</p> <p>Although the WHO guideline for the management of dengue fever considers the presence of ascites or pleural effusions in the diagnosis of DSS, it does not emphasize the importance of their presence when selecting fluids for resuscitation.</p> <p>Case presentation</p> <p>We highlight three patients with DSS who received boluses of crystalloids on priority basis as recommended by WHO guidelines during resuscitation. All three patients had varying degrees of third space fluid loss (ascites and pleural effusions) at the time of development of DSS. Ascites and pleural effusions were detected in all 3 patients at the time of shock irrespective of whether iv fluids were given or not. All three patients had documented liver involvement at the time of shock evidenced by elevation of AST (4800 iu/L, 5000 iu/L and 1960 iu/L). One patient who had profound shock died 6 hours after admission with evidence of acute pulmonary oedema in the convalescence phase. All of them needed CPAP ventilator support and potent diuretics.</p> <p>Conclusions</p> <p>We therefore feel that resuscitation of patients with DSS who already have third space fluid accumulation with crystalloid boluses on priority basis may contribute to recovery phase pulmonary oedema.</p

What clinicians who practice in countries reaching malaria elimination should be aware of: lessons learnt from recent experience in Sri Lanka

Following progressive reduction in confirmed cases of malaria from 2002 to 2007 (41,411 cases in 2002, 10,510 cases in 2003, 3,720 cases in 2004, 1,640 cases in 2005, 591 cases in 2006, and 198 cases in 2007). Sri Lanka entered the pre-elimination stage of malaria in 2008. One case of indigenous malaria and four other cases of imported malaria are highlighted here, as the only patients who presented to the Professorial Medical Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka over the past eight years, in contrast to treating several patients a week about a decade ago. Therefore, at the eve of elimination of malaria from Sri Lanka, it is likely that the infection is mostly encountered among travellers who return from endemic areas, or among the military who serve in un-cleared areas of Northern Sri Lanka. They may act as potential sources of introducing malaria as until malaria eradication is carried out. These cases highlight that change in the symptomatology, forgetfulness regarding malaria as a cause of acute febrile illness and deterioration of the competency of microscopists as a consequence of the low disease incidence, which are all likely to contribute to the delay in the diagnosis. The importance regarding awareness of new malaria treatment regimens, treatment under direct observation, prompt notification of suspected or diagnosed cases of malaria and avoiding blind use of anti-malarials are among the other responsibilities expected of all clinicians who manage patients in countries reaching malaria elimination