Burden of hydrocoele assessed from medical and surgical records in a lymphatic filariasis endemic country, Samoa

Background: Samoa is a Pacific Island country that has long been known to have a high burden of lymphatic filariasis. Little has been documented about the burden of disability due to the chronic complications of the disease. We examined the rates of hydrocoele amongst the Samoan male population to better understand the situation. Methods: Information on numbers of suspected hydrocoele cases in men aged 18 years and older from 2006 to 2013 was sought using ICD-10 codes and/or keywords from three sources: the hospital patient information system plus the surgical clinic and operating theater records in Tupua Tamasese Meaole and Malietoa Tanumafili II hospitals in Samoa. Chart review of suspected hydrocoele cases was used to confirm the diagnosis of hydrocoele amongst suspected cases. The following data items were extracted from patient records where available: date of diagnosis, age, village, hydrocoele characteristics (duration, size, and volume), history and cause of injuries, whether lymphatic filariasis was a differential diagnosis, whether ultrasound scan was used to verify diagnosis, and details of any surgery performed. Population data were obtained from the Samoa Bureau of Statistics. Results: There were 535 suspected cases identified from the 3 sources between 2006 and 2013, of which 328 were diagnosed as hydrocoele; charts for 56 suspected cases (10.5%) could not be located. The mean age of men with hydrocoele was 49.2 years. The proportion of men aged ≥ 18 years diagnosed with hydrocoele over the study period was 0.62% (328/52,944). North West Upolu had the highest proportion amongst the four regions of Samoa (p < 0.001). The proportion of men presenting with hydrocoele increased with age (p < 0.001). 14.3% of patients had an injury that could have contributed to the hydrocoele. Only 4.0% of all patient records had lymphatic filariasis recorded as a differential diagnosis. 60.7% of all patients with hydrocoele had some form of surgery, with no difference between regions (p = 0.276). The majority of surgeries were hydrocoelectomies, where the tunica vaginalis is everted. The mean age of patients that had surgery was 48.2 years. It was difficult to estimate hydrocoele size and duration due to non-standardized way of reporting. Conclusions: This study used multiple sources to document the number of hydrocoele cases that presented annually to medical facilities in Samoa. This represents a minimum estimate of the burden since some cases may have not presented for treatment. The numbers presenting have fluctuated over the years (2006 to 2013), and improvements in the reporting system are needed. The health system needs to consider ways to address a large number of patients that still require surgery, as well as conducting follow-up of those that did receive surgery. Additionally, clinicians should consider lymphatic filariasis as a differential diagnosis for hydrocoeles

Bekkenbanden voor acute stabilisatie van instabiele bekkenfracturen

Bekkenbanden zijn ontwikkeld voor de acute behandeling van instabiele bekkenringfracturen in de prehospitale fase. Deze behandeling is gericht op het beperken van het inwendig bloedverlies door het verkleinen van het bij bekkenfracturen toegenomen bekkenvolume en het stabiliseren van de fractuurdelen. Het effect van commercieel verkrijgbare bekkenbanden op de reductie van de symphysis pubisdiastase en de hemodynamische stabiliteit is aangetoond. Het langdurig gebruik van bekkenbanden wordt ontraden wegens toegenomen risico op het ontwikkelen van decubitus. Met name langdurige immobilisatie met een bekkenband op een traumaplank dient voorkomen te worden. In dit artikel wordt een aantal verschillende bekkenbanden besproken en wordt een casus gepresenteerd.Pelvic circumferential compression devices have been developed for initial treatment of unstable pelvic ring fractures in the prehospital situation. The treatment is aimed at achieving tamponade by reducing the increased pelvic volume and reducing the bleeding from fracture surfaces. The effect of commercially available pelvic circumferential compression devices on the reduction of symphysis pubis diastasis and the resuscitation has been proved. Prolonged use of these devices is complicated by the risk of development of pressure sores. Therefore prolonged immobilization on a spine board should be avoided. A number of different pelvic binders will be discussed in this article, which also presents a case

Selective solar absorber coating research at the CSIR (South Africa)

Abstract: A sol-gel technique has been established at a laboratory scale for low cost production of high efficient selective solar absorbers comprising a composite material of nano-structured carbon in a nickel oxide matrix. In order for these materials to be applied in real world scenarios it is necessary to extensively scale up the fabrication process to allow large area coatings. This can be done by adapting this sol-gel technique to large area deposition. In this project, we are undertaking research and development activities for three-years to make a &apos;Lab to Large scale&apos; transition in order to eventually integrate into existing solar collectors for low cost domestic water heating in a rural area for social good. A spray coating technique has been used to deposit these C/NiO coatings on aluminum substrates. Preliminary optical results have shown absorptance of up to 90 %. The preparation and characterization as well as the process towards developing a large-area solar selective coating for low cost domestic heating will be discussed

Mechanical construction and installation of the ATLAS tile calorimeter

This paper summarises the mechanical construction andinstallation of the Tile Calorimeter for the ATLASexperiment at the Large Hadron Collider in CERN, Switzerland. The TileCalorimeter is a sampling calorimeter using scintillator as the sensitivedetector and steel as the absorber and covers the central region of the ATLASexperiment up to pseudorapidities ±1.7. The mechanical construction ofthe Tile Calorimeter occurred over a periodof about 10 years beginning in 1995 with the completionof the Technical Design Report and ending in 2006 with the installationof the final module in the ATLAS cavern. Duringthis period approximately 2600 metric tons of steel were transformedinto a laminated structure to form the absorber of the sampling calorimeter.Following instrumentation and testing, which is described elsewhere, themodules were installed in the ATLAS cavern with a remarkable accuracy fora structure of this size and weight.Peer Reviewe

Determinants of outcome in operatively and non-operatively treated Weber-B ankle fractures

Introduction: Treatment of ankle fractures is often based on fracture type and surgeon's individual judgment. Literature concerning the treatment options and outcome are dated and frequently contradicting. The aim of this study was to determine the clinical and functional outcome after AO-Weber B-type ankle fractures in operatively and conservatively treated patients and to determine which factors influenced outcome. Patients and methods: A retrospective cohort study in patients with a AO-Weber B-type ankle fracture. Patient, fracture and treatment characteristics were recorded. Clinical and functional outcome was measured using the Olerud-Molander Ankle Score (OMAS), the American Orthopaedic Foot and Ankle Society ankle-hindfoot score (AOFAS) and a Visual Analog Score (VAS) for overall satisfaction (range 0-10). Results: Eighty-two patients were treated conservatively and 103 underwent operative treatment. The majority was female. Most conservatively treated fractures were AO-Weber B1.1 type fractures. Fractures with fibular displacement (mainly AO type B1.2 and Lauge-Hansen type SER-4) were predominantly treated operatively. The outcome scores in the non-operative group were OMAS 93, AOFAS 98, and VAS 8. Outcome in this group was independently negatively affected by age, affected side, BMI, fibular displacement, and duration of plaster immobilization. In the surgically treated group, the OMAS, AOFAS, and VAS scores were 90, 97, and 8, respectively, with outcome negatively influenced by duration of plaster immobilization. Conclusion: Treatment selection based upon stability and surgeon's judgment led to overall good clinical outcome in both treatment groups. Reducing the cast immobilization period may further improve outcome