About a uni-cervical unicorn uterus case with vaginal septum

The unicorn uterus is a common uterine malformation after septate uteri, accounting for 30 to 50% of cases. We report a case of unicorn uterus with an associated vaginal septum discovered during the obstetrical examination of a consultant surgeon for hemorrhage, and exploration of the uterus revealed a uterus during a cesarean section. Maternal-fetal rescue for placenta previa. The interest of this case is to show the double embryological mechanism involved, unilateral aplasia of the muller ducts and the lack of resorption explaining this vaginal septum

Implications of storing urinary DNA from different populations for molecular analyses.

Molecular diagnosis using urine is established for many sexually transmitted diseases and is increasingly used to diagnose tumours and other infectious diseases. Storage of urine prior to analysis, whether due to home collection or bio-banking, is increasingly advocated yet no best practice has emerged. Here, we examined the stability of DNA in stored urine in two populations over 28 days

Implications of Storing Urinary DNA from Different Populations for Molecular Analyses

Molecular diagnosis using urine is established for many sexually transmitted diseases and is increasingly used to diagnose tumours and other infectious diseases. Storage of urine prior to analysis, whether due to home collection or bio-banking, is increasingly advocated yet no best practice has emerged. Here, we examined the stability of DNA in stored urine in two populations over 28 days.Urine from 40 (20 male) healthy volunteers from two populations, Italy and Zambia, was stored at four different temperatures (RT, 4 degrees C, -20 degrees C & -80 degrees C) with and without EDTA preservative solution. Urines were extracted at days 0, 1, 3, 7 and 28 after storage. Human DNA content was measured using multi-copy (ALU J) and single copy (TLR2) targets by quantitative real-time PCR. Zambian and Italian samples contained comparable DNA quantity at time zero. Generally, two trends were observed during storage; no degradation, or rapid degradation from days 0 to 7 followed by little further degradation to 28 days. The biphasic degradation was always observed in Zambia regardless of storage conditions, but only twice in Italy.Site-specific differences in urine composition significantly affect the stability of DNA during storage. Assessing the quality of stored urine for molecular analysis, by using the type of strategy described here, is paramount before these samples are used for molecular prognostic monitoring, genetic analyses and disease diagnosis

Oral ketamine: A four-years experience in a tumour clinic in Lusaka Zambia

Pain management is an important component in cancer management. The administration of painful injections to children in an oncology clinic can create difficulties. This study was undertaken to determine the role of oral ketamine to modify the response to pain. Between 1996 and 1999,6324 patients attended a tumour clinic in a developing country teaching hospital. Forty eight children required cytotoxic injections on 103 occasions. These children were subdivided into 3 groups according to the year of attendance: 1996,1997 and 1998/8. each group was premeded differently. The first group received ketamine 4.5mg/Kg; the second received ketamine Gmg/Kg and the third had ketamine 6mg/Kg with diazepam O.lmg/Kg. The  esponse to pain in each group was evaluated by using an observer based scoring system. The visual analogue scale was not used. The study showed that oral ketamine is an effective and safe drug for use in a clinic setting. However, its action was not always predictable due to a number of confounding factors. A phenothiazine should be routinely used in these children to enhance the effectiveness of ketamine and to diminish the likelihood of its well-known side effects. Further studies using less costly lower doses of ketamine is recommended. Key words: Oral Ketamine, Premedication and Oncology

Brain-Machine Interface for Mechanical Ventilation Using Respiratory-Related Evoked Potential

International audienceThe correct ventilation for patients in intensive care units plays a critical role for the prognostic and the recovery during the stay in the hospital. Desynchronization between the ventilator and the patient is an important source of stress, emphasized by the lack of communication due to intubation or loss of consciousness. This contribution proposes a novel approach based on electroencephalographic (EEG) activity to detect breathing effort. Relying both on recent neuroscience finding on respiratory-related evoked potential and on latest development of information geometry, the proposed approach elaborates on Rieman-nian distances between EEG covariance matrices to differentiate among different respiratory loads. The results demonstrate that this approach outperform existing state-of-the-art methods quantitatively, in terms of mean accuracy, and qualitatively, being able to predict level of breathing discomfort

Epidemiological aspects and molecular characterization of the hepatitis B virus among blood donors in Lubumbashi, Democratic Republic of Congo.

OBJECTIVES : The strains of HBV circulating among blood donors in Lubumbashi, Democratic Republic of Congo (DRC), are not yet characterized. The purpose of this study was to determine seroprevalence, changes in biochemical parameters during HBV infection and molecular characterization of HBV in blood donors in Lubumbashi. METHODS : The detection of HBsAg was carried out by rapid diagnostic test then confirmed by the Liaison XL® Quant HBsAg technique. PCR targeting the P gene was carried out on LightCycler® 96 and genotyping by the sequencing technique on ABI 3500. RESULTS : The seroprevalence was 7.9%. The genotypes E (53.1%), A (41.8%), A3/E (3.8%), A1/E (1.3%) and some drug resistance mutations were identified. Disturbances of HDL-cholesterol, direct bilirubin, transaminases (ASAT and ALAT), PAL, GGT and albumin have been observed in HBsAg positive blood donors. CONCLUSION : The results of our study indicated that Lubumbashi is in a region with high endemicity for HBV and report for the first time HBV of genotypes A, E, A1/E and A3/E. They highlight the need to implement strategies to improve transfusion safety in blood transfusion centers and hospital blood banks in Lubumbashi in order to reduce HBV infection in recipients. They could also contribute to the implementation of treatment strategies and the development of mapping of circulating HBV genotypes in the DRC.[Aspects épidémiologiques et caractérisation moléculaire du virus de l’hépatite B chez les donneurs de sang à Lubumbashi, République démocratique du Congo] OBJECTIFS : Les souches du virus de l’hépatite B (VHB), circulant parmi les donneurs de sang à Lubumbashi, en République démocratique du Congo (RDC), ne sont pas encore caractérisées. Le but de cette étude était de déterminer la séroprévalence et les changements des paramètres biochimiques au cours de l’infection par le VHB et la caractérisation moléculaire du VHB chez les donneurs de sang à Lubumbashi. METHODES : La détection de l’AgHBs a été réalisée par le test de diagnostic rapide, puis confirmée par la technique Liaison XL® Quant HBsAg. La PCR ciblant le gène P a été réalisée sur LightCycler® 96 et le génotypage par la technique de séquençage sur ABI 3500. RESULTATS : La séroprévalence était de 7,9 %. Les génotypes E (53,1 %), A (41,8 %), A3/E (3,8 %), A1/E (1,3 %) et certaines mutations de résistance aux médicaments ont été identifiées. Des perturbations du cholestérol HDL, de la bilirubine directe, des transaminases (ASAT et ALAT), de la PAL, de la GGT et de l’albumine ont été observées chez des donneurs de sang AgHBs positif. CONCLUSION : Les résultats de notre étude avaient indiqué que Lubumbashi se trouve dans une région de forte endémicité pour le VHB et rapportent, pour la première fois, le VHB des génotypes A, E, A1/E et A3/E. Ils soulignent la nécessité de mettre en œuvre des stratégies pour améliorer la sécurité transfusionnelle dans les centres de transfusion sanguine et les banques de sang des hôpitaux de Lubumbashi, afin de réduire l’infection par le VHB chez les receveurs. Ils pourraient également contribuer à la mise en œuvre de stratégies de traitement au développement de la cartographie des génotypes circulants en RDC

Enhancement of the ionoacoustic effect through ultrasound and photoacoustic contrast agents

The characteristic depth dose deposition of ion beams, with a maximum at the end of their range (Bragg peak) allows for local treatment delivery, resulting in better sparing of the adjacent healthy tissues compared to other forms of external beam radiotherapy treatments. However, the optimal clinical exploitation of the favorable ion beam ballistic is hampered by uncertainties in the in vivo Bragg peak position. Ionoacoustics is based on the detection of thermoacoustic pressure waves induced by a properly pulsed ion beam (e.g., produced by modern compact accelerators) to image the irradiated volume. Co-registration between ionoacoustics and ultrasound imaging offers a promising opportunity to monitor the ion beam and patient anatomy during the treatment. Nevertheless, the detection of the ionoacoustic waves is challenging due to very low pressure amplitudes and frequencies (mPa/kHz) observed in clinical applications. We investigate contrast agents to enhance the acoustic emission. Ultrasound microbubbles are used to increase the ionoacoustic frequency around the microbubble resonance frequency. Moreover, India ink is investigated as a possible mean to enhance the signal amplitude by taking advantage of additional optical photon absorption along the ion beam and subsequent photoacoustic effect. We report amplitude increase of up to 200% of the ionoacoustic signal emission in the MHz frequency range by combining microbubbles and India ink contrast agents

Verification of dried blood spot as a sample type for HIV viral load and early infant diagnosis on Hologic Panther in Zambia

Abstract Objective Zambia has embarked on improving the diagnostic capacity by setting up high throughput and accurate machines in the testing process and introduction of dried blood spot (DBS) as a sample type. This was a cross sectional study to verify dried blood spot as a sample type for HIV viral load and early infant diagnosis (EID) on Hologic Panther platform and Evaluate the analytical performance (precision, linearity and measurement of uncertainty) of the Hologic Panther. Results The specificity and sensitivity of EID performance of Aptima Quant Dx assay on Hologic panther machine against the gold standard machine COBAS Taqman (CAP/CTM) was 100% with an overall agreement of 100%. The quantitative HIV Viral Load (VL) accuracy had a positive correlation of (0.96) obtained against the gold standard (plasma samples) run on COBAS4800 platform. Analytical performance of the Hologic panther machine was evaluated; Precision low positive repeatability 3.50154 and within lab 2.268915 at mean 2.88 concentration and precision high positive repeatability 1.116955 and within lab 2.010677 at mean 5.09 concentration were obtained confirming manufacturers claims. Uncertainty of measurement for this study was found to be ± 71 copies/ml. Linearity studies were determined and all points were within acceptable limits. We therefore recommend DBS as a sample type alternative to plasma for the estimation of HIV-1 viral load and EID diagnosis on the Hologic panther machine