Giant vesical calculi: experience with management of two Nigerians

Two cases of Giant Vesical Calculi were encountered in a semi-urban health facility (Nakowa Hospital, Yauri, Nigeria). careful clinical evaluation and investigation is important in the work up of the patients. surgical technique and accurate diagnosis are essential in their treatment. Nigerian Journal of Surgical Research Vol. 7(1&2) 2005: 203-20

Pyocolpos with imperforate hymen during early childhood presented with urine retention and bouts of intestinal obstruction

An imperforate hymen is not a rare condition in female newborns, but is often ignored in a genital examination by doctors. We report an unusual case of a 2 years old Sudanese girl with an imperforate hymen and pyocolpos presented with urine retention and intermittent bouts of intestinalobstruction. To our knowledge, this is a first case of female child with  pyocolpos to be documented in Sudan literature. Keywords: Hydrocolpos, urinary ascites, hymenotomy

Effects of different amounts of organic fertilizers on growth and production of tilapia in monoculture

The experiment was conducted to determine the effects of different amounts of organic fertilizers on growth and production of Tilapia (monosex GIFT tilapia) in monoculture system for a period of 120 days. The experiment was carried out in six earthen ponds, which were situated at the south-east corner of the Fisheries Faculty Building under the Department of Fisheries Management, Bangladesh Agricultural University, Mymensingh. The experiment was designed with three treatments and each of them consisted of two replications. Fish population density was 120 fish per decimal for all the treatments. Ponds were treated with organic fertilizers (cow dung) at the rate of 2 kg, 4 kg and 6 kg per decimal were supplied fortnightly for treatment-I, treatment-II and treatment-III, respectively. The ranges of water temperature, transparency, dissolved oxygen, total alkalinity, free CO2, phosphate-phosphorus and nitrate-nitrogen found were 15.82 to 24.49 ºC, 17.00 to 32.00 cm, 7.00 to 10.30 mg L-1, pH 7.20 to 7.90, 140.00 to 192.00 mg L-1, 2.00 to 6.00 mg L-1, 1.40 to 1.95 mg L-1 and 3.30 to 3.73 mg L-1, respectively. All the physical and chemical parameters except temperature were within the productive range and more or less similar among all the ponds under three treatments. 18 genera of phytoplankton under five major groups and 9 genera of zooplankton under three major groups were identified in the experimental ponds. Average survival rate of fish under treatment-I, treatment-II, and treatment-III were 94.50%, 94.00% and 95.00%, respectively. The calculated net fish production under treatment-I was 3.554 ton ha-1 yr-1 and that under treatment-II was 3.648 ton ha-1 yr-1 and under treatment-III was 2.919 ton ha-1 yr-1. The net fish productions under treatment-II and treatment-III were 102.64% and 82.13% comparing with treatment on which was taken for 100%. According to cost-benefit analysis, the ratios of net profit under treatments I, II, and III were 1:0.81, 1:0.54, and 1:0.04. According to specific growth rate, treatment-II was the best and survival rate of treatment-III was the best, and according to cost-benefit analysis, treatment-I (ratio 1:0.81) was the best. So, organic fertilizer at the rate of 2 kg per decimal (treatment-I) was considered the best among three treatments in this experiment. Int. J. Agril. Res. Innov. & Tech. 8 (2): 24-31, December, 201

Separation and recovery of organic acids from fermented kitchen waste by an integrated process

Organic acids produced from anaerobic digestion of kitchen waste were recovered using a new integrated method which consisted of freezing and thawing, centrifugation, filtration and evaporation. The main organic acid produced was lactic acid (98%). After the freezing and thawing process, 73% of the total suspended solids were removed and the organic acids were elevated from 59.0 to 70 g/L. The evaporation technique was used to further concentrate the organic acids up to 224 g/L. Using the integrated recovery method, the reduction of the total suspended solids in the solution achieved was about 93%. The material balance for the recovery process was also presented

Switching treatments in clinically stable relapsing remitting multiple sclerosis patients planning for pregnancy

Background: The decision to have children can be complex, particularly for people with multiple sclerosis (MS). A key concern is the use of disease modifying drugs (DMDs) during pregnancy, and how continuing, stopping or switching them may affect the mother and child. In people with active MS, stopping medications puts the mother at risk of relapse and disease rebound. Objectives: Review evidence on the effect of different switching strategies in people with stable relapsing remitting MS (RRMS). Methods: We searched MEDLINE, EMBASE, EMCARE, CINAHL, SCOPUS, Cochrane Library up to March 2020. Only papers in English were included and no other limits were applied. Seven articles were included: four cohorts, two case reports and one randomized controlled trial (RCT). Results: Two strategies were found: de-escalating, which was associated with an increased risk of relapses, and switching between first line injectables, with no change in relapse rate observed. Conclusion: Evidence on the effect of switching strategy on disease course in stable RRMS patients planning for pregnancy is scarce, but when switching, current evidence suggests the risk of relapses mirrors known medication efficacy

Management of TB in the private sector in Khartoum, Sudan: quality and impact on TB control

IntroductionSudan has a large and growing private health sector. No survey was done in Sudan to show the extent of the use of private health care services by the population. Also precise data on tuberculosis (TB) diagnosis and treatment in the private sector are not available.Material and methodsA facility-based cross-sectional survey was carried out during February2007-June 2007 in Khartoum state, whereby consented private physicians working in the all private clinics (n=110) were interviewed.ResultsThis study showed that a large private sector exist in the country and deliver care to TB patients and reported the non-adherence of this sector to National Tuberculosis Program (NTP) guidelines. 59.1% of the interviewed physicians correctly mentioned the TB treatment regimens, only 8(12.3%) physicians that reported management of TB patients actually prescribed these regimens to their patients. Similarly, only 10(15.4%) physicians requested sputum smear examination for TBdiagnosis.ConclusionA considerable proportion of cases is inadequately managed by the private sector and is not notified to NTP. The information delivered by this study can be used to develop a workable Public-private mix (PPM) model with the private sector.Key words: Isoniazid, Rifampicin, Pyrazinamide, Ethambutol

Thoracoscopy and talc poudrage compared with intercostal drainage and talc slurry infusion to manage malignant pleural effusion: the TAPPS RCT

Background: There are around 40,000 new cases of malignant pleural effusion in the UK each year. Insertion of talc slurry via a chest tube is the current standard treatment in the UK. However, some centres prefer local anaesthetic thoracoscopy and talc poudrage. There is no consensus as to which approach is most effective. Objective: This trial tested the hypothesis that thoracoscopy and talc poudrage increases the proportion of patients with successful pleurodesis at 3 months post procedure, compared with chest drain insertion and talc slurry. Design: This was a multicentre, open-label, randomised controlled trial with embedded economic evaluation. Follow-up took place at 1, 3 and 6 months. Setting: This trial was set in 17 NHS hospitals in the UK. Participants: A total of 330 adults with a confirmed diagnosis of malignant pleural effusion needing pleurodesis and fit to undergo thoracoscopy under local anaesthetic were included. Those adults needing a tissue diagnosis or with evidence of lung entrapment were excluded. Interventions: Allocation took place following minimisation with a random component, performed by a web-based, centralised computer system. Participants in the control arm were treated with a bedside chest drain insertion and 4 g of talc slurry. In the intervention arm, participants underwent local anaesthetic thoracoscopy with 4 g of talc poudrage. Main outcome measures: The primary outcome measure was pleurodesis failure at 90 days post randomisation. Secondary outcome measures included mortality and patient-reported symptoms. A cost–utility analysis was also performed. Results: A total of 166 and 164 patients were allocated to poudrage and slurry, respectively. Participants were well matched at baseline. For the primary outcome, no significant difference in pleurodesis failure was observed between the treatment groups at 90 days, with rates of 36 out of 161 (22%) and 38 out of 159 (24%) noted in the poudrage and slurry groups, respectively (odds ratio 0.91, 95% confidence interval 0.54 to 1.55; p = 0.74). No differences (or trends towards difference) were noted in adverse events or any of the secondary outcomes at any time point, including pleurodesis failure at 180 days [poudrage 46/161 (29%), slurry 44/159 (28%), odds ratio 1.05, 95% confidence interval 0.63 to 1.73; p = 0.86], mean number of nights in hospital over 90 days [poudrage 12 nights (standard deviation 13 nights), slurry 11 nights (standard deviation 10 nights); p = 0.35] and all-cause mortality at 180 days [poudrage 66/166 (40%), slurry 68/164 (42%); p = 0.70]. At £20,000 per quality-adjusted life-year gained, poudrage would have a 0.36 probability of being cost-effective compared with slurry. Limitations: Entry criteria specified that patients must be sufficiently fit to undergo thoracoscopy, which may make the results less applicable to those patients presenting with a greater degree of frailty. Furthermore, the trial was conducted on an open-label basis, which may have influenced the results of patient-reported measures. Conclusions: The TAPPS (evaluating the efficacy of Thoracoscopy And talc Poudrage versus Pleurodesis using talc Slurry) trial has robustly demonstrated that there is no additional clinical effectiveness or cost-effectiveness benefit in performing talc poudrage at thoracoscopy over bedside chest drain and talc slurry for the management of malignant pleural effusion. Trial registration: Current Controlled Trials ISRCTN47845793. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 26. See the NIHR Journals Library website for further project information

Pilot-scale recovery of low molecular weight organic acids from anaerobically treated palm oil mill effluent (POME) with energy integrated system

Low molecular weight organic acids such as acetic acid, propionic acid and butyric acids generated from partial anaerobic treatment of palm oil mill effluent (POME) were recovered using pilot scale filtration and evaporation system. Mechanical filter press (14 L) was used for removing solid fractions and fraction distillation unit (40 L) for evaporation and clarification of concentrated acid from POME. Clarification using rotary evaporator was found to be more suitable than distillation column. Due to the presence of more than 90% of water in POME, the final clarified product comprises only 7% of the total volume. The material balance for the overall process was estimated and integrated system for the bioconversion of organic acids into polyhydroxyalkanoates (PHA) was proposed. The recovery of organic acids has a significant and economical impact, since around 50% cost of PHA production is believed to be associated with the substrate itself

Metallointercalator [Ru(dppz)2(PIP)]2+ Renders BRCA Wild-Type Triple-Negative Breast Cancer Cells Hypersensitive to PARP Inhibition

There is a need to improve and extend the use of clinically-approved poly(ADP-ribose) polymerase (PARP) inhibitors (PARPi), including for BRCA wild-type triple-negative breast cancer (TNBC). The demonstration that ruthenium(II) polypyridyl complex (RPC) metallo-intercalators can rapidly stall DNA replication fork progression provides the rationale for their combination alongside DNA damage response (DDR) inhibitors to achieve synergism in cancer cells. The aim of the present study was to evaluate use of the multi-intercalator [Ru(dppz)2(PIP)]2+ (dppz = dipyrido[3,2-a:2′,3′-c]phenazine, PIP = (2-(phenyl)imidazo[4,5-f][1,10]phenanthroline, Ru-PIP) alongside the PARP inhibitors (PARPi) olaparib and NU1025. Cell proliferation and clonogenic survival assays indicated a synergistic relationship between Ru-PIP and olaparib in MDA-MB-231 TNBC and MCF7 human breast cancer cells. Strikingly, low dose Ru-PIP renders both cell lines hypersensitive to olaparib, with a 300-fold increase in olaparib potency in TNBC; the largest non-genetic PARPi enhancement effect described to date. Negligible impact on the viability of normal human fibroblasts was observed for any combination tested. Increased levels of DNA double-strand break (DSB) damage and olaparib abrogation of Ru-PIP activated pChk1 signalling is consistent with PARPi-facilitated collapse of Ru-PIP-associated stalled replication forks. This results in enhanced G2/M cell-cycle arrest, apoptosis and decreased cell motility for the combination treatment compared to single-agent conditions. This work establishes that an RPC metallo-intercalator can be combined with PARPi for potent synergy in BRCA-proficient breast cancer cells, including TNBC

Evaluating the efficacy of thoracoscopy and talc poudrage versus pleurodesis using talc slurry (TAPPS trial): protocol of an open-label randomised controlled trial

INTRODUCTION: The management of recurrent malignant pleural effusions (MPE) can be challenging. Various options are available, with the most efficacious and widely used being talc pleurodesis. Talc can either be applied via a chest drain in the form of slurry, or at medical thoracoscopy using poudrage. Current evidence regarding which method is most effective is conflicting and often methodologically flawed. The TAPPS trial is a suitably powered, multicentre, open-label, randomised controlled trial designed to compare the pleurodesis success rate of medical thoracoscopy and talc poudrage with chest drain insertion and talc slurry. METHODS AND ANALYSIS: 330 patients with a confirmed MPE requiring intervention will be recruited from UK hospitals. Patients will be randomised (1:1) to undergo either small bore (<14 Fr) Seldinger chest drain insertion followed by instillation of sterile talc (4 g), or to undergo medical thoracoscopy and simultaneous poudrage (4 g). The allocated procedure will be performed as an inpatient within 3 days of randomisation taking place. Following discharge, patients will be followed up at regular intervals for 6 months. The primary outcome measure is pleurodesis failure rates at 3 months. Pleurodesis failure is defined as the need for further pleural intervention for fluid management on the side of the trial intervention. ETHICS AND DISSEMINATION: The trial has received ethical approval from the National Research Ethics Service Committee North West-Preston (12/NW/0467). There is a trial steering committee which includes independent members and a patient and public representative. The trial results will be published in a peer-reviewed journal and presented at international conferences, as well as being disseminated via local and national charities and patient groups. All participants who wish to know the study results will also be contacted directly on their publication. TRIAL REGISTRATION NUMBER: ISRCTN47845793