174 research outputs found

    Evaluation of Cattle Rearer’s Knowledge, Attitude and Practices About Tsetse Fly in Muri District, Taraba State, Nigeria

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    A study using a structural questionnaire was conducted in Muri district, Taraba State to evaluate knowledge, attitude and practices of cattle rearers about Tsetse fly (Glossina). Most cattle rearers (94.8%) had adequate knowledge of Tsetse fly, (69.0%) gave a local name to it and (100%) know the effect of Tsetse fly to their cattle. Cattle rearers (52.3%) reported Tsetse flies transmit disease to cattle, (85.7%) know where their cattle make contact with the tsetse flies and (67.0%) know season and period of the day when tsetse flies bite their cattle. 48.1% recognized tsetse fly as an important threat to their cattle, (90.0%) reported their herd had contact with tsetse flies in the preceding 12 months, (90.9%) practices preventive measures against tsetse flies, and only (9.1%) do not. Respondents had high knowledge of tsetse fly and the economic significance attributed to cattle and the use of pour- on in the control of tsetse fly in the districts should bee raised among cattle rearers. Results obtained from this study could be used in the formulation of extension material in trypanosomosis prevention.Keywords: Knowledge, attitude, practice, tsetse fly (Glossina) trypanotolerant, Taraba, Muri

    Dry season prevalence of contagious bovine pleuropneumonia based on postmortem examination at Hadejia Abattoir, Jigawa State

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    The current prevalence study of CBPP was conducted at Hadejia abattoir of Jigawa state, Nigeria using  postmortem examination of CBPP lesions in lungs of cattle at slaughter. A total of 172 slaughtered cattle were examined at postmortem over the period of 3 months (March - May, 2014). Of the total, 5(2.9%) were positive for the presence of CBPP lesions. The disease was significantly higher (P<0.05) in females 4(8.3%) than in males 1(1.8%). Cattle within the rage of 3.5 – 4 years 3(9.7%) were significantly (P<0.05) infected than other age groups. Breed specific prevalence was highest 1(6.7%) in Sokoto gudali and lowest 1(3.1%) in white Fulani. This study concluded that CBPP is endemic and its prevalence is on the increase in the study area.Key words: Contagious bovine pleuropneumonia, postmortem, prevalence, vaccination, abattoir, slaughtered

    Combined sedation with midazolam/propofol for gastrointestinal endoscopy in elderly patients

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    <p>Abstract</p> <p>Background</p> <p>Although gastrointestinal endoscopy with sedation is increasingly performed in elderly patients, data on combined sedation with midazolam/propofol are very limited for this age group.</p> <p>Methods</p> <p>We retrospectively analyzed 454 endoscopic procedures in 347 hospitalized patients ≥ 70 years who had received combined sedation with midazolam/propofol. 513 endoscopic procedures in 397 hospitalized patients < 70 years during the observation period served as controls. Characteristics of endoscopic procedures, co-morbidity, complications and mortality were compared.</p> <p>Results</p> <p>Elderly patients had a higher level of co-morbidity and needed lower mean propofol doses for sedation. We observed no major complication and no difference in the number of minor complications. The procedure-associated mortality was 0%; the 28-day mortality was significantly higher in the elderly (2.9% vs. 1.0%).</p> <p>Conclusions</p> <p>In this study on elderly patients with high level co-morbidity, a favourable safety profile was observed for a combined sedation with midazolam/propofol with a higher sensitivity to propofol in the elderly.</p

    A comparative analysis of toluidine blue with frozen section in oral squamous cell carcinoma

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    Background:Surgical excision of the primary tumor with safe margins remains the mainstay of treatment for oral cavity squamous cell carcinoma (OSCC). The standard of care for assessment of intraoperative margins is frozen section histopathology. Unfortunately the facility is not available at most centers in limited resource countries. Toluidine blue, a metachromatic dye, has been well described in clinical identification of malignant and premalignant lesion in the oral cavity. Considering this we decided to explore intraoperative use of toluidine blue staining, in comparison with frozen sections, for the assessment of tumor-free margins. Methods: After obtaining clearance from the in-house ethical review committee, a prospective study was conducted at Aga Khan University Hospital, Karachi, from August 15, 2009 to March 14, 2010. A sample of 56 consenting Patients with biopsy-proven OSCC were included in the study, giving us 280 tumor margins. Margins were analyzed using toluidine blue staining and frozen section histopathology. A receiver operator curve (ROC) was then applied to compare assessment of margin status by toluidine blue and frozen section. Results: Of the 280 examined margins 11 stained positive with toluidine blue, three were positive on frozen section biopsy, and three were positive on final histopathology. Toluidine blue staining had sensitivity and specificity of 100% and 97%, respectively. The diagnostic accuracy of toluidine blue was found to be 97.1% with a positive predictive value (PPV) of 27.2% and a negative predictive value (NPV) of 100%. Conclusions: Toluidine blue can be used as an effective screening modality for the assessment of intraoperative margins in resource limited environments and reducing the number of frozen section biopsies performed. Further by providing real-time clinical information within minutes it can reduce indirect costs such as operating room time. It may also be used as an ad hoc for frozen section biopsies where frozen section facilities are available

    Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry

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    Transoral laser microsurgery (TLM) is an emerging technique for the management of laryngeal and other head and neck malignancies. It is increasingly being used in place of traditional open surgery because of lower morbidity and improved organ preservation. Since the surgery is performed from the inside working outward as opposed to working from the outside in, there is less damage to the supporting structures that lie external to the tumor. Coupling the laser to a micromanipulator and a microscope allows precise tissue cutting and hemostasis; thereby improving visualization and precise ablation. The basic approach and principles of performing TLM, the devices currently in use, and the associated dosimetry parameters will be discussed. The benefits of using TLM over conventional surgery, common complications and the different settings used depending on the location of the tumor will also be discussed. Although the CO2 laser is the most versatile and the best-suited laser for TLM applications, a variety of lasers and different parameters are used in the treatment of laryngeal cancer. Improved instrumentation has lead to an increased utilization of TLM by head and neck cancer surgeons and has resulted in improved outcomes. Laser energy levels and spot size are adjusted to vary the precision of cutting and amount of hemostasis obtained

    2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary.

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    Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

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    Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability
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