Dermis-fat grafts and enucleation in Ghanaian children: 5 years’ experience

Background: Enucleation in young children often results in retarded orbital growth ipsilaterally. The need for an implant that will naturally grow with the child, like Dermis-fat Graft (DFG), for managing the anophthalmia has been of interest over the years.Objective: To evaluate the use of DFG as an implant for volume replacement post-enucleation.Study Design: A prospective non-comparative case series involving 18 consecutive children who had DFG either primarily or secondarily in  conjunction with enucleation for intraocular pathologies, from December2007 to September 2012, at the ophthalmology unit, Korle-Bu. Data from patients who had a minimum of three months follow up(FUP) were analysed.Outcome measures: Complete covering of DFG with healthy conjunctiva, increase in volume of DFG, and presence or absence of   complications.Results: Fifteen patients were analysed, aged nine months to ten years (mean (SD), 3.7±2.7years). Eight (53.3%) were females. Thirteen (86.7%) DFGs were secondary and 2(13.3%) primary. Indications for enucleationwere intraocular retinoblastoma (n=10, 66.7%), unexplained retinal detachment mimicking retinoblastoma (n=3,20.0%), anterior staphyloma(n=1,6.7%) and medulloepithelioma (n=1,6.7%). Fourteen (93.3%) patients showed increase in volume of DFG. Time for Conjunctival  reepithelialisation of the dermal surface was four to fourteen weeks(mean/median=5.5/4.0). Complications encountered were infection (n=1,6.7%), infection with necrosis (n=1,6.7%), melanosis /keratinization (n=2, 13.3%) and cysts(n=2,13.3%). The patients were followed upfor 3 to 54 months (mean/median 20.13 /16.00).Conclusion: DFG for management of post-enucleation anophthalmia in Ghanaian children showed 93.3% success. Keywords: Dermis- fat graft, enucleation, volume replacement,anophthalmi

Impacts of land use change on peatland degradation: a review

No Abstrac

Toxoplasma Gondii Infection in HIV/AIDS: Prevalence and Risk Factors

BACKGROUND: Toxoplasmosis is an infection caused by the protozoan Toxoplasma gondii. It is common in severely immunecompromisedpersons.OBJECTIVE: To determine the seroprevalence of T. gondii infection and the risk factors associated with the infection and to investigate the association between T. gondii infection and CD4 cell count.METHODS: Sera collected from 242 HIV positive HAART- naive patients were tested for T. gondii specific immunoglobulin G antibodies. Information was obtained using a structured questionnaire. Baseline CD4 cell counts were obtained from patients case files. Data was managed using SPSS version 20 software and Microsoft Excel worksheet.RESULTS: One hundred and sixty eight (69.4%) subjects were females while 74(30.6%) were males. One hundred (41.3%) of study participants were Toxoplasma IgG antibody positive. Thirty two(32) HIV positive pregnant women were among this group studied with 12( 37.5%) being Toxo IgG antibody positive. Toxoplasma seropositivity was higher in females (42.8%) than in males (39.2%), P= 0.60. CD4 cell count level of < 200 was negatively associated with Toxoplasma seropositivity than CD4 count . 200 by logistic regression (OR= 0.6; 95% CI 0.3- 1.0). Living in proximity with cat was positively associated with T. gondii infection (P= 0.01).CONCLUSION: T. gondii infection is common in pregnant women indicating greater probability of congenital transmission of T. gondii. This could form a basis for recommending intensifying health education and prophylactic treatment for all HIV positive pregnant women. Measures should be taken to prevent stray cats from entering homes.Keywords: Toxoplasma gondii , IgG, Seroprevalence, HIV positive, CD4 cells

Anesthesia assessment based on ICA permutation entropy analysis of two-channel EEG signals

Inaccurate assessment may lead to inaccurate levels of dosage given to the patients that may lead to intraoperative awareness that is caused by under dosage during surgery or prolonged recovery in patients that is caused by over dosage after the surgery is done. Previous research and evidence show that assessing anesthetic levels with the help of electroencephalography (EEG) signals gives an overall better aspect of the patient’s anesthetic state. This paper presents a new method to assess the depth of anesthesia (DoA) using Independent Component Analysis (ICA) and permutation entropy analysis. ICA is performed on two-channel EEG to reduce the noise then Wavelet and permutation entropy are applied on these channels to extract the features. A linear regression model was used to build the new DoA index using the selected features. The new index designed by proposed methods performs well under low signal quality and it was overall consistent in most of the cases where Bispectral index (BIS) may fail to provide any valid value

Selenium as adjunct to HAART in the management of HIV/Hepatitis B Virus coinfection: A Randomized open label study

Objective: Management of viral hepatitis in patients with HIV disease is quite challenging and  complex. With effective HIV treatment, people with HIV/HBV co-infection are living longer. HBV  epidemiologic surveys showed an inverse association between selenium (Se) level and regional cancer incidence, as well as viral infection. This study assessed effect of selenium as adjunct to HAART in management of HIV/HBV co-infection.Methods: A randomized open label study with participants allocated into three treatment groups: – HAART-only, Se-only and HAART-plus-Se. HIV viral load, HBV viral load, CD4 cell count, and alanine aminotransaminase (ALT), were analyzed at baseline and 18th month, analyzed using SPSS 5 v11. Ethical approval was obtained from Institute’s Ethical Review Board.Results: Sample size was 149 HIV/HBV patients. Rate of HBV clearance was higher among those on HAART-plus-Se at 18th month when compared with rate of clearance among those on HAART-only (p=0.046). CD4 count increment among HAARTplus- Se group compared with HAART-only group was higher (p=0.133), though not statistically significant. On comparison of baseline and 18th month ALT, there was significant decline for HAART-plus-Se (p=0.002) compared with HAART-only group.Conclusion: Selenium seems to have protective effect on liver cells; may be beneficial as adjunct to HAART in HIV/HBV management.Key words: HIV/HBV co-infection, Selenium adjunct, HAAR

Interval type-2 defuzzification using uncertainty weights

One of the most popular interval type-2 defuzzification methods is the Karnik-Mendel (KM) algorithm. Nie and Tan (NT) have proposed an approximation of the KM method that converts the interval type-2 membership functions to a single type-1 membership function by averaging the upper and lower memberships, and then applies a type-1 centroid defuzzification. In this paper we propose a modification of the NT algorithm which takes into account the uncertainty of the (interval type-2) memberships. We call this method the uncertainty weight (UW) method. Extensive numerical experiments motivated by typical fuzzy controller scenarios compare the KM, NT, and UW methods. The experiments show that (i) in many cases NT can be considered a good approximation of KM with much lower computational complexity, but not for highly unbalanced uncertainties, and (ii) UW yields more reasonable results than KM and NT if more certain decision alternatives should obtain a larger weight than more uncertain alternatives

Physics of Neutron Star Kicks

It is no longer necessary to `sell' the idea of pulsar kicks, the notion that neutron stars receive a large velocity (a few hundred to a thousand km s$^{-1}$) at birth. However, the origin of the kicks remains mysterious. We review the physics of different kick mechanisms, including hydrodynamically driven, neutrino and magnetically driven kicks.Comment: 8 pages including 1 figure. To be published in "Stellar Astrophysics" (Pacific Rim Conference Proceedings), (Kluwer Pub.