Open versus closed sandwich wound dressing method in burn children

Background: Open method of dressing burn wounds has been the accepted mode of burn wound care in most of our hospitals. Closed dressing has been shunned because of the belief that it is costly and labour intensive.Methods: A retrospective study was conducted on 170 children under 12years admitted to the Pediatric surgical/female burn ward between the months of June 2006 to March 2007. A comparison was made between the open and closed sandwich method of burn wound dressing. The sandwich method entailed using 17 by 17cm square pieces of gauze with a layer of cotton in between. The dressing was left on for between 3 and 4 days. The open method was used on 92 patients (Group A) admitted between the months of June 2006 to October 2006, while the closed method was applied on 78 patients (Group B) admitted during the months of November 2006 to March 2007.The demographic data of the two groups were analyzed. The duration of hospital stay, fatalities and proportion of patients discharged were used as outcome indicators for the two groups. Results: The male to female ratio was found to be 1.4:1 for Group A and 1.5:1 for the Group B. The majority of burn wounds were caused by scalds with children under five being the most affected in both groups (81.5% and 85.9% respectively). Most of the burns in the two groups were less than 10% of the body. The results of outcome indicators showed no statistical differences between the two groups.Conclusion: Sandwich closed dressing changed every after three to four days does not adversely affect outcome of burn patients. This type of dressing is recommended for health facilities with limited resources since it reduces the burden on the nurse and also the cost of dressing materials while providing the benefits of closed dressing

Spontaneous extrusion of ventriculoperitoneal catheter through anterolateral chest wall: A case report and review of literature

Ventriculo-peritoneal shunting is the commonest surgery for management of hydrocephalus. However, about 80% develop complications in their lifetime. These include common ones like shunt blockage and infection, to rare ones like shunt migration, extrusion and perforation of viscus. The authors present a rare case of shunt extrusion through the chest wall of an 8 year old male. The shunt was inserted 3years earlier for post-meningitic hydrocephalus. Clinical Examination revealed extrusion of the peritoneal end of the shunt at the level of the 6th rib with cloudy CSF dripping from the tube. A chest radiograph done outlined the shunt. This is an unusual extrusion of a peritoneal shunt and literature search did not reveal any papers with a similar case in the region. We hope clinicians will always be wary of these rare complications for early recognition to improve outcome

Preaxial polydactyly: Our experience at the Rift Valley Provincial General Hospital, Nakuru, Kenya

No Abstrac

Adenocarcinoma of the Colon in a 10-year-old child

Colonic adenocarcinoma is rare in children, more so in the first decade of life. Owing to the non-specificity and vagueness of symptoms, most patients in this age group present with advanced malignacy. The authors report a case of adenocarcinoma of the colon in a 10-year-old female child presenting with a history of abdominal pain, distention and constipation. Barium enema highlighted a narrowing of the distal ascending colon with laparotomy revealing a growth involving the caecum and ascending colon. Histology confirmed it as a poorly diffentiated mucin secreting adenocarcinoma. A right hemicolectomy with end to end ileo-transverse anastomosis was perfomed. Four months later, she presented with symptoms of intestinal obstruction. Intraoperatively, widespread metastatic nodules with recurrent tumour were noted. It is important for clinicians to be aware that colorectal carcinoma does occur in children, and age alone should not be a basis for its exclusion. This case is presented to draw attention to a disease in which the prognosis, by wider recognition of its occurrence in childhood, might be improved

Surgical Aspects of Genitourinary Bilharzia

The blood fluke Schistosoma haematobium mainly affects the lower genitourinary tract, where the pathological effects are a result of the reaction to the schistosome ova. The chronic effects cause damage to the musculature of the urinary tract resulting in scarring and fibrosis. The ureters dilate and or stricture. Contracture of the bladder and or detrussor failure may occur. Secondary calculi in the upper tracts and bladder are common. There is strong association with bladder cancer development of the squamous cell type. Emphasis is on the prevention of the infestation

Comparing Floristic Diversity between a Silviculturally Managed Arboretum and a Forest Reserve in Dambulla, Sri Lanka

Repeated slash and burn cultivation creates wasteland with thorny shrubs, which then takes a long time to become secondary forests through serial stages of succession. Assisted natural regeneration through silvicultural management is a useful restoration method to accelerate succession. This survey evaluates the effectiveness of a simple silvicultural method for the rehabilitation of degraded lands to productive forest, thereby increasing floristic wealth. Field-based comparative analyses of floristic composition were carried out at a silviculturally managed forest (Popham Arboretum) and a primary forest (Kaludiyapokuna Forest Reserve) which is located in Dambulla in Sri Lanka. Floristic analysis was used to examine the effectiveness of silvicultural techniques for successful restoration of degraded forest in the dry zone. Nine 20 m × 20 m plots in each forest were enumerated and the vegetation ≥ 10 cm girth at breast height was quantitatively analyzed. Cluster analysis resulted in five distinguishable clusters (two from Popham Arboretum and three from Kaludiyapokuna Forest Reserve). Similarity indices were generated to compare the plots within and between sites. Floristic similarity was higher in forest reserve plots compared to arboretum plots. A total of 72 plant species belonging to 60 genera and 26 families were recorded from the study sites. Of the recorded species, Grewia damine and Syzygium cumini (Importance Value Index, IVI = 24 and 23 respectively) were the ecologically co-dominant taxa at the Popham Arboretum. In contrast, Mischodon zeylanicus (IVI = 31), Schleichera oleosa (IVI = 25) and Diospyros ebenum (IVI = 21) were the abundant taxa in the forest reserve

TDR Targets: a chemogenomics resource for neglected diseases

The TDR Targets Database (http://tdrtargets.org) has been designed and developed as an online resource to facilitate the rapid identification and prioritization of molecular targets for drug development, focusing on pathogens responsible for neglected human diseases. The database integrates pathogen specific genomic information with functional data (e.g. expression, phylogeny, essentiality) for genes collected from various sources, including literature curation. This information can be browsed and queried using an extensive web interface with functionalities for combining, saving, exporting and sharing the query results. Target genes can be ranked and prioritized using numerical weights assigned to the criteria used for querying. In this report we describe recent updates to the TDR Targets database, including the addition of new genomes (specifically helminths), and integration of chemical structure, property and bioactivity information for biological ligands, drugs and inhibitors and cheminformatic tools for querying and visualizing these chemical data. These changes greatly facilitate exploration of linkages (both known and predicted) between genes and small molecules, yielding insight into whether particular proteins may be druggable, effectively allowing the navigation of chemical space in a genomics context

Trypanosoma brucei Glycogen Synthase Kinase-3, A Target for Anti-Trypanosomal Drug Development: A Public-Private Partnership to Identify Novel Leads

Over 60 million people in sub-Saharan Africa are at risk of infection with the parasite Trypanosoma brucei which causes Human African Trypanosomiasis (HAT), also known as sleeping sickness. The disease results in systemic and neurological disability to its victims. At present, only four drugs are available for treatment of HAT. However, these drugs are expensive, limited in efficacy and are severely toxic, hence the need to develop new therapies. Previously, the short TbruGSK-3 short has been validated as a potential target for developing new drugs against HAT. Because this enzyme has also been pursued as a drug target for other diseases, several inhibitors are available for screening against the parasite enzyme. Here we present the results of screening over 16,000 inhibitors of human GSK-3β (HsGSK-3) from the Pfizer compound collection against TbruGSK-3 short. The resulting active compounds were tested for selectivity versus HsGSK-3β and a panel of human kinases, as well as their ability to inhibit proliferation of the parasite in vitro. We have identified attractive compounds that now form potential starting points for drug discovery against HAT. This is an example of how a tripartite partnership involving pharmaceutical industries, academic institutions and non-government organisations such as WHO TDR, can stimulate research for neglected diseases

Dietary species richness as a measure of food biodiversity and nutritional quality of diets

Biodiversity is key for human and environmental health. Available dietary and ecological indicators are not designed to assess the intricate relationship between food biodiversity and diet quality. We applied biodiversity indicators to dietary intake data from and assessed associations with diet quality of women and young children. Data from 24-hour diet recalls (55% in the wet season) of n = 6,226 participants (34% women) in rural areas from seven low- and middle-income countries were analyzed. Mean adequacies of vitamin A, vitamin C, folate, calcium, iron, and zinc and diet diversity score (DDS) were used to assess diet quality. Associations of biodiversity indicators with nutrient adequacy were quantified using multilevel models, receiver operating characteristic curves, and test sensitivity and specificity. A total of 234 different species were consumed, of which <30% were consumed in more than one country. Nine species were consumed in all countries and provided, on average, 61% of total energy intake and a significant contribution of micronutrients in the wet season. Compared with Simpson’s index of diversity and functional diversity, species richness (SR) showed stronger associations and better diagnostic properties with micronutrient adequacy. For every additional species consumed, dietary nutrient adequacy increased by 0.03 (P < 0.001). Diets with higher nutrient adequacy were mostly obtained when both SR and DDS were maximal. Adding SR to the minimum cutoff for minimum diet diversity improved the ability to detect diets with higher micronutrient adequacy in women but not in children. Dietary SR is recommended as the most appropriate measure of food biodiversity in diets