One year audit of surgical admissions at Gondar university medical college

Background: The new University of Gondar enrolled surgeons for post graduate training in November 2003. A new surgical curriculum was designed in partnership with the Leicester Gondar Link. Admissions to the Department of Surgery over twelve months were subject to audit. The objectives of the audit study were to introduce a new concept, to review the surgical experience of the Department, to support organizational change, to integrate audit into post graduate training, and to measure and improve the quality of the service.Method: Social, medical and administrative data on inpatients was recorded on a discharge summary sheet. The data was coded using a six letter descriptive code and transferred to a computer for presentation on a spread sheet.Results: The results list the social and the demographic distribution of patients; the surgical details including diagnosis, operation and outcome; and administrative data of patient numbers and duration of stay.Conclusion: The discussion is related the objectives of the study. The concept of audit was successfully introduced. Although data was incomplete, trends were apparent. The surgical experience of the Department was documented. The results supported the argument for organizational change including a move to sub-specialization. Audit has become an integral part of the postgraduate curriculum underwriting the monthly morbidity and mortality meetings and providing data for clinical research. The data has provided a baseline mortality rate and exposed quality issues for example, demographic restrictions on access to surgery, and the high mortality rate among patients with head injury

Prolactin Receptor in Primary Hyperparathyroidism – Expression, Functionality and Clinical Correlations

<div><h3>Background</h3><p>Primary hyperparathyroidism (PHPT) is an endocrine disorder most commonly affecting women, suggesting a role for female hormones and/or their receptors in parathyroid adenomas. We here investigated the prolactin receptor (PRLr) which is associated with tumours of the breast and other organs.</p> <h3>Methodology/Principal Findings</h3><p>PRLr expression was investigated in a panel of 37 patients with sporadic parathyroid tumours and its functionality in cultured parathyroid tumour cells. In comparison with other tissues and breast cancer cells, high levels of prolactin receptor gene (<em>PRLR</em>) transcripts were demonstrated in parathyroid tissues. PRLr products of 60/70 kDa were highly expressed in all parathyroid tumours. In addition varying levels of the 80 kDa PRLr isoform, with known proliferative activity, were demonstrated. In parathyroid tumours, PRLr immunoreactivity was observed in the cytoplasm (in all cases, n = 36), cytoplasmic granulae (n = 16), the plasma membrane (n = 12) or enlarged lysosomes (n = 4). In normal parathyroid rim (n = 28), PRLr was uniformly expressed in the cytoplasm and granulae. In <em>in vitro</em> studies of short-term cultured human parathyroid tumour cells, prolactin stimulation was associated with significant transcriptional changes in JAK/STAT, RIG-I like receptor and type II interferon signalling pathways as documented by gene expression profiling. Moreover, <em>PRLR</em> gene expression in parathyroid tumours was inversely correlated with the patients’ plasma calcium levels.</p> <h3>Conclusions</h3><p>We demonstrate that the prolactin receptor is highly abundant in human parathyroid tissues and that PRLr isoforms expression and PRLr subcellular localisation are altered in parathyroid tumours. Responsiveness of PRLr to physiological levels of prolactin was observed in the form of increased PTH secretion and altered gene transcription with significant increase of RIG-I like receptor, JAK-STAT and Type II interferon signalling pathways. These data suggest a role of the prolactin receptor in parathyroid adenomas.</p> </div

One Year Audit of Surgical Admissions at Gondar University Medical College

Background: The new University of Gondar enrolled surgeons for post graduate training in November 2003. A new surgical curriculum was designed in partnership with the Leicester Gondar Link. Admissions to the Department of Surgery over twelve months were subject to audit. The objectives of the audit study were to introduce a new concept, to review the surgical experience of the Department, to support organizational change, to integrate audit into post graduate training, and to measure and improve the quality of the service. Method: Social, medical and administrative data on inpatients was recorded on a discharge summary sheet. The data was coded using a six letter descriptive code and transferred to a computer for presentation on a spread sheet. Results: The results list the social and the demographic distribution of patients; the surgical details including diagnosis, operation and outcome; and administrative data of patient numbers and duration of stay. Conclusion: The discussion is related the objectives of the study. The concept of audit was successfully introduced. Although data was incomplete, trends were apparent. The surgical experience of the Department was documented. The results supported the argument for organizational change including a move to sub-specialization. Audit has become an integral part of the postgraduate curriculum underwriting the monthly morbidity and mortality meetings and providing data for clinical research. The data has provided a baseline mortality rate and exposed quality issues for example, demographic restrictions on access to surgery, and the high mortality rate among patients with head injury

Magnification of mantle resonance as a cause of tectonics

Variance spectral analysis of superconducting gravimeter (SG) decadal data (noise inclusive) is presented suggesting that the Earth tectonogenesis is based on magnification of the mass (mainly the mantle) mechanical resonance, in addition to or instead of previously hypothesized causes. Here the use of raw (gapped and unaltered) data is regarded as the criterion for a physical result validity, so data were not altered in any way. Then analogously to the atmospheric tidal forcing of global high frequency free oscillation, I propose that the Moon synodically recurring pull could likewise drive the long-periodic (12 to 120 minutes) oscillation of the Earth. To demonstrate this, I show that the daily magnitudes of mass (gravity) oscillation, as a relative measure of the non-stationary Earth kinetic energy, get synodically periodic while correlating up to 0.97 with seismic energies on the day of shallow and 3 days before deep earthquakes. The forced oscillator equations for the mantle usual viscosity and the Earth springtide and grave mode periods successfully model an identical 3 days phase. Finally, whereas reports on gravest earthquakes (of around M9.5) put the maximum coseismic displacement at around 10 m, the same equations predict the maximum displacement as 9.8 m, too. Hence, the same mechanism that causes bridges to collapse under the soldiers step marching could be making the lithosphere fail under the springtide induced magnification of mantle resonance resulting in strong earthquakes of unspecified type. If this assertion is correct, then many if not most large earthquakes could be spatially and temporally predictable.Comment: Published version, 14 pages, 6 figure