Urinary bladder metastasis from breast cancer: a rare cause of hematuria

Breast cancer is the most common cancer in women globally as well as in Kenya. The most common sites of metastases reported include the bones, liver and lung. Metastasis to the urinary bladder is relatively uncommon with only a few case reports in literature. It can therefore be easily overlooked as a cause of hematuria in these patients. We describe a rare case of a patient with breast cancer who presented with urinary bladder metastasis as a late complication of her illness

Multimedia Application: Virtual Reality with 3D Graphics for Interactive Environment in Medical Education

Technology evolution and the need for teaching modernization led to the design of virtual reality applications in medical education. The current study aims to create an interactive environment by using three-dimensional (3D) models of the human arterial system. 3D arterial models allow undergraduate medical students to easily memorize main arterial branching pattern after intra-arterial navigation. The students have the ability by using the application for enjoyable interaction during navigation for learning process and continue or repeat the intra-arterial navigation. The study compares two students’ groups by using the criterion whether or not they have followed the anatomy of the arterial system course and were successfully examined to it. The results showed no difference in experience in the evaluation of virtual reality application between the two groups, as well as no gender differences. Digital applications, although complex, offer great advantages, such as learning without jeopardizing human body and the possibility of multiple repetitions, that allows students fully understand the educational subject

DENDRITIC AND SPINAL PATHOLOGY OF THE PURKINJE CELLS FROM THE HUMAN CEREBELLAR VERMIS IN ALZHEIMER’S DISEASE

Background: Alzheimer’s disease constitutes one of the main causes of dementia. It is clinically characterized by memory impairment, deterioration of intellectual faculties and loss of professional skills. Furthermore changes in equilibrium and limb coordination are clinically demonstrable in persons with Alzheimer’s disease. In the present study we tried to figure out possible changes of the Purkinje cells in Alzheimer’s disease brains. Subjects and methods: We studied the Purkinje cells from the vermis of the cerebellum in 5 Alzheimer’ disease brains Golgi technique. Results: In the Purkinje cells from the inferior surface of the cerebellar hemispheres severe dendritic and spinal pathology consisting of loss of distal dendritic segments and alterations of dendritic spine morphology can be noticed in Alzheimer’s disease brains. Conclusions: The morphological and morphometric estimation of the dendrites and the dendritic spines of the Purkinje cells from the inferior surface of the cerebellar hemispheres in Alzheimer’s disease brains revealed substantial alterations of the dendritic arborization and marked loss of the dendritic spines, which may be related to cognitive impairment and motor deficits in Alheimer’s disease

The importance of market signals in crop varietal development: Lessons from Komboka rice variety

Growing high-yielding varieties is crucial for successful crop production and maximizing farmers’ net returns. One such example is IR05N221, locally referred to as Komboka rice variety, which was released in Kenya in 2013. On the one hand, Komboka can bridge the gap in rice imports since yields of existing rice varieties do not meet the increasing rice consumption levels of the Kenyan population. On the other hand, it has taken about seven years for Komboka to be appreciated by farmers, necessitating the need to understand farmer preferences when it comes to adopting a new improved variety. We used a mixed-method study approach by combining quantitative and qualitative data collected regionally and locally in both rainfed and irrigated ecologies. When compared to most of the other rice varieties under evaluation, Komboka was high-yielding, early-maturing, and had moderate tolerance to diseases in both rainfed and irrigated ecologies. However, farmers at the regional level ranked Komboka either at the same or lower rank in terms of sensory attributes. At the local level, farmers predominantly grew older and more aromatic Basmati 370 rice variety for sale, as it fetched them more money, with preferences for both men and women rice farmers being the same. Despite Komboka being a high-yielding variety, Mwea rice farmers’ perceptions and preferences for this improved variety were low. While Komboka was equally aromatic, the lack of a ready market dissuaded these farmers from widely preferring the new Komboka variety. We provide prerequisite information that can support the commercialization and promotion of the Komboka variety. We also show that widespread favourable perception of new varieties hinges on matching preferences between breeders’ efforts for improved rice productivity with farmers’ needs for market competitiveness in these new varieties

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Technological Cost and Regulatory Framework and Uptake of Standards by Micro Small and Medium Enterprises in Kenya: A Case Study of Selected Enterprises in Nairobi County

<p>The purpose of the study was to investigate the technological factors and uptake of KEBS standards by micro small and medium enterprises in Kenya with specific reference to Nairobi County in Kenya. The specific purpose of the study was to determine how the cost of technology, technological competencies technological automation, and regulatory framework affect the uptake of standards by micro small, and medium enterprises in Kenya. A descriptive study methodology was used, and a case study approach was employed in the study to collect extensive and unambiguous data. Nairobi County was used with a target population of 2956 micro, small, and medium business enterprises. These were selected from the Kenya Bureau of Standards Product Certification office for firms with standardization marks since 2019. stratified random sampling techniques were applied to pick a sample of 296 MSMEs operating in Nairobi County. The data was corrected by use of open and closed questionnaires which were analyzed both qualitatively and quantitatively, where quantitative data was presented using tables and graphs while qualitative data was presented using descriptive notes. The findings from the analyzed data show that respondents agreed that the cost of technology technological competencies, technological automation, and regulatory framework affects the uptake of standards by micro small, and medium enterprises in Kenya. The sturdy recommended reduction in the cost of technology by lowering the price of equipment software and machines. There is a need to increase government funding for MSMEs and policies to support local production of equipment to ensure they are affordable for small businesses. Also, startup incentives and packages promote the use of KEBS Standards and the utilization of technology in production. This would result in a higher uptake of KEBS standards which has a positive correlation to economic development. This accelerates the growth of the manufacturing sector, creating employment, and increasing the GDP of the country. Higher profit due to quality products and services that are competitive in the market resulting in the growth of local production by micro, small, and medium enterprises. This is a huge milestone in opening up the country for industrialization and the attainment of sustainable development with economic, environmental, and social pillars.</p><p>Keywords:- Automation,Competence,Cost, Regulations, Uptake of Standards, Technological Cost, Regulatory Framework.</p&gt

Xpert® MTB/RIF assay on formalin-fixed paraffin-embedded tissues in the diagnosis of extrapulmonary tuberculosis

Background: Diagnosis of extrapulmonary tuberculosis continues to be a challenge due to the complexity of the causative organism and the wide array of pathologic features seen in this infection. Xpert MTB/RIF can be used on fresh or frozen tissue specimens for diagnosis of tuberculosis with good results. However, there is little data on its use with formalin-fixed paraffin-embedded (FFPE) tissues. Objectives: The aim of this study was to demonstrate the potential utility of Xpert MTB/RIF and to compare its performance to Ziehl-Neelsen staining for the detection of Mycobacterium tuberculosis from FFPE tissues using histological features from haematoxylin and eosin staining as the gold standard. Methods: Eighty randomly selected archival FFPE tissues exhibiting histological features of tuberculosis were included in the study. After deparaffinisation and lysis, all the tissue specimens were subjected to the Xpert® MTB/RIF assay. The outcome measures were proportions of positively identified cases by each test. Results: Using histology as the gold standard, the sensitivity of Ziehl-Neelsen staining was 20.3% (95% confidence interval: 12% – 30.8%), and the sensitivity of the Xpert® MTB/RIF assay was 53.2% (95% confidence interval: 41.6% – 64.9%); the difference was statistically significant (p = 0.002). None of the cases tested positive for rifampicin resistance. Conclusion: With prior deparaffinisation and lysis, FFPE tissues are amenable to testing by Xpert® MTB/RIF assay. A validation study to determine the clinical utility, analytical optimisation and cost implications of this assay for FFPE tissues is recommended

Perioperative changes in serum magnesium concentration during cholecystectomy with general anaesthesia

In the study we analysed the variation of serum magnesium (Mg) concentrations during perioperative period in twenty male and twenty female patients that were subjected to cholecystectomy under general anaesthesia. Five serum blood samples were collected at intervals: 1 h preoperative (S1), 3 min after the introduction in anaesthesia and intubation (S2), 1h (S3), 8h (S4) and 24h (S5) after the beginning of operation. The concentration of Mg in serum samples was determined by atomic absorption spectrophotometry. The mean value (± SD) serum Mg concentrations obtained were: S1:13.77 ± 5.60, S2:12.64 ± 3.78, S3:11.70 ± 5.18, S4:12.32 ± 4.73, S5:10.86 ± 3.76 μg/ml. Our results demonstrate a reduction of Mg concentrations between S2 and S3 in relation with S1. Increased Mg is observed in S4. In S5, there is a reduction of Mg concentrations in relation with S1. ANOVA and t-test were used for statistic analysis. It has been observed that the fluctuation of Mg concentrations depends on gender. The determination of Mg changes in blood serum perioperatively, shows the importance of Mg monitoring and significance in avoiding the complications because of its fluctuation