Compare Outcomes Of Single Stage Vs Two Stage Urethroplasty For Panurethral Strictures Including Pre-Operative And Post-Operative Course

Aim: The aim of the present study was to compare outcomes of single stage vs two stage urethroplasty for panurethral strictures including pre-operative and post-operative course. Methods: The Observational study was conducted at Dr. D.Y. Patil Medical College and Research Centre, Pimpri for the period of 2 years. The study was conducted in 40 patients randomly dividing into two groups, 20 patients underwent single stage urethroplasty and 20 underwent two staged urethroplasty with or without buccal mucosal graft urethroplasty based on size of urethral plate. Results: In the present study, majority of the patients belonged to 41-50 years age group followed by 31-40 years age group and it was found that age groups were not statistically significant. Majority of the patients had Balanitis xerotica obliterans (LS) etiology followed by Post instrumentation/catheter and the results were not statistically significant. Majority of the patients had 13-15 cms length of stricture. In the present study, 12 and 16 were narrow external uretheral meatus in single and two stage respectively. In the two stage, Johanson’s urethroplasty procedure was done and in single stage, Kulkarni’s full length dorsal onlay BMG urethroplasty procedure was done. In single and two stage, Urethrocutaneous Fistula and Epididymo-orchitis complications were noted. In single stage, success was noted in 16 patients and in two stage, success was noted in 17 patients. Conclusion: The single stage repair in patients with LS had good results with less re-stricture rates. The use of BMG as a substitution in single stage repair had re-stricture rates compared to flaps substitution. The two-stage repair should be limited to complex urethral strictures, failed urethroplasty and obliterated urethral stricture urethral caliber is less than 6F

Volvulus as a complication of chronic intestinal pseudo-obstruction syndrome

Chronic intestinal pseudo-obstruction syndrome (CIPS) is a severe motility disorder of the gastrointestinal tract that presents with continuous or recurrent symptoms and signs of intestinal obstruction without evidence of a structural lesion occluding the intestinal lumen. Mechanical obstruction might occur in these patients as well but is typically difficult to distinguish from an exacerbation of CIPS. We report two pediatric cases in which mechanical obstruction by volvulus mimicked an exacerbation of CIPS, requiring surgical intervention. Conclusion: Awareness of the possibility of true mechanical obstruction in CIPS patients during an exacerbation episode is needed, as this is a severe condition and usually requires surgical intervention

Secretion of Genome-Free Hepatitis B Virus – Single Strand Blocking Model for Virion Morphogenesis of Para-retrovirus

As a para-retrovirus, hepatitis B virus (HBV) is an enveloped virus with a double-stranded (DS) DNA genome that is replicated by reverse transcription of an RNA intermediate, the pregenomic RNA or pgRNA. HBV assembly begins with the formation of an “immature” nucleocapsid (NC) incorporating pgRNA, which is converted via reverse transcription within the maturing NC to the DS DNA genome. Only the mature, DS DNA-containing NCs are enveloped and secreted as virions whereas immature NCs containing RNA or single-stranded (SS) DNA are not enveloped. The current model for selective virion morphogenesis postulates that accumulation of DS DNA within the NC induces a “maturation signal” that, in turn, triggers its envelopment and secretion. However, we have found, by careful quantification of viral DNA and NCs in HBV virions secreted in vitro and in vivo, that the vast majority of HBV virions (over 90%) contained no DNA at all, indicating that NCs with no genome were enveloped and secreted as empty virions (i.e., enveloped NCs with no DNA). Furthermore, viral mutants bearing mutations precluding any DNA synthesis secreted exclusively empty virions. Thus, viral DNA synthesis is not required for HBV virion morphogenesis. On the other hand, NCs containing RNA or SS DNA were excluded from virion formation. The secretion of DS DNA-containing as well as empty virions on one hand, and the lack of secretion of virions containing single-stranded (SS) DNA or RNA on the other, prompted us to propose an alternative, “Single Strand Blocking” model to explain selective HBV morphogenesis whereby SS nucleic acid within the NC negatively regulates NC envelopment, which is relieved upon second strand DNA synthesis

Effects of Operating Conditions on Gas Release Thermal Consequences: a case study of the Trans- Saharan Gas Pipeline

A recent study concluded that militant activities/insurgency constitutes the biggest threat to the proposed Trans-Saharan Gas Pipeline (TSGP) intended to traverse Nigeria, Niger and Algeria. Hence gas release is a credible source of concern. Using the potential leak of inventory from the TSGP as a case study; this paper assesses the Simplex Source Term and Multivariate Consequence Modelling approaches. Aspen HYSYS® platform was used to determine the average Molecular Weight and Lower Heat of Combustion of the gas mixture. Thereafter, the gas discharge rates for various leak scenarios were evaluated. The gas release rates and the flame length of the potential jet fires were initially estimated using Simplex Source Term Models which pay limited attention to operating conditions. Finally a more detailed follow-up study, accounting for a range of practical factors was conducted. A number of useful risk management metrics were determined. For example, the release rate for the 100mm leak is about 130.50 kg/s and 162.13 kg/s for scenarios with and without modifiers respectively. Similarly, the maximum flame lengths were found to be significantly different with values of 8m and 142m with and without modifiers respectively. The results show that the direct approach could be overly conservative, hence more expensive to implement

Rabies Vaccination Coverage and Antibody Profile of Owned Dogs in Abuja, Nigeria

ObjectiveTo determine the vaccination status of owned dogs, assess therabies antibody titre of vaccinated dogs and risk factors associatedwith vaccination of dogs in Abuja, Nigeria.IntroductionRabies is a zoonotic disease of high public health importance1.There have been documented reports of rabies in vaccinateddogs2. Rabies is enzootic in domestic dogs in Nigeria. Hence,annual vaccination campaigns of dogs are advocated with the aimof rabies elimination. Vaccination status, type of vaccination andthe immunogenicity of the various rabies vaccines used in AbujaNigeria has not been studied. To date, no effective medical therapyhas been established for rabies3. Most human rabies deaths occurin the developing countries and though effective and economicalcontrol measures are available their application in developingcountries is hampered by a range of economic, social and politicalfactors. It is widely recognized that the number of deaths officiallyreported in most developing countries greatly underestimates the trueincidence of disease, with several factors contributing to widespreadunderreporting3. Preventive vaccination against rabies virus is ahighly effective method for preventing rabies in humans and animals3but do people vaccinate and how long does the immunity conferredby the vaccine remain protective in the dogs in Abuja?. Rabies hashigh financial expenditure burden on any country where it is endemicmainly associated with costs incurred on post-exposure prophylaxis(determined by the type of vaccine, vaccine regimen and route ofadministration as well as the type of immunoglobulin used).MethodsDog serum samples (n=276) were collected from Abuja the FederalCapital Territory (FCT) Nigeria, from 5 locations (Phase 1, 2, 3,Gwagwalada and Kubwa) based on availability and owners consent.Rabies antibody serum titer was determined using an indirect enzymelinked immuno-sorbent assay. Face to face structured questionnaireswere used to obtain demographic and zoographic information fromthe dog owners. Associations between the demographic variables,vaccination status and rabies antibody titer of each dog were assessedusingχ2analysis.ResultsOf the dogs sampled, 229 (83%) had certified antirabies vaccinationrecord. The dogs sampled, which were vaccinated from Phase I, II,III and the satellite towns were; 109/118 (92.37%), 32/33 (96.97%),48/49 (97.96%) and 40/76 (52.63%), respectively. A total of 276serum samples were collected, processed and analyzed during thisstudy. Out of the 276 dogs sampled, 239 (86.6%) had rabies antibodytitre≥0.6EU/ml whilst 37 (13.4%) had less than 0.6EU/ml. Therewas a marked decline in rabies antibody titre with increase in time.Out of the 228 exotic breeds of dogs sampled, 218 (95.6%) werevaccinated whilst 11 (22.9%) of the 48indigenous breed of dogssampled were vaccinated. All the exotic breed of dogs had rabiesantibody titre≥0.6EU/ml whilst 37 (77.1%) of the indigenousbreed of dogs had less than 0.6 EU/ml levels of rabies antibody titre.All dogs within 6 months to 1 year and greater than 10 years of agehad≥0.6EU/ml rabies antibody titre whilst dogs within 1-5 years had1 (0.5%) and 36(69.2%) dogs of age 6-10 years had rabies antibodytitre < 0.6EU/ml. Twelve (7.6%) of the males and 25 (21.2%) of thefemales had less than 0.6EU/ml rabies antibody titre. All the dogsacquired by importation and from breeders had rabies antibody titre≥0.6EU/ml whilst 37 (27.2%) of the dogs acquired from friends hadless than 0.6EU/ml rabies antibody titre.Significant associations were observed between breed (χ2= 203,df = 1, P-value < 0.05), age (χ2= 172, df = 3, P-value < 0.05), sex(χ2= 10.75, df = 1, P-value < 0.05), source (χ2= 43.99, df = 2, P-value< 0.05), rabies vaccination status (χ2= 276.00, df = 2, P-value < 0.05)and the rabies antibody prevalence of sampled dogs.ConclusionsThis cross-sectional study shows that not all dog owners vaccinatetheir dogs and that the vaccines conferred protection beyond12 months. The Preventive vaccination against rabies virus is ahighly effective method for preventing rabies in humans and animals.Policies to enhance mass mandatory annual vaccination to achieve70% coverage should be implemented in order to eradicate rabies