Sewing Needle as Foreign Body in Urethra of an Adolescent Boy: Case Report

Self-insertion of a foreign body in the urethra is an uncommon presentation clinically. The cases usually arise due to fulfillment of sexual desire, for recreation, play, or exploration, or the foreign body insertion may take place accidentally. We present a case of an adolescent boy with a foreign body urethra presenting to the emergency room with urinary retention, pain, and dysuria. Attending urologist suspected urethral stricture and ordered ultrasonography to investigate which turned out to be a sewing needle in his urethra. The patient was then enquired about the foreign body. He tried to self-dilate his urethra as he was experiencing lower urinary tract symptoms. The sewing needle was removed by endoscopy and he was administered with antibiotics and painkillers. The urethral foreign bodies may present with pain, dysuria, or urinary incontinence and these foreign bodies are mostly seen in the male population in the adolescent age group

Biochar remediation improves the leaf mineral composition of Telfairia occidentalis grown on gas flared soil

This study evaluates the effects of remediation of gas flared soil by biochar on the nutritional composition of cultivated Telfairia occidentalis leaves, relative to non-gas flared soil. Gas flared soils are degraded due to the presence of heavy metals, noxious gases, carbon soot and acidic rain. Biochar produced from oil palm fibre was applied at five different amounts: 0 t ha−1, 7.1 t ha−1, 13.9 t ha−1, 20.9 t ha−1 and 28.0 t ha−1 to containerized soils (both gas flared and control soil), inside a greenhouse, which were allowed to mineralize for two weeks. Two viable seeds of T. occidentalis per replicate were sown. After eight weeks of growth, leaves were harvested, dried and chemically analyzed. Application of biochar significantly increased leaf ash and crude fibre content of Telfairia occidentalis. Plants from soil treated with 13.9 t ha−1 of biochar had the highest concentrations of vitamins A, B1, B2, B6, C and E irrespective of soil type. Maximum increase in leaf vitamin and mineral content was obtained from leaves cultivated on gas flared soil treated with 13.9 t ha−1 and 7.1 t ha−1 of biochar respectively. The results show that biochar treatment can increase leaf mineral concentrations and that this effect is dependent on the amount of biochar application

Desarda Vs Lichtenstein “Hernioplasty” A One Year Comparative Study at a Teaching Hospital Lahore

Acomparative, prospective study was carried out in surgical department of LGH to evaluate the efficacy of Dessardahernioplsty technique by comparing with Lichtenstein repair in terms of post operative pain, hospital stay, rate of early and late complications and recurrence. Total (n=60) cases were divided in two groups A and B. with mean age 41.5 and 43.5 years for dessarda and Lichtenstein groups respectively. Insignificant statistical difference was noted in both groups as for as severity of acute pain, post operative hospital stay and wound infections are concerned. Regarding chronic pain and recurrence rate, patients in group A (Dessarda) show statistically significant advantage over group B (Lichtenstein). It, therefore was concluded that Dessarda-hernioplasty technique is useful in our patients as no foreign material has to be inserted that makes it cost effective with advantage of less chronic pain and zero recurrence rate at the end of one year

Effectiveness of Endoscopic Third Ventriculostomy in the Treatment of Obstructive Hydrocephalus

Introduction: Hydrocephalus is an abnormal accumulation of cerebrospinal fluid in the ventricles of the brain that is or has been under high pressure. It results in raised intracranial pressure and compressive effects of vital brain structures that can be lethal if not treated in time. Various treatment options had been tried over the years but ventriculoperitoneal shunt has been the most common treatment option. As ventriculoperitoneal shunt is associated with obstruction, infection and over drainage, endoscopic third ventriculostomy has been used to avoid these complications.Objective: To determine the effectiveness of endoscopic third ventriculostomy in the treatment of obstructive hydrocepalus.Material and Methods: This is a descriptive study that was conducted in the Department of Neurosurgery Lady Reading Hospital Peshawar from October 2010 to October 2011. In this study all patients who underwent endo-scopic third ventriculostomy of more than six months were included. Total of 94 patients were included in the study. Effectiveness of the procedure was measured in terms of improvement in clinical condition i.e. GCS, head-ache, vomiting.Results: Total of 94 patients were included of which 58 were male and 36 were female. Age ranged from one to 70 years, with 50% of the patients were below 10 years of age. Majority of the patients had hydrocephalus due to space occupying lesion making 71.9% of the whole. In 75.5% of the patients the procedure was effective. Effecti-veness had no statistically significant difference in different age groups, however procedure is more effective in hydrocephalus due to space occupying lesion.Conclusion: Endoscopic third ventriculostomy is a very effective procedure for the treatment of obstructive hydrocephalus. It is effective irrespective of the age of the patient and cause of obstruction

Whose Castle is it Anyway?: Local/Global Negotiations of a Shakespearean Location

Kronborg Castle in the Danish town of Elsinore is a location strongly associated with Shakespeare thanks to the setting of Hamlet. It is a place where fiction currently eclipses history, at least in the context of a cultural tourist industry where Shakespeare’s name is worth a great deal more than Danish national heritage sites. Indeed, Kronborg is now widely marketed as ‘Hamlet’s Castle’ and the town of Elsinore has acquired the suffix ‘Home of Hamlet’. This article examines the signifiers implied in the naming and renaming of Kronborg as a Shakespearean location, while also looking at its unique international Shakespearean performance tradition, which spans two centuries. It describes how the identity of the castle has been shaped by its Shakespearean connection against the backdrop of changing ideologies in the twentieth and twenty-first centuries, and poses questions as to how this identity may continue to develop within the current contexts of renewed nationalism in Europe and the world

Frequency of Hydrocephalus in Patients Presenting with Spinal Dysraphism

Objective: The objective of this study is to determine the frequency of hydrocephalus in patients presenting with spinal dysraphism.Material and Methods: This cross sectional descriptive study was conducted at Department of Neurosurgery, Postgraduate Medical Institute Lady Reading Hospital, Peshawar, Pakistan. A total of 119 patients of spinal dysraphism were included through convenience (non-probability) sampling, in a period of six months (from June, 2011 to December 2011). All patients with spinal dysraphism with either sex and age less than 2 years included, while patients with post spinal dysraphism surgery who developed hydrocephalus, posterior fossa lesion causing obstructive hydrocephalus and Patients with post tuberculous meningitis with hydrocephalus were excluded. Hydrocephalus was observed in these patients. The data was analyzed using the statistical program SPSS version 17.Results: Out of total number of 119 patients, majority was males with 66 in number (55.5%), while female were 53 (44.5%). The age of patients ranged from 10 days to 23 months with overall mean age 5.47 + 5.439 months. Majority of patients, 82 (68.9%), were in the age range of 01-06 months. Most of the patients, i.e., 56 (47.1%) were harboring spinal dysraphism at lumbar region. Hydrocephalus was found in quite large number of cases, 79 cases (66.4%), in patients of spinal dysraphism.Conclusion: Spinal dysraphism is slightly more common in males with frequency of 55.5%. Majority of the patients of spinal dysraphism (68.9%) were presented in the age range of 1 – 6 months. Spinal dysraphism is more common (47.1%) at lumbar region. Hydrocephalus was found in 79 cases (66.4%) of spinal dysraphism

Microbial Diversity Analysis in Malachite Green Dye Treating Sequencing Batch Reactor

ABSTRACT Microbial diversity was investigated in an optimized sequencing batch reactor (SBR), treating malachite green containing wastewater, with the decolorization efficiency of 89 % and chemical oxygen demand (COD) removing ability of 93%. Both culture-independent 16S rRNA gene method and culture-dependent plate-dilution method were utilized. Phylogenetic trees were sketched by neighbor-joining method using bioinformatics tools. Cultureindependent method showed the SBR community affiliation with the Alpha, Beta, Gamma and Delta proteobacteria, in addition to the moderate resemblances with Verrucomicrobia, and some uncultured bacteria. The culture-dependent isolates, however, identified only with the Beta and Gamma proteobacteria. Some sequences had less than 95% homology to the data in GenBank indicates the possibility of novel bacterial species

The Impact of Thyroid Cancer and Post-Surgical Radioactive Iodine Treatment on the Lives of Thyroid Cancer Survivors: A Qualitative Study

BACKGROUND: Adjuvant treatment with radioactive iodine (RAI) is often considered in the treatment of well-differentiated thyroid carcinoma (WDTC). We explored the recollections of thyroid cancer survivors on the diagnosis of WDTC, adjuvant radioactive iodine (RAI) treatment, and decision-making related to RAI treatment. Participants provided recommendations for healthcare providers on counseling future patients on adjuvant RAI treatment. METHODS: We conducted three focus group sessions, including WDTC survivors recruited from two Canadian academic hospitals. Participants had a prior history of WDTC that was completely resected at primary surgery and had been offered adjuvant RAI treatment. Open-ended questions were used to generate discussion in the groups. Saturation of major themes was achieved among the groups. FINDINGS: There were 16 participants in the study, twelve of whom were women (75%). All but one participant had received RAI treatment (94%). Participants reported that a thyroid cancer diagnosis was life-changing, resulting in feelings of fear and uncertainty. Some participants felt dismissed as not having a serious disease. Some participants reported receiving conflicting messages from healthcare providers on the appropriateness of adjuvant RAI treatment or insufficient information. If RAI-related side effects occurred, their presence was not legitimized by some healthcare providers. CONCLUSIONS: The diagnosis and treatment of thyroid cancer significantly impacts the lives of survivors. Fear and uncertainty related to a cancer diagnosis, feelings of the diagnosis being dismissed as not serious, conflicting messages about adjuvant RAI treatment, and treatment-related side effects, have been raised as important concerns by thyroid cancer survivors

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes