Special issue: urban regeneration for sustainable development

Guest editorial&nbsp

Foreign bodies of the upper digestive tract in Komfo Anokye teaching hospital

Foreign body impaction in the upper digestive tract poses as an emergency condition to the otorhinolaryngologist as it discomforts the patient’s ability to swallow food and water. The main objective of the study was to investigate the incidence, the anatomical site of impaction, the nature of the foreign body, the management and the outcome of foreign body impaction in the upper digestive tract, in Komfo Anokye Teaching Hospital (KATH) between January 2007 and December 2012. This was a cross-sectional retrospective study of cases which was diagnosed and managed as foreign body in the upper digestive tract within this period. The data collected from the clinical records of 1,412 patients was analyzed by using simple proportion and the statistical calculation by SPSS 16.0. Analysis showed male preponderance (61.8%), with an average age of 28.8 ± 1.9 (mean ± standard deviation). The commonest foreign body was bone (fish/meat/ chicken) in (45.7%), followed by coin in (29.6%) and then dentures in (14.3%), etc. Direct laryngoscopy was performed in (63.0%), rigid esophagoscopy under general anaesthesia in (34.0%) and direct clinical removal in (3.0%). 95.8% were successfully removed, (1.5%) were not successfully removed and were referred to the Cardio-Thoracic Unit (CTU). In (2.7%) of the cases the foreign bodies were not visualized and were managed conservatively. Although foreign body impaction in the upper gastrointestinal tract (GIT) was among one of the commonest emergency in ORL practices it can be a major challenge to the otorhinolaryngologist and as such measures need to be taken to prevent such incident.Keywords: Foreign body, Upper digestive tract, Coin, McIntosh laryngoscope, Chevalier-Jackson esophagoscop

Ear, Nose and Throat Manifestations in Geriatrics

The aim of this study is to present my observation of the common ear, nose and throat conditions in geriatrics, i.e. in the old age patients. This is a retrospective study analysis of 417 geriatric patients that presented at the Ear, Nose and Throat (ENT) clinic at the Komfo Anokye Teaching Hospital between January 2006 and December 2010. The diagnosis in each patient was based on the history, clinical findings and investigations done on each patient at the time of presentation. The patients were aged between 65 and 93 years with a mean age of 74.6 years. The main presentation of these geriatric patients were otological conditions in 209 (50.1%), rhinological conditions in 118 (28.3%) and then pharyngolaryngological conditions in 90 (21.6%). Some of the common conditions include presbyacusis (16.7%), cerumen obturans (15.3%), allergic rhinitis (14.9%), pharyngolaryngitis (9.8%), rhinosinusitis (8.2%), foreign body in throat (7.0%) etc. With the current improvement in life style, the life expectancy is supposed to be increased. In effect the otolaryngologist is going to be affronted with these challenges.Keywords: Geriatrics, Ear, Nose and Throat manifestations, Presbyacusis, Cerumen obturans, Allergic rhinitis

Interactions between the endocrine and immune systems in locusts

The prophenoloxidase cascade in the haemolymph of mature adult Locusta migratoria migratorioides (R & F) is activated in response to injection of laminarin, a -1,3 glucan. Co-injection of adipokinetic hormone-I (Lom-AKH-I) and laminarin prolongs the activation of the enzyme in a dose-dependent manner. However, injections of bacterial lipopolysaccharide (LPS) do not activate prophenoloxidase unless AKH is co-injected, when there is a dose-dependent increase in the level of phenoloxidase that persists in the haemolymph for several hours. Even when AKH is co-injected, the highest levels of phenoloxidase activity are always greater after injection of laminarin than after LPS, and these two immunogens must activate the prophenoloxidase cascade by quite distinct pathways. In the present study, interactions between the endocrine and immune systems were examined with respect to activation of prophenoloxidase and the formation of nodules: injection of LPS induces nodule formation in adult locusts. With LPS from Pseudomonas aeruginosa, nodules form exclusively in dense accumulations in the anterior portion of the abdomen on either side of the dorsal blood vessel associated with the dorsal diaphragm. However, with LPS from Escherichia coli, fewer nodules are formed but with a similar distribution, except that occasionally some nodules are aligned additionally on either side of the ventral nerve cord. Co-injection of Lom-AKH-I with LPS from either bacteria stimulates greater numbers of nodules to be formed. This effect of coinjection of AKH on nodule formation is seen at low doses of hormone with only 0.3 or 0.4 pmol of Lom-AKH-1, respectively, increasing the number of nodules by 50%. Injections of octopamine or 5-hydroxytryptamine do not mimic either of the actions of Lom-AKH-I described here. Co-injection of an angiotensin-converting enzyme inhibitor, captopril, reduces nodule formation in response to injections of LPS but has no effect on the activation of phenoloxidase. Co-injection of an inhibitor of eicosanoid synthesis, dexamethasone, with LPS influences nodule formation (with or without AKH) in different ways according to the dose of dexamethasone used, but does not affect activation of prophenoloxidase. Eicosanoid synthesis is important for nodule formation, but not for the activation of the prophenoloxidase cascade in locust haemolymph

Sustainable Regeneration project delivery in the UK: A qualitative analysis of practitioners’ engagement

PURPOSE: The aim of this paper is to explore the key practitioner’s level of involvement in the delivery of sustainable regeneration projects in the UK. Practitioners’ level of involvement is a major factor which has, and continues to determine the delivery of sustainability outcomes of regeneration projects. DESIGN/METHODOLOGY/APPROACH: The paper adopted a qualitative study which obtained data from 21 key practitioners’ through a semi-structured interviews in exploring practitioners’ level of involvement in the delivery of sustainable regeneration projects in the UK. The semi-structured interviews are conducted with seven practitioners’ each from the three construction organisations selected through a purposive sampling approach for the study. FINDINGS: The findings identify varied levels of involvement of the key practitioners’ at the three delivery stages - early, construction and post construction of the projects. The findings further reveal that clients’ representatives, commercial managers and architects are the most frequently involved practitioners during the early stages of the projects. The findings also indicate that practitioners who have sustainability assigned to their roles and their responsibilities, such as sustainability managers etc. are the least involved in all the three delivery stages of the projects. RESEARCH LIMITATIONS/IMPLICATIONS: The study involves interview with 21 practitioners from three organisations delivering sustainable regeneration projects; hence this could limit the generalization of the research findings. However, the findings of this study could serve as a useful source of information for future further study in this area. PRACTICAL IMPLICATIONS: The paper is of the view that the level of key practitioner’s involvement in the delivery of the projects will have an impact on their knowledge and will determine how sustainability benefits are promoted and delivered from the projects. ORIGINALITY/VALUE: Although some studies have been carried out on practitioner’s engagement in the delivery of ‘normal’ construction projects, none has focused on practitioner’s levels of involvement in sustainable regeneration projects. Hence, this study has brought to the fore how the key practitioners’ tasked with the responsibilities of delivering sustainability benefits of regeneration projects have been involved (at various levels of the project lifecycle) in the delivery of these projects

Hearing loss in post-meningitis patients in Komfo Anokye Teaching Hospital

Meningitis is one of the infective disorders which can complicate with hearing loss. This study evaluates the incidence of hearing loss in patients who had suffered from a bacterial meningitis infection. The aim of this study was to find out the incidence rate of hearing loss in patients afterrecovering from meningitis. Some patients who were admitted, diagnosed and managed as cases of bacterial meningitis from the medical and the children’s wards of the Komfo Anokye Teaching Hospital were recruited to participate in this study after they had been discharged. Thesepatients underwent a hearing assessment using a pure tone audiometer. These patients who survived meningitis were aged between (8-62) years with a mean age of 32.1 years. Of the 58 patients evaluated 12 (20.7%) presented with a sensorineural hearing loss. 6.9% of the patients presented with a mild hearing loss, 8.7% with a moderate hearing loss, 1.7% with a severe hearing loss whereas the remaining 3.4% presented with a profound hearing loss. This study showed that patients who suffered from meningitis infection may develop hearing loss.Keywords: Meningitis, Sensorineural hearing loss, Epilepsy, Hydrocephalus, Cognitive defec

The role of built environment practitioners in driving the socio-economic sustainability aspects of sustainable regeneration

In the United Kingdom (UK), over the past three decades efforts have been made to ensure adequate promotion of sustainability objectives through various policy initiatives. However, despite the effort and the existence of these policy initiatives, sustainability projects in particular, regeneration projects are yet to deliver their intended sustainability objectives. While there is a rise in demand for higher sustainability benefits by stakeholders such as clients, communities and policy makers, the delivery of sustainability benefits from sustainability regeneration projects are yet to meet the expectations of these stakeholders. This article provides an overview of sustainability benefits within the context of the sustainable regeneration projects in the UK from a study that examines the roles and sustainability drivers of construction practitioners towards the promotion of sustainability on their regeneration projects. To do so, a qualitative research approach is adopted using a semi-structured interview technique for the study. The data obtained was analysed using content analysis. The findings revealed that out of the eight socio-economic sustainability drivers presented to practitioners, enhancement of reputation was the most important ‘socio-economic’ sustainability driver while the least important driver was legislative and legal requirement. The findings further revealed that majority of practitioners/ organisations were promoting the socio-economic sustainability driver they believed will enable them to meet their own corporate business objectives

Histological pattern of laryngeal cancers in Komfo Anokye Teaching Hospital

Carcinoma of the larynx is one of the commonest malignant tumours of the upper respiratory system.The main objective of this study was to highlight the histological pattern and evaluate the occurrence of the  malignant tumours of the larynx. This was a retrospective study involving 146 patients aged between 36 to 77 years with an average age of 59.7 years. Patients with symptoms and signs of laryngeal tumour were studied at the Komfo Anokye Teaching Hospital, Kumasi for a 10 year period from 2003 to 2012. Biopsies of suspected cases were taken and sent to the Histopathology Laboratory for histological analysis. The study revealed that there was a high occurrence of squamous cell carcinoma resulting in 92.0% of the patients. This was followed by verrucous carcinoma in 3.4% of the patients, adenocarcinoma and adenoid cystic carcinoma in 1.7% of the patients. Lastly, there was neuroendocrine carcinoma in only one patient (0.9%). This study confirmed histologically that the squamous cell  carcinoma was the most frequently manifested tumour of the larynx.Keywords: Larynx, Cancers, Histology, Carcinoma

Discrete approximations to vector spin models

We strengthen a result of two of us on the existence of effective interactions for discretised continuous-spin models. We also point out that such an interaction cannot exist at very low temperatures. Moreover, we compare two ways of discretising continuous-spin models, and show that, except for very low temperatures, they behave similarly in two dimensions. We also discuss some possibilities in higher dimensions.Comment: 12 page