Pattern of major surgery among the elderly and aged patients seen in Kampala, Uganda

A cross sectional descriptive prospective study was conducted at three of  Kampala's tnain hospitals with the aim of determining the pattern of major surgery among the  elderly and aged patients over a six months period from 1" July to 31" December  1999. In the study, patients aged between 65 and 74 years were regarded as elderly while those aged 75 years and above were considered aged. A total of 196 patients  were included in the study. There were 152 (75.5%)males  and 46 (23.5%) females (M: F=3:1). More elderly patients than the aged were operated on. Only 25.3% of the emergencies. Operations on the  gastrointestinal tract were the commonest and   accounted for 36.9% of cases, followed by surgery of the genitourinary (30.8%) and cardiovascular (13.1%) systems. In 63% of cases, the operations were palliative. Wound sepsis was the commonest postoperative complication and accounted for  17.8% of all complications. There were 19 deaths, an overall mortality rate of 9.6%. Thirteen (68.4%) of all deaths occurred after operations on the gastrointestinal tract. The mean hospital stay was 11.6 days for both the elderly and aged. Both the short and long term outcome of both emergency and elective operations were good. The study confirmed that age should not be a contraindication to surgery

Phase sensitive amplifiers for regeneration of phase encoded optical signal formats

We discuss the application of phase sensitive fiber optical parametric devices for the regenerative processing of high baud rate optical signals. We present recent advances in phase-sensitive amplification technology and its application to the regeneration of phase-encoded signals. By combining four wave mixing based parametric effects in highly nonlinear optical fibers and injection locking assisted synchronisation of multiple coherent lasers, we demonstrate how it possible to derive phase regeneration in signals with more than two levels of phase encoding

Clinical presentation and outcome of neurosurgical conditions at Butare Teaching Hospital, Rwanda

Background: Neurosurgical services have only been introduced in Rwanda recently. Consequently little information about spectrum of neurosurgical conditions in th country is available. This descriptive prospective study was aimed at determining the pattern, causes and outcome of management of neurosurgical conditions seen in Butare University Teaching Hospital (BUTH) in Rwanda.Methods: The study population consisted of 152 patients admitted at BUTH with neurosurgical conditions between October 1 2007 and May 31 2008. Patients were grouped into different neurosurgical conditions according to their clinical presentations. . Information collected included age, gender, cause and severity of injury, the time interval between injury Glasgow Coma Score, GOS scales were used to assess head injured patients.Results: The majority (70.4%) of patients came from rural areas. Their ages ranged from 15 days to 78 years with a mean of 31.98+/-18.75 years. The Male to female sex ratio was 2:1. Most (73.0%) of the patients suffered from trauma with 67.6% of them sustaining head injury and 32.4%, spinal trauma. Motor Vehicle crashes were the major cause of traumatic injuries (20% in spinal trauma and 70.7% of head trauma). Only 23% of the patients had CT scan performed. Only 12% of patients with traumatic brain injury (TBI) had CT scan.. A total of 78.7% of all head injuries were admitted in the first 24 hours following trauma. A significant number (44.4%) of spinal cord injury presented late (up to 7 days before referral to a neurosurgeon) and stayed longer in the hospital (52.7% up to 3 months). Laminectomy and fixation was the most common spinal operative procedure (58.7%) followed by discectomy (34.8%). The commonest cranial operation was for posttraumatic intracranial haemorrhage (41.4%) followed by surgery for depressed fracture (37.9%). One child had a shunt procedure for hydrocephalus. Good recovery was associated with GCS >13 on admission (P<0.001). The overall mortality rate was 13.2%. The mortality among patients admitted with GCS <8 was 52.4%.Conclusion: Neurological injuries were the most commonly seen conditions mainly in head injuries. This study confirms that neurosurgical procedures can still be done with fair results using very little equipment. Providing basic equipment to national neurosurgeons, however, and training them to work in an adverse environment remains a big challenge

Phase-sensitive wavelength conversion based on cascaded quadratic processes in periodically poled lithium niobate waveguides

We propose and experimentally demonstrate a novel scheme of phase-sensitive wavelength conversion, based on a combination of cascaded second-order nonlinear effects in two cascaded periodically poled lithium niobate waveguides

Practical issues and some lessons learned from realization of phase sensitive parametric regenerators

Practical issues in pump phase synchronization necessary for coherent all-optical processing are discussed, including feed-forward carrier recovery of phase encoded signals

All-optical phase-regenerative multicasting of 40 Gbit/s DPSK signal in a degenerate phase sensitive amplifier

We demonstrate all-optical 1-to-5 differential phase-shift keyed (DPSK) wavelength multicasting at 40 Gbit/s using a degenerate four-wave mixing (FWM) based phase sensitive amplifier (PSA). Phase regenerative properties are reported with a sensitivity improvement of more that 10 dB

Saturation effects in degenerate phase sensitive fiber optic parametric amplifiers

We experimentally study saturation effects in degenerate phase sensitive amplifiers, revealing and explaining a gain regime suitable for all-optical signal processing functions such as phase regeneration

Brachial plexus lesions: Anatomical knowledge as an essential diagnostic tool in a situation of limited imaging facilities

Diagnosing brachial plexus lesion is a challenge in countries where imaging facilities are not well developed. Here we report 3 cases of different lesions of the brachial plexus sustained after a road traffic crush. The first case presented with a lesion of the 3 primary trunks of the right brachial plexus. The clinical examination showed paralysis of all terminal nerves of the brachial plexus and the collateral branches of both anterior and posterior brachial plexus. The second patient showed paralysis of all muscles of the shoulder and muscles of the anterior compartment of the arm. This clinical feature is in accordance of the upper brachial trunk lesion. The third patient had paralysis of muscles of the hand being innerved by median nerve or ulna nerve. He showed also paralysis of muscles of the anterior compartment of the forearm and anaesthesia of the medial region of hand and forearm. This clinical feature was in conformity with a lesion of inferior primary trunk. All diagnoses were made based on the clinical findings. These cases demonstrate the significance of a through anatomical knowledge in the clinical examination if one has to avoid confusing the signs of terminal nerves lesion with the trunk’s lesion. These cases underscore the importance of applied anatomy in clinical situations

Packet compression of complex modulation formats based on coherent optical superposition

We propose and numerically demonstrate a packet compression scheme based on re-coding of complex modulation formats through the use of a delay line interferometer (DLI) followed by a temporal gate. A variety of modulation formats can be accommodated and high compression factors can be obtained by using multiple DLIs to achieve higher order modulation formats

Homodyne operation of a phase-only optical amplifier

We utilise cascaded four wave mixing to multiply the modulation depth of a phase-only optical signal and generate a comb of phase locked local oscillators allowing homodyne retrieval of the phase information with enhanced fidelity