Pattern of corrosive ingestion injuries in Port Harcourt: A ten year review

Background: Corrosive substance ingestion is a Global health concern as it results in varied damage to the digestive tract, ranging from minor injury to strictures, and sometimes even death. In the developing world the morbidity of corrosive ingestion particularly corrosive esophageal burns remains a significant but overlooked problem. The objective of this study is to determine the pattern of corrosive ingestion as seen in University of Port- Harcourt Teaching Hospital (UPTH) over a ten year period.Methodology: This is a retrospective descriptive study of the patients who were admitted with a history of corrosive ingestion to the department of Ear, Nose and Throat (E.N.T) surgery of UPTH over a ten year period (March 2005 to March 2010). Demographic and clinical data was obtained from the clinical records of the subjects and analyzed.Results: Thirty cases were seen over the study period. Theage range of the patients was 2-47 years old with a mean of 23.9 ± 13.4 years. Among adults there was a high incidence in the third decade while in children there was a high incidence among the under five. The most common type of corrosive ingested was caustic soda in 40% of cases. The commonest complication was esophageal stricture (40%). Fifty percent of cases were due to suicide attempt, while 9 (30%) cases were accidental ingestion of which all were children. The commonest clinical presentation was odynophagia (30%) while mortality accounted for 10% 0f cases.Conclusion: Corrosive injury is still a major surgical emergency in our society which carries a major risk of several complications (mainly esophageal stricture). There is a need for preventive measures to avoid accidental ingestion especially in children.Keywords: Corrosive ingestion, esophageal stricture

Media coverage of liver transplant events promotes donations from the deceased

Commentarypublished_or_final_versio

Ensemble of Hankel Matrices for Face Emotion Recognition

In this paper, a face emotion is considered as the result of the composition of multiple concurrent signals, each corresponding to the movements of a specific facial muscle. These concurrent signals are represented by means of a set of multi-scale appearance features that might be correlated with one or more concurrent signals. The extraction of these appearance features from a sequence of face images yields to a set of time series. This paper proposes to use the dynamics regulating each appearance feature time series to recognize among different face emotions. To this purpose, an ensemble of Hankel matrices corresponding to the extracted time series is used for emotion classification within a framework that combines nearest neighbor and a majority vote schema. Experimental results on a public available dataset shows that the adopted representation is promising and yields state-of-the-art accuracy in emotion classification.Comment: Paper to appear in Proc. of ICIAP 2015. arXiv admin note: text overlap with arXiv:1506.0500

The Limits of Anthropocene Narratives

The rapidly growing transdisciplinary enthusiasm about developing new kinds of Anthropocene stories is based on the shared assumption that the Anthropocene predicament is best made sense of by narrative means. Against this assumption, this article argues that the challenge we are facing today does not merely lie in telling either scientific, socio-political, or entangled Anthropocene narratives to come to terms with our current condition. Instead, the challenge lies in coming to grips with how the stories we can tell in the Anthropocene relate to the radical novelty of the Anthropocene condition about which no stories can be told. What we need to find are meaningful ways to reconcile an inherited commitment to narrativization and the collapse of storytelling as a vehicle of understanding the Anthropocene as our current predicament

Anti-Trypanosomal Potential Of Momordica Balsamina Linn Fruit Pulp Extract Against Trypanosoma brucei brucei Infection

The search for new trypanocides has not been keenly pursued due to high cost of design and development with no promise of financial returns. Momordica balsamina fruit pulp extract was screened for antitrypanosomal activity in experimental Trypanosoma brucei brucei infection in rabbits. The extract was administered prior to parasite inoculation, 24 hours post parasite inoculation and on establishment of infection. The treatment was by oral administration of the extract at 500mg/kg body weight for 14 consecutive days. Parasitaemia was monitored daily while body weight and packed cell volume (PCV) were determined before commencement of studies and subsequently at weekly intervals for 28 days. The result showed a significant (

A survey of UK medical schools' arrangements for early patient contact

Background: Many U.K. medical schools have patient contact in the first two years of the undergraduate course. Aim: To compare the purposes and organization of early patient contact in UK medical schools and to relate these arrangements to the schools' curricular objectives. Methods: A telephone survey of lead educators in UK medicals schools. Categories of contact were plotted against phases of the course to discern patterns of organisation. Results: The quantity of contact varies considerably (four to 65 days). There is a pattern, with learning objectives around the social context of health and illness preceding skills based work and integrated clinical knowledge for practice coming later. Schools fall into three categories: close adherence to the preclinical/clinical split, with limited early contact acting as an introduction to social aspects of health; provision of substantial patient contact to maximize the integration of knowledge and skills; and transitional, with limited clinical goals. General practice provides between one third and one half of early patient contact. Conclusions: Arrangements meet the objectives set by each school and reflect differing educational philosophies. Change is toward more early contact. There appears to be no national guidance which supports a minimum quantity of patient contact or specific educational purpose in the early years of U.K. basic medical training

Speed and Accuracy of Static Image Discrimination by Rats

When discriminating dynamic noisy sensory signals, human and primate subjects achieve higher accuracy when they take more time to decide, an effect attributed to accumulation of evidence over time to overcome neural noise. We measured the speed and accuracy of twelve freely behaving rats discriminating static, high contrast photographs of real-world objects for water reward in a self-paced task. Response latency was longer in correct trials compared to error trials. Discrimination accuracy increased with response latency over the range of 500-1200ms. We used morphs between previously learned images to vary the image similarity parametrically, and thereby modulate task difficulty from ceiling to chance. Over this range we find that rats take more time before responding in trials with more similar stimuli. We conclude that rats' perceptual decisions improve with time even in the absence of temporal information in the stimulus, and that rats modulate speed in response to discrimination difficulty to balance speed and accuracy

Effect of Intensive Patient Education vs Placebo Patient Education on Outcomes in Patients with Acute Low Back Pain: A Randomized Clinical Trial

© 2018 2018 American Medical Association. All rights reserved. Importance: Many patients with acute low back pain do not recover with basic first-line care (advice, reassurance, and simple analgesia, if necessary). It is unclear whether intensive patient education improves clinical outcomes for those patients already receiving first-line care. Objective: To determine the effectiveness of intensive patient education for patients with acute low back pain. Design, Setting, and Participants: This randomized, placebo-controlled clinical trial recruited patients from general practices, physiotherapy clinics, and a research center in Sydney, Australia, between September 10, 2013, and December 2, 2015. Trial follow-up was completed in December 17, 2016. Primary care practitioners invited 618 patients presenting with acute low back pain to participate. Researchers excluded 416 potential participants. All of the 202 eligible participants had low back pain of fewer than 6 weeks' duration and a high risk of developing chronic low back pain according to Predicting the Inception of Chronic Pain (PICKUP) Tool, a validated prognostic model. Participants were randomized in a 1:1 ratio to either patient education or placebo patient education. Interventions: All participants received recommended first-line care for acute low back pain from their usual practitioner. Participants received additional 2 × 1-hour sessions of patient education (information on pain and biopsychosocial contributors plus self-management techniques, such as remaining active and pacing) or placebo patient education (active listening, without information or advice). Main Outcomes and Measures: The primary outcome was pain intensity (11-point numeric rating scale) at 3 months. Secondary outcomes included disability (24-point Roland Morris Disability Questionnaire) at 1 week, and at 3, 6, and 12 months. Results: Of 202 participants randomized for the trial, the mean (SD) age of participants was 45 (14.5) years and 103 (51.0%) were female. Retention rates were greater than 90% at all time points. Intensive patient education was not more effective than placebo patient education at reducing pain intensity (3-month mean [SD] pain intensity: 2.1 [2.4] vs 2.4 [2.2]; mean difference at 3 months, -0.3 [95% CI, -1.0 to 0.3]). There was a small effect of intensive patient education on the secondary outcome of disability at 1 week (mean difference, -1.6 points on a 24-point scale [95% CI, -3.1 to -0.1]) and 3 months (mean difference, -1.7 points, [95% CI, -3.2 to -0.2]) but not at 6 or 12 months. Conclusions and Relevance: Adding 2 hours of patient education to recommended first-line care for patients with acute low back pain did not improve pain outcomes. Clinical guideline recommendations to provide complex and intensive support to high-risk patients with acute low back pain may have been premature. Trial Registration: Australian Clinical Trial Registration Number: 12612001180808

A metabolite-derived protein modification integrates glycolysis with KEAP1-NRF2 signalling.

Mechanisms that integrate the metabolic state of a cell with regulatory pathways are necessary to maintain cellular homeostasis. Endogenous, intrinsically reactive metabolites can form functional, covalent modifications on proteins without the aid of enzymes1,2, and regulate cellular functions such as metabolism3-5 and transcription6. An important 'sensor' protein that captures specific metabolic information and transforms it into an appropriate response is KEAP1, which contains reactive cysteine residues that collectively act as an electrophile sensor tuned to respond to reactive species resulting from endogenous and xenobiotic molecules. Covalent modification of KEAP1 results in reduced ubiquitination and the accumulation of NRF27,8, which then initiates the transcription of cytoprotective genes at antioxidant-response element loci. Here we identify a small-molecule inhibitor of the glycolytic enzyme PGK1, and reveal a direct link between glycolysis and NRF2 signalling. Inhibition of PGK1 results in accumulation of the reactive metabolite methylglyoxal, which selectively modifies KEAP1 to form a methylimidazole crosslink between proximal cysteine and arginine residues (MICA). This posttranslational modification results in the dimerization of KEAP1, the accumulation of NRF2 and activation of the NRF2 transcriptional program. These results demonstrate the existence of direct inter-pathway communication between glycolysis and the KEAP1-NRF2 transcriptional axis, provide insight into the metabolic regulation of the cellular stress response, and suggest a therapeutic strategy for controlling the cytoprotective antioxidant response in several human diseases