Pattern of childhood burn injuries and their management outcome at Bugando Medical Centre in Northwestern Tanzania

Burn injuries constitute a major public health problem and are the leading cause of childhood morbidity and mortality worldwide. There is paucity of published data on childhood burn injuries in Tanzania, particularly the study area. This study was conducted to describe the pattern of childhood burn injuries in our local setting and to evaluate their management outcome. A cross sectional study was conducted at Bugando Medical Centre (in Northwestern Tanzania) over a 3-year period from January 2008 to December 2010. Data was collected using a pre-tested coded questionnaire and statistical analyses performed using SPSS software version 15.0. A total of 342 burned children were studied. Males were mainly affected. Children aged = 2 were the majority accounting for 45.9% of cases. Intentional burn injuries due to child abuse were reported in 2.9% of cases. Scald was the most common type of burns (56.1%). The trunk was the most commonly involved body region (57.3%). Majority of patients (48.0%) sustained superficial burns. Eight (2.3%) patients were HIV positive. Most patients (89.8%) presented to the hospital later than 24 h. The rate of burn wound infection on admission and on 10th day were 32.4% and 39.8% respectively.Staphylococcus aureus were more common on admission wound swabs, with Pseudomonas aeruginosa becoming more evident after 10th day. MRSA was detected in 19.2% of Staphylococcus aureus. Conservative treatment was performed in 87.1% of cases. Surgical treatment mainly skin grafting (65.9%) was performed in 44 (12.9%) of patients. The overall average of the length of hospital stay (LOS) was 22.12 ± 16.62 days. Mortality rate was 11.7%. Using multivariate logistic regression analysis; age of the patient, type of burn, delayed presentation, clothing ignition, %TBSA and severity of burn were found to be significantly associated with LOS (P < 0.001), whereas mortality rate was found to be independently and significantly related to the age of the patient, type of burn, HIV positive with stigmata of AIDS, CD4 count, inhalation injury, %TBSA and severity of burn (P < 0.001). Childhood burn injuries still remain a menace in our environment with virtually unacceptable high morbidity and mortality. There is need for critical appraisal of the preventive measures and management principles currently being practiced

Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial

Background Tranexamic acid reduces surgical bleeding and decreases mortality in patients with traumatic extracranial bleeding. Intracranial bleeding is common after traumatic brain injury (TBI) and can cause brain herniation and death. We aimed to assess the effects of tranexamic acid in patients with TBI. Methods This randomised, placebo-controlled trial was done in 175 hospitals in 29 countries. Adults with TBI who were within 3 h of injury, had a Glasgow Coma Scale (GCS) score of 12 or lower or any intracranial bleeding on CT scan, and no major extracranial bleeding were eligible. The time window for eligibility was originally 8 h but in 2016 the protocol was changed to limit recruitment to patients within 3 h of injury. This change was made blind to the trial data, in response to external evidence suggesting that delayed treatment is unlikely to be effective. We randomly assigned (1:1) patients to receive tranexamic acid (loading dose 1 g over 10 min then infusion of 1 g over 8 h) or matching placebo. Patients were assigned by selecting a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was head injury-related death in hospital within 28 days of injury in patients treated within 3 h of injury. We prespecified a sensitivity analysis that excluded patients with a GCS score of 3 and those with bilateral unreactive pupils at baseline. All analyses were done by intention to treat. This trial was registered with ISRCTN (ISRCTN15088122), ClinicalTrials.gov (NCT01402882), EudraCT (2011-003669-14), and the Pan African Clinical Trial Registry (PACTR20121000441277). Results Between July 20, 2012, and Jan 31, 2019, we randomly allocated 12 737 patients with TBI to receive tranexamic acid (6406 [50·3%] or placebo [6331 [49·7%], of whom 9202 (72·2%) patients were treated within 3 h of injury. Among patients treated within 3 h of injury, the risk of head injury-related death was 18·5% in the tranexamic acid group versus 19·8% in the placebo group (855 vs 892 events; risk ratio [RR] 0·94 [95% CI 0·86-1·02]). In the prespecified sensitivity analysis that excluded patients with a GCS score of 3 or bilateral unreactive pupils at baseline, the risk of head injury-related death was 12·5% in the tranexamic acid group versus 14·0% in the placebo group (485 vs 525 events; RR 0·89 [95% CI 0·80-1·00]). The risk of head injury-related death reduced with tranexamic acid in patients with mild-to-moderate head injury (RR 0·78 [95% CI 0·64-0·95]) but not in patients with severe head injury (0·99 [95% CI 0·91-1·07]; p value for heterogeneity 0·030). Early treatment was more effective than was later treatment in patients with mild and moderate head injury (p=0·005) but time to treatment had no obvious effect in patients with severe head injury (p=0·73). The risk of vascular occlusive events was similar in the tranexamic acid and placebo groups (RR 0·98 (0·74-1·28). The risk of seizures was also similar between groups (1·09 [95% CI 0·90-1·33]). Interpretation Our results show that tranexamic acid is safe in patients with TBI and that treatment within 3 h of injury reduces head injury-related death. Patients should be treated as soon as possible after injury. Funding National Institute for Health Research Health Technology Assessment, JP Moulton Charitable Trust, Department of Health and Social Care, Department for International Development, Global Challenges Research Fund, Medical Research Council, and Wellcome Trust (Joint Global Health Trials scheme)

Effect of extracts from nine plant species found in Africa on the mycelial growth of Aspergillus flavus Link

Farmer survey conducted in 1991 and 1992 revealed that some farmer's combat storage moulds using locally available plants. Extracts and combination of extracts of nine different plant species that are used as traditional medicines and aromatic spices in Nigeria were tested for the effect in vitro on the growth of Aspergillus flavus. Aqueous extracts from the combination of dried fruits of xylopia aethiopica and dried seeds of piper guineense completely inhibited the growth of the fungus. Dried roots of the Zingiberaceae and fresh leaves of the Labiateae showed a range of fungistasis. Significant fungistatic effects were seen for all but two of the plant species tested, through some fungal inhabitation was short lived. Testing to identify efficacious plant species from various agroecological zones is continuing

Estudios sobre la patogenicidad de Fusarium oxysporum f. phaseoli en el frijol

Tesis (M. Sc) -- IICA, Turrialba (Costa Rica), 1967Se efectuaron estudios de la patogenicidad del hongo Fusarium oxysporum Schlecht f. phaseoli Kendrick y Snyder sobre 103 variedades de frijol del germoplasma del Programa de cultivos Alimenticios del IICA: Se hicieron tambi?n pruebas preliminares sobre la toxicidad de filtrados obtenidos al cultivar el hongo en medio sint?tico y afrecho de trigo h?medo. A trav?s de los estudios de patogenicidad del hongo en sus estados conidial y de clamid?spora fue posible determinar los diferentes grados de resistencia, tolerancia o susceptibilidad de las variedades de frijol probadas. Los resultados demuestran que las variedades de frijol estudiadas no ten?an verdadera resistencia al ataque del hongo cuando el in?culo ten?a 10 d?as de edad. Algunas de las variedades que mostraron cierta tolerancia al estado conidial del hongo fueron, sin embargo, susceptibles al estado de clamid?spora. El n?mero y la longitud de ra?ces laterales presentes en las plantas, que mostraron tolerancia al ataque del hongo, sugieren que la tolerancia puede deberse hasta cierto punto a la capacidad de las plantas para producir numerosas y fuertes ra?ces laterales despu?s de que tuvo lugar la infecci?n. Se obsev? que hay correlaci?n entre el color de la testa de la variedad y la manifestaci?n de los s?ntomas. Entre los s?ntomas observados hab?a evidencia tanto de amarillamiento intenso como marchitez sin p?rdida de la pigmentaci?n, siendo la causa de ambas el mismo hongo Fusarium oxysporum f. phaseoli. Los filtrados obtenidos al cultivar el hongo en los dos medios (soluci?n nutritiva y afrecho de trigo h?medo) fueron letales a las plantas de frijol introducidas en ellos, tanto para tolerantes como susceptibles. Al calentar el filtrado no se perdi? este efecto nocivo. Las plantas de frijol, puestas en contacto con los filtrados del medio sin cultivo del hongo y en agua destilada esterilizada, permanecieron vivas por muchos d?as

Diagnosis of yam viruses

Diagnosis of virus diseases of yams at the International Institute of Tropical Agriculture (IITA) is based on the use of indicator plants, insect vectors, serological diagnostics, and electron microscopy (EM). Yam I (YVI), yam mosaic (YMV), and Dioscorea dumetorum (DdV) potyviruses even in mixed virus infection. Yam mosaic virus is mechanically transmissible to Nicotiana benthamiana and YVI is vector-transmissible to Vigna unguiculata. The three viruses can be visualised by EM and their identities confirmed serologically. Dioscorea alata badnavirus (DaV) can be graft-transmitted to V, unguiculata and its presence confirmed by EM and serology, Cucumber mosaic cucumovirus (CMV), reported to occur in yams in West is readily mechanically transmissible to a range of indicator plants and can be detected serologically. Other isometric viruses have recently been found in Nigeria, and these can be isolated and differentiated by mechanical and vector transmission to indicator plants. These diagnostic techniques have enabled initiation of surveys of viruses of Dioscorea spp. in West Africa and substantial progress has been made on the production of virus-tested planting material for international distribution

Comparative effects of organic soil amendments and carbofuran on Meloidogyne incognita and cacao growth

This investigation was conducted to evaluate the effects of four organic soil amendments (cow dung, cocoa pod husk, poultry manure and wood ash) and carbofuran treatments on Meloidogyne incognita inducing root-knot disease of cacao seedlings. All soil treatments reduced the nematode population in soil and root of cacao seedlings compared to the control. Poultry manure, cow dung and cocoa pod husk accounted for a significant (p=0.05) increase in shoot-biomass production, plant height, stem girth and dry root weight, as compared to carbofuran treated plants and control, thereby exhibiting the most pronounced effect on plant growth and performance. The significance of these findings is discussed in relation to the use of organic amendments as a nematode disease control measures on cacao seedlings. Keywords: Organic amendments, Meloidogyne incognita, cacao seedlings, carbofuran IJOTAFS Vol. 1 (1) 2007: pp. 13-1

Mixité sociale et choix modal : importance des dimensions symboliques dans l'attrait des transports collectifs

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