The Role of Current Emergency Radiology Practice: A prospective Cross-sectional Study Done at Tikur Anbessa Specialized Hospital

Background: The role of radiogy in the management of emergency  patients is tremendous. Which imaging modality best evaluates specific clinical emergencies has evolved and continues to advance with clinical practice trends. The purpose of this study was to show the role of radiology in emergency patient handeling and compare specific clinical entities with the standard.Methods: A prospective cross sectional study was done to describe the pattern of duty hour emergency utilization at Tikur Anbessa Hospital Department of Radiology. A total of 384 patient’s data were collected for the period of Jananuary 1st to April 30th 2010. The data which weredemographic variables, clinical diagnosis, radiologic diagnosis, type of investigation used, type of anatomic area imaged, whether primary investigation used or not, recommendations made by the radiology residents were collected and tabulated.Results: There were 242 (63%) males and 142 (37%) females. Suspected fracture was the commonest clinical indication for referring patients to the department of radiology at the duty hours and accounted for 40.9% of all cases. Otherclinical diagnoses included pnumonia (21.6%), blunt  abdominal trauma (5.7%) and pulmonary edema (4.7%). Plain  radiographs were taken in 88% of patients sent for imaging. Among the sonographic studies done, 43.4% were for patients presenting with blunt abdominal trauma. Of all patients in 90.4% primary investigative  modalities were used. Comparison of clinical and radiologic diagnosis was made in most common clinical cases and in general 51.3% of radiologic interpretations were normal.Conclusion: Plain radiography was used as the cornerstone investigative modality for emergency imaging. Fracture and pneumonia constituted the commonest indications for emergency imaging in all age groups. Over half of radiologic investigations were normal. It was observed that lack ofappropriate investigative modalities such as CT scan, doppler and high frequency ultrasonography greatly affected the quality of service the department offered and also negatively affected the training process.Key words: Emergency, Radiology, Practic

Incidence of neonatal morbidity at Gondar Town, Ethiopia

A CAJM article on rates of infant mortality in Gondar, Ethiopia.Perinatal, neonatal and infant mortality rates are now recognized indicators of child health in many countries and regions of the world. To this effect, there are numerous epidemiological and clinical studies that have focused on the causes of perinatal, neonatal and infant mortality in a given community or country. But, information on neonatal morbidity rates are not generally available.' The very limited data on neonatal morbidity also have problems of definition and are not as unambiguous and comprehensive as are the indices of mortality. Morbidity health interview surveys are widely used in developed countries to obtain information about sickness, disability, and the use of health facilities. An alternative method for collecting morbidity information is a survey based on physical examination where subjects are expected to attend a clinic or to be examined in their dwelling places. Use of clinical medical records also provide information on health as the need arises. Each of these systems of collecting information have their own advantages and disadvantages

Positively selected modifications in the pore of TbAQP2 allow pentamidine to enter Trypanosoma brucei

Mutations in the Trypanosoma brucei aquaporin AQP2 are associated with resistance to pentamidine and melarsoprol. We show that TbAQP2 but not TbAQP3 was positively selected for increased pore size from a common ancestor aquaporin. We demonstrate that TbAQP2’s unique architecture permits pentamidine permeation through its central pore and show how specific mutations in highly conserved motifs affect drug permeation. Introduction of key TbAQP2 amino acids into TbAQP3 renders the latter permeable to pentamidine. Molecular dynamics demonstrates that permeation by dicationic pentamidine is energetically favourable in TbAQP2, driven by the membrane potential, although aquaporins are normally strictly impermeable for ionic species. We also identify the structural determinants that make pentamidine a permeant although most other diamidine drugs are excluded. Our results have wide-ranging implications for optimising antitrypanosomal drugs and averting cross-resistance. Moreover, these new insights in aquaporin permeation may allow the pharmacological exploitation of other members of this ubiquitous gene family

Anopheles stephensi mosquitoes as vectors of Plasmodium vivax and P. falciparum, Horn of Africa, 2019

Anopheles stephensi mosquitoes, efficient vectors in parts of Asia and Africa, were found in 75.3% of water sources surveyed and contributed to 80.9% of wild-caught Anopheles mosquitoes in Awash Sebat Kilo, Ethiopia. High susceptibility of these mosquitoes to Plasmodium falciparum and vivax infection presents a challenge for malaria control in the Horn of Africa

School-based surveys of malaria in Oromia Regional State, Ethiopia: a rapid survey method for malaria in low transmission settings

BACKGROUND: In Ethiopia, malaria transmission is seasonal and unstable, with both Plasmodium falciparum and Plasmodium vivax endemic. Such spatial and temporal clustering of malaria only serves to underscore the importance of regularly collecting up-to-date malaria surveillance data to inform decision-making in malaria control. Cross-sectional school-based malaria surveys were conducted across Oromia Regional State to generate up-to-date data for planning malaria control interventions, as well as monitoring and evaluation of operational programme implementation. METHODS: Two hundred primary schools were randomly selected using a stratified and weighted sampling frame; 100 children aged five to 18 years were then randomly chosen within each school. Surveys were carried out in May 2009 and from October to December 2009, to coincide with the peak of malaria transmission in different parts of Oromia. Each child was tested for malaria by expert microscopy, their haemoglobin measured and a simple questionnaire completed. Satellite-derived environmental data were used to assess ecological correlates of Plasmodium infection; Bayesian geostatistical methods and Kulldorff's spatial scan statistic were employed to investigate spatial heterogeneity. RESULTS: A total 20,899 children from 197 schools provided blood samples, two selected schools were inaccessible and one school refused to participate. The overall prevalence of Plasmodium infection was found to be 0.56% (95% CI: 0.46-0.67%), with 53% of infections due to P. falciparum and 47% due to P. vivax. Of children surveyed, 17.6% (95% CI: 17.0-18.1%) were anaemic, while 46% reported sleeping under a mosquito net the previous night. Malaria was found at 30 (15%) schools to a maximum elevation of 2,187 metres, with school-level Plasmodium prevalence ranging between 0% and 14.5%. Although environmental variables were only weakly associated with P. falciparum and P. vivax infection, clusters of infection were identified within Oromia. CONCLUSION: These findings demonstrate the marked spatial heterogeneity of malaria in Oromia and, in general, Ethiopia, and provide a strong epidemiological basis for planning as well as monitoring and evaluating malaria control in a setting with seasonal and unstable malaria transmission

Primaquine in vivax malaria: an update and review on management issues

Primaquine was officially licensed as an anti-malarial drug by the FDA in 1952. It has remained the only FDA licensed drug capable of clearing the intra-hepatic schizonts and hypnozoites of Plasmodium vivax. This update and review focuses on five major aspects of primaquine use in treatment of vivax malaria, namely: a) evidence of efficacy of primaquine for its current indications; b) potential hazards of its widespread use, c) critical analysis of reported resistance against primaquine containing regimens; d) evidence for combining primaquine with artemisinins in areas of chloroquine resistance; and e) the potential for replacement of primaquine with newer drugs