Pattern and Management of acquired Facial defects in Imo State University Teaching Hospital, Orlu, Nigeria.

Background: The face combines function with important aesthetic implications. With organs and units so closely related a fine balance and symmetry must be maintained in reconstructing facial defects. Imo State University Teaching Hospital Orlu, has the bulk of its patients drawn from neigbouring rural communities and are mainly of a low socioeconomic group. They therefore tend to present late with relatively complicated pathologies. This article looks at the pattern, aetiology and management approach for facial defects in our centre and highlights the challenges faced in managing these patients.Method: A review of clinical records of consecutive patients with acquired defects of the face managed at the Imo State University Teaching Hospital over a 12 month period was performed. Socio-demographic and clinical data were retrieved and analyzed.Results: There were 31 patients (15 males and 16 females) with 33 facial defects, and a mean age of 36.2 years. The lips were most commonly involved (30%). The eyelids and eyebrows were least affected. Most defects (48%) followed excision of neoplastic tumors and 87% of these were in Albinos. Human bite was the commonest cause of lip defects. The nasal defects more often required a combination of procedures with multiple theatre sessions. Ninety one percent (91%) of the defects were reconstructed primarily with good results.Conclusion: Surgical excision of squamous cell cancers in albinos and human bite are the commonest causes of facial defects in our  environment. In reconstructing facial defects of diverse aetiologies, adherence to laid down principles of facial reconstruction is necessary to achieve consistently acceptable results. We recommend primary repair of acquired facial defects as this gives optimal results. Keywords: Acquired facial defects; Pattern; Management; Nigeri

Transfer of Multidrug Resistance among Bacteria Isolated from Industrial Wastes

One hundred and twenty two (122) bacterial isolates belonging to the genera Micrococcus, Streptococcus, Pseudomonas, Actinomyces, Bacillus, Corynebacterium, Brucella, Shigella, Hafnia, Proteus and Salmonella were isolated from four different industrial waste sites. Thirty five (28.68%) of these were resistant to two or more antibiotics. Of these, multiple drug resistant species of Pseudomonas and Proteus were chosen as donors in resistance transfer studies with selected susceptible environmental and clinical isolates as recipients. Results showed that the drug resistance is transferable among environmental isolates and from environmental to clinical isolates. Following treatment with sodium dodecyl sulphate in a resistance curing protocol, thirty one (88. 57%) of the resistant isolates lost resistance to all the antimicrobial drugs to which they were previously resistant. These findings suggest that the resistance may be plasmid-mediated and promiscuous. The possible public health implication of this is discussed.Keywords: Industrial wastes, Bacterial isolates, Antimicrobial resistance, Resistance transfer, Curin

Adverse drug reactions in Ghanaian children: review of reports from 2000 to 2012 in VigiBase

Objective: The aim of this article is to describe adverse drug reactions (ADRs) reported for children aged 0 - 17 years in Ghana. Methods: Paediatric reports submitted by the Ghana National Centre for Pharmacovigilance to the World Health Organisation (WHO) Global ADR database, VigiBase up to December 2012 were extracted. The data were analysed for number of reports per year, types of reporters and suspected ADRs and drugs. Results: A total of 343 reports for children were received during the period. The drug classes most frequently reported were vaccines (115, 31%), antimalarials (106, 28%) and antibiotics (57, 15%). Of the top 20 individual drugs, 19 were anti-infectives. The most frequently reported ADRs were injection site infection, fever and rash. There were 23 deaths reported, and antimalarials were implicated in 12 cases. Conclusions: Vaccines, antimalarials and antibiotics are the leading medicines reported to cause ADRs in Ghanaian children. There was a high mortality rate, with many of the deaths due to causes explained in the individual case safety reports

Effects of Supersymmetric Threshold Corrections on High-Scale Flavor Textures

Integration of superpartners out of the spectrum induces potentially large contributions to Yukawa couplings. These corrections, the supersymmetric threshold corrections, therefore influence the CKM matrix prediction in a non-trivial way. We study effects of threshold corrections on high-scale flavor structures specified at the gauge coupling unification scale in supersymmetry. In our analysis, we first consider high-scale Yukawa textures which qualify phenomenologically viable at tree level, and find that they get completely disqualified after incorporating the threshold corrections. Next, we consider Yukawa couplings, such as those with five texture zeroes, which are incapable of explaining flavor-changing proceses. Incorporation of threshold corrections, however, makes them phenomenologically viable textures. Therefore, supersymmetric threshold corrections are found to leave observable impact on Yukawa couplings of quarks, and any confrontation of high-scale textures with experiments at the weak scale must take into account such corrections.Comment: 25 pages, submitted to JHE

Success Factors of European Syndromic Surveillance Systems: A Worked Example of Applying Qualitative Comparative Analysis

Introduction: Syndromic surveillance aims at augmenting traditional public health surveillance with timely information. To gain a head start, it mainly analyses existing data such as from web searches or patient records. Despite the setup of many syndromic surveillance systems, there is still much doubt about the benefit of the approach. There are diverse interactions between performance indicators such as timeliness and various system characteristics. This makes the performance assessment of syndromic surveillance systems a complex endeavour. We assessed if the comparison of several syndromic surveillance systems through Qualitative Comparative Analysis helps to evaluate performance and identify key success factors. Materials and Methods: We compiled case-based, mixed data on performance and characteristics of 19 syndromic surveillance systems in Europe from scientific and grey literature and from site visits. We identified success factors by applying crisp-set Qualitative Comparative Analysis. We focused on two main areas of syndromic surveillance application: seasonal influenza surveillance and situational awareness during different types of potentially health threatening events. Results: We found that syndromic surveillance systems might detect the onset or peak of seasonal influenza earlier if they analyse non-clinical data sources. Timely situational awareness during different types of events is supported by an automated syndromic surveillance system capable of analysing multiple syndromes. To our surprise, the analysis of multiple data sources was no key success factor for situational awareness. Conclusions: We suggest to consider these key success factors when designing or further developing syndromic surveillance systems. Qualitative Comparative Analysis helped interpreting complex, mixed data on small-N cases and resulted in concrete and practically relevant findings

Lepton flavour violation in the MSSM

We derive new constraints on the quantities delta_{XY}^{ij}, X,Y=L,R, which parametrise the flavour-off-diagonal terms of the charged slepton mass matrix in the MSSM. Considering mass and anomalous magnetic moment of the electron we obtain the bound |delta^{13}_{LL} delta^{13}_{RR}|<0.1 for tan beta=50, which involves the poorly constrained element delta^{13}_{RR}. We improve the predictions for the decays tau -> mu gamma, tau -> e gamma and mu -> e gamma by including two-loop corrections which are enhanced if tan beta is large. The finite renormalisation of the PMNS matrix from soft SUSY-breaking terms is derived and applied to the charged-Higgs-lepton vertex. We find that the experimental bound on BR(tau -> e gamma) severely limits the size of the MSSM loop correction to the PMNS element U_{e3}, which is important for the proper interpretation of a future U_{e3} measurement. Subsequently we confront our new values for delta^{ij}_{LL} with a GUT analysis. Further, we include the effects of dimension-5 Yukawa terms, which are needed to fix the Yukawa unification of the first two generations. If universal supersymmetry breaking occurs above the GUT scale, we find the flavour structure of the dimension-5 Yukawa couplings tightly constrained by mu -> e gamma.Comment: 37 pages, 15 figures; typo in Equation (35) and (49) correcte

Hurricanes and climate in the Caribbean during the past 3700 years BP

International audienceA multiproxy analysis of lacustrine sediments cored in Grand-Case Pond at Saint-Martin, north of the Lesser Antilles archipelago, reveals three distinct climatic periods for the last 3700 years. From 3700 to ~2500 yr cal. BP and from 1150 yr cal. BP to the present, carbonate mud deposition occurred in connection with pond lowstands. These periods were also punctuated by severe drought events, marked by gypsum laminae, and hurricane landfalls, leading to marine sand inputs into the pond. The intermediate time interval, from 2500 to 1150 yr cal. BP, is typified by black organic mud deposition, suggesting that hypoxic to anoxic conditions prevailed at the pond bottom. These were probably linked with a perennial pond highstand and reflect more uniform and wetter climatic conditions than today. The carbon isotopic composition of the ostracod Perissocytheridea bisulcata shows that the lowest δ13C values are recorded during the hypoxic periods, as a consequence of bacterial recycling of isotopically depleted organic matter. Such a climatic history agrees closely with that documented from other records in the Caribbean area, such as the Cariaco Basin, central coast of Belize or Barbados. By constrast, discrepancies seem to emerge from the comparison between hurricane activity recorded at Saint-Martin on the one hand and Vieques (Puerto Rico) on the other hand. We explain this apparent contradiction by a balance between two distinct storm paths in response to latitudinal shifts of the Intertropical Convergence Zone (ITCZ). Stronger storm activity over the Gulf coast and the inner Caribbean Sea is favoured by a southern position of the ITCZ in connection with dry climatic conditions. Plausible links with the North Atlantic Oscillation (NAO) are also suggested

Rotation Curves of Spiral Galaxies

Rotation curves of spiral galaxies are the major tool for determining the distribution of mass in spiral galaxies. They provide fundamental information for understanding the dynamics, evolution and formation of spiral galaxies. We describe various methods to derive rotation curves, and review the results obtained. We discuss the basic characteristics of observed rotation curves in relation to various galaxy properties, such as Hubble type, structure, activity, and environment.Comment: 40 pages, 6 gif figures; Ann. Rev. Astron. Astrophys. Vol. 39, p.137, 200

Intravenous Fluid Administration May Improve Post-Operative Course of Patients with Chronic Subdural Hematoma: A Retrospective Study

Background: The treatment of chronic subdural hematoma (cSDH) is still charged of significant risk of hematoma recurrence. Patient-related predictors and the surgical procedures themselves have been addressed in many studies. In contrast, postoperative management has infrequently been subjected to detailed analysis. Moreover variable intravenous fluid administration (IFA) was not reported in literature till now in the context of cSDH treatment. Methodology/Principal Findings: A total of 45 patients with cSDH were operated in our department via two burr hole craniostomy within one calendar year. Downward drainage was routinely left in hematoma cavity for a one day. Independent variables selected for the analysis were related to various aspects of patient management, including IFA. Two dependent variables were chosen as measure of clinical course: the rate of hematoma recurrence (RHR) and neurological status at discharge from hospital expressed in points of Glasgow Outcome Scale (GOS). Univariate and multivariate regression analyses were performed. Hematoma recurrence with subsequent evacuation occurred in 7 (15%) patients. Univariate regression analysis revealed that length of IFA after surgery influenced both dependent variables: RHR (p = 0.045) and GOS (p = 0.023). Multivariate regression performed by backward elimination method confirmed that IFA is a sole independent factor influencing RHR. Post hoc dichotomous division of patients revealed that those receiving at least 2000 ml/day over 3 day period revealed lower RHR than the group with less intensive IFA. (p = 0.031)