Hegar uterine dilator as an unusual cause of small bowel obstruction: a case report

<p>Abstract</p> <p>Introduction</p> <p>The unusual event of surgical instrument retention in the abdominal cavity usually occurs after laparotomy.</p> <p>Case presentation</p> <p>A 45-year-old African woman from Cameroon with no previous abdominal surgery presented with a three-day history of colicky abdominal pain. Abdominal X-ray showed an opaque, linear object in the lower abdomen. Exploratory laparotomy revealed a Hegar uterine dilator that was lost during a dilatation and curettage performed seven years prior to the present admission.</p> <p>Conclusions</p> <p>The trans-uterine route should be included as a rare and unusual source of surgical instruments retained in the abdomen.</p

Public health risk status of the water supply frame work at Kwame Nkrumah (Postgraduate) Hall, University of Nigeria, Nsukka and environs

The aim of the study is to assess the public health risk status of the potable water supply framework at the Kwame Nkurumah Postgraduate Residence (PG) Hall, University of Nigeria, Nsukka, (UNN), Enugu State, Nigeria, and environs. Four potable water supply frame-works at the PG Hall, UNN, and exposed stagnant water were sampled and analysed in accordance with the Association of Official Analytical Chemists (AOAC) Official Method of Analysis to detect their limits of chemical and microbial constituents with high public health risk. The samples comprised of tap water (A), tap-to-reservoir water (B), commercial sachet water (C) commercial bottled water (D) and exposed stagnant water (E). The nitrate levels of all the sources (except &lsquo;B&rsquo;) were above the World Health Organisation (WHO) limit (10.00 mg/L). Thus they could cause methaemoglobinemia in infants. Nitrate content of &lsquo;B&rsquo; (6.99 mg/L) was significantly (p &lt; 0.05) low, relative to that of &lsquo;A&rsquo; (23.08 mg/L); and indicated microbial action. The physicochemical and microbial quality of the tap water differed significantly (p &lt; 0.05) from that of the tap-to-reservoir water. All the pH, except that of &lsquo;D&rsquo;, were below WHO recommended pH range (6.5 to 8.5) for drinking water. &lsquo;D&rsquo; was more or less a mineral concentrate, as its chemical constituents were significantly (p &lt; 0.05) higher than those of other samples. Total viable count (TVC) and coli form count of the reservoir water and sachet water (0.17 to 0.20 and 0.11 to 0.09 cfu/ml, respectively), indicated heavy microbial contamination. While &lsquo;D&rsquo;, was devoid of biological contamination. Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa were among the bacteria isolated. Taken together, the sampled potable water (except &lsquo;A&rsquo; and &lsquo;D&rsquo;) was generally, of poor chemical and microbial quality; and may be considered unacceptable.Key words: Public health risk, potable water, physicochemical and microbial water quality, water pollution

Case-Detection Rate of Direct Sputum Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Abia State, Nigeria

The accuracy of sputum smear microscopy, the tuberculosis case-finding method in the Abia State TB Control Programme has never been assessed due to lack of culture facilities. To assess the accuracy of sputum smear microscopy in routine control programme conditions in Abia State, sputum samples from patients undergoing investigation for tuberculosis were analyzed using Ziehl-Neelsen staining technique for sputum smear  microscopy and culture on Löwenstein-Jensen medium as reference standard. Out of 150 participants tested, 51 were smear –positive for acid fast bacilli (positivity rate, 34.0 %, 51/150) while 79 were culture positive for Mycobacterium tuberculosis complex and 12 for non-tuberculous mycobacteria (NTM). Thirty-seven of the 79 culture positive for M. tuberculosis were smear positive giving a ratio of smear to culture positivity of 46.84%. Forty-two (42.4%) of the 99 smear negative cases were culture positive for M. tuberculosis. The sensitivity of smear microscopy was 50.0%(95%CI=39.0-61.0) and specificity was 92.3% (95% CI=86.4-98.2). The prevalence of HIV/TB coinfection among the study participants was 48% (12/25). Although the case- detection rate of smear microscopy was moderate in this study, the large proportion of TB patients missed by smear microscopy is a cause for concern and requires concerted effort to improve the sensitivity of smear microscopy. Introduction of more sensitive diagnostic methods like culture also need to be considered. La précision des frottis, la méthode la recherche de cas de tuberculose  dans le programme de lutte contre la tuberculose dans l’Etat d'Abia n'a jamais été évalué en raison du manque d'installations de culture. Pour évaluer la précision des frottis dans les conditions du programme de  contrôle de routine dans cet Etat , les expectorations de patients subissant une enquête de la tuberculose ont été analysées à l'aide de technique de coloration de Ziehl-Neelsen pour la microscopie des frottis de crachats etde la culture sur milieu de Löwenstein- Jensen en tant que norme de  référence . Sur les 150 participants testés, 51 étaient à frottis positif pour les bacilles acido rapide (taux de positivité, 34,0%, 51/150), tandis que 79 étaient positifs à la culture pour complexe Mycobacterium tuberculosis et 12 pour les mycobactéries non tuberculeuses (NTM). Trente-sept de la culture 79 positive pour M.tuberculosis étaient à frottis positif donnant un ratio de frottis de positivité de la culture de 46,84 %. Quarante-deux  (42,4%) des 99 cas à frottis négatifs étaient positifs à la culture pour M. tuberculosis. La sensibilité de la microscopie des frottis était de 50,0 % (IC à 95% = 39,0 à 61,0) et la spécificité était de 92,3 % (IC à 95% = 86,4 à 98,2). La prévalence du VIH / TB coïnfection parmi les participants à l'étude était de 48% (12 /25). Bien que le taux de microscopique des  frottis de dépistage des cas ait été modéré dans cette étude, la forte proportion de patients atteints de tuberculose manqués par examen microscopique des frottis est un sujet préoccupant et exige un effort concerté pour améliorer la sensibilité de la microscopie des frottis. La présentation des méthodes de diagnostic plus sensibles comme la culture doivent aussi être pris en considération

Does low dose oral ketamine have oxytocic effect?

Objectives: To evaluate if low dose oral Ketamine has oxytotic effect on term pregnant uterus.Methodology: This is a cross sectional double blind placebo control prospective study. A total of 745 parturients were studied, 261 had low dose oral Ketamine in active phase of labour (group A), 227 had Oxytocin augmentation (group B) and 257 had none of these medication (control group C). Their age, parity, gestational age, duration of labour and APGAR score were determined and all data analyzed using Epi Info.Results: The parturients were predominantly within the age group 26 – 35 years and their mean gestational age at delivery was 39.1weeks. The mean (± S.D.) duration of labour ( first stage of labour) was found to be shortest in group A 5.80 ± 2.06 hours, while it was 8.03 ± 3.37 hours in group B and 7.01 ± 3.25 hours in group C. Foetal outcome was comparable in all the three groups.Conclusion: Low dose oral Ketamine probably has an Oxytocic effect which needs to be explored in future research. And if this be the case, then it will be a suitable and safe single agent for labour analgesia and augmentation and for extended use in repairs of episiotomy and perineal tears.Key words: Oral Ketamine, low dose, oxytocic effect, labour duration, foetal outcome

Innovative Strategies for improving Special Educational Needs for Students with Learning Disabilities in Nigerian Schools: An Analytical Study

This study was designed to determine innovative strategies for improving special educational needs for students with learning disabilities in Nigerian Schools. The study used descriptive research design and was conducted in ten selected secondary schools in Ebonyi State Nigeria. The researchers selected 100 teachers in the sampled schools and 65 senior secondary school students were also selected using simple random sampling from 214 students with learning disabilities. Three principals and four (4) special need education teachers were selected through sampling. The data sources were teachers, students, and principals. The main data gathering instrument for the study was questionnaire. Interview and observation were also used to supplement the information obtained through the questionnaire items. However, out of 172 people that formed the study population and were given study questionnaire items, the researchers randomly selected 80 items, which was used for data analysis. Data collected were analyzed using mean and percentage. Based on the data collected, the reliability of questionnaire was computed using Cronbach alpha method at 0.76. This coefficient indicates that the tool was consistent. Findings among others revealed that developing alternative activities and to use less of the traditional method of teaching and learning processes will improve supports for students with learning disabilities. Also, Students with learning disabilities are highly neglected with little or no understanding of their conditions. The study concluded by recommending that special educators should focus on the abilities of students with learning disabilities and not on their physical or behavioural disabilities.   Keywords: behavioural disabilities, Learning Disabilities, Special Educational Need

Beyond The Call of Duty: Realities of Work-Life Balance in the United Arab Emirates Education Sector

Previous research have been intrigued to assess the mechanisms used by employees to cope with tedious work schedules and other areas of their non-work lives. While there are yet to be sufficient studies that explore the countries in the Middle East, this paper aimed to explore the realities of WLB among professionals in the education sector in the United Arab Emirates (UAE). We further considered the implications of workplace and family support, and organisational culture on employees’ WLB and productivity. The study employs the use of qualitative data generated from semi-structured interviews of 41 lecturers across seven higher education institutions in Dubai, UAE aimed at investigating the various contexts of WLB

Circular Production and Maintenance of Automotive Parts:An Internet of Things (IoT) Data Framework and Practice Review

The adoption of the Circular Economy paradigm by industry leads to increased responsibility of manufacturing to ensure a holistic awareness of the environmental impact of its operations. In mitigating negative effects in the environment, current maintenance practice must be considered for its potential contribution to a more sustainable lifecycle for the manufacturing operation, its products and related services. Focusing on the matching of digital technologies to maintenance practice in the automotive sector, this paper outlines a framework for organisations pursuing the integration of environmentally aware solutions in their production systems. This research sets out an agenda and framework for digital maintenance practice within the Circular Economy and the utilisation of Industry 4.0 technologies for this purpose

The media as both friend and enemy of the state

The mass media – radio, television newspaper, magazine and the internet – are very relevant in every society. They are the channels through information and messages are propagated simultaneously to large number of people in different areas. They are agents of socialisation and education as well as development. The mass media surveys the environment for news, analyse issues of people‟s interest, provide entertainment and also help the propagation of the societal cultural norms and values. However, in spite of the important roles of the media in the society, they as well have their disadvantageous roles in the society. The study evaluated the mass media as both friend and also as enemy of the state. According to this paper, the media act as friend of the state by serving as watchdogs, agents of cultural transmission and agents of political orientation to the people in the society. However, the media act as enemy of the state as they are used as channels for people, especially politicians to throw abusive words at one another, huge contributors to decadence in our society and they aid the spread of violence and hatred through propagation of hate speeches and words that can incite people into violence. The researcher concluded that the media have been both constructive (friend) and destructive (enemy) to the society. The study recommended that the media should keep to their social responsibility functions and adhere to the ethics of the profession in all their operations