Unnecessary surgical operations on an undiagnosed sickler in abdominal crisis: Case report

This is a case of a child that presented with signs and symptoms of acute abdomen. There were scars from previous surgical operations on his abdomen following presentation with similar signs and symptoms suggestive of acute abdomen in two different hospitals. Furthermore, on careful physical examination some features of sickle cell anaemia were present. Blood was taken for laboratory investigations prior to commencement of intravenous 5% Dextrose-water. And lo! There was dramatic relief of his symptoms with a beam of smile on his face. Haemoglobin genotype revealed HbSS

Patterns of antibiotics susceptibility of isolates and plasmid analysis of Staphylococcus from surgical site infections in Nigeria

There has been a significant increase in resistance of common bacterial isolates from surgical site infections in our community resulting in prolonged hospital stay, disability and deaths of patients. In this vein,we surveyed the antibiotic susceptibility profiles of aerobic bacterial isolates from postoperative wound infections and determined whether resistance in Staphylococcus aureus was genetically mediated. A total of 161 isolates were obtained from 153 swab samples of infected wounds using cultural, morphological, and biochemical characteristics. The predominant bacterial isolates were: S. aureus (53.4%), Escherichia coli (23.0%), Staphylococcus epidermidis (11.2%), Pseudomonas aeruginosa (5.0%), and species of Klebsiella and Proteus 3.7% each. On the whole: Escherichia coli, Klebsiella and Proteus showed similar antibiotic susceptibility patterns viz: 66.7-100% for ciprofloxacin, 66.7-100% gentamicin and 50-80% augmentin; and less than 50% for amoxacillin, erythromycin, tetracycline, cotrimoxazole, cloxacillin and chloramphenicol. S. aureus showed percentage susceptibility of 50-100% and Staphylococcus epidermidis (50-100%) for cloxacillin and augmentin, and less than 60% for amoxacillin, erythromycin, tetracycline, cotrimoxazole, gentamicin and chloramphenicol. Multi drug resistance (MDR) of S. aureus strains to at least three classes of the antibiotics used was about 70.5%. Four out of the 11 MDR S. aureus strains were found to harbor plasmidswith varying molecular weights that ranged from 3.114 to 6.509 kb. One of the multi-drug resistant isolates still exhibited resistance even after curing. This showed that other genetic elements may also be involved in theacquisition of these forms of resistance other than plasmid elements.Key Words: Postoperative –Wounds-Aerobic bacteria-Staphylococcus aureus

Economics of Local Cow Milk Products Marketing in Kwara State, Nigeria

This study examined the local cow milk products marketing in Nigeria, using Kwara as a case study. Specifically, the study appraised socio-economic characteristics of local cow milk products marketers, the marketing profile and identified problems limiting marketing activities for local cow milk products. For the study 75 respondents were surveyed across the study area while data gathered were analysed using marketing margin and marketing efficiency analyses. Results show that only women were marketers of local cow milk products. The marketing chain for the commodity is simple and crude. It starts from the raw cow milk processors through retailers to the consumer. Local cow milk products include cheese: fried and raw, ‘nono’ (sour-milk), ‘mai sanu’(local butter) and ‘ori-amo’. However these products were poorly packaged. Estimated average marketing margin was ı90.6 per kg of processed milk while the estimated marketing efficiency is 115.5%. Most respondents sourced their marketing funds solely from their meager personal savings. Problems militating against the local milk products marketing were lack of efficient storage facilities and the seasonal supply/availability of cow milk. Considering the study findings, there is the need for stake-holders in the milk market to work out necessary improvements in the quality of local cow milk products. Researches and relevant efforts aimed at increasing cow milk yields in the study area should be stepped up so as to facilitate raw milk availability. Better processing equipment for the local milk processing activities should also be researched into. There is also the need to provide credit facilities to local cow milk processors and traders alike as this will go a long way to supplement marketer’s personal savings.Key words: retailers, consumers, marketing margin, marketing efficiency, personal saving

The Arclight vs. traditional ophthalmoscope:a cross-over trial

BACKGROUND/OBJECTIVES: To compare skill acquisition of the new, cost-effective Arclight ophthalmoscope, with the traditional ophthalmoscope (TO), in medical students with no prior experience of ophthalmoscopy. SUBJECTS/METHODS: University of Dundee medical students took part in a cross-over trial. Students were divided into two groups and were alternately taught each device using a video tutorial. In period one, Group A was taught the TO first; Group B was taught the Arclight. They were then assessed using simulated objective, structured, clinical, examinations, examining four model heads with lettered fundal photographs of varying sizes of font. Groups crossed over following a 2-week washout period and were taught the second device and reassessed. A questionnaire was distributed to ascertain students’ opinions and preferences. RESULTS: Forty medical students participated. Overall, 92.5% of students performed better with the Arclight, irrespective of cross-over trial period. The mean difference in score in period one of the cross-over trial was 16.77 (95% CI: 11.63–21.93), with students performing better with the Arclight (p < 0.0001). The mean difference in score in period two was 8.02 (95% CI: 4.52–11.52), with students performing better with the Arclight (p < 0.0001). In addition, performance with the TO improved by 52.9% following initial exposure to the Arclight. The Arclight was the preferred device by 82.5% of students, and 82.5% of students would choose this device for future practice. CONCLUSION: Students performed better with and preferred the Arclight ophthalmoscope. The Arclight could be considered as a suitable alternative to the TO used for training medical students

Usaha-usaha Milik Negara

Badan usaha milik negara (disingkat BUMN) merupakan pelaku ekonomi dalam sistem perekonomian secara nasional. BUMN didirikan dengan tujuan untuk mewujudkan kesejahteraan masyarakat dan memenuhi kebutuhan masyarakat di berbagai sektor. Beberapa sektor yang dinaungi BUMN diantaranya seperti sektor perkebunan, pertanian, perikanan, transportasi, perdagangan telekomunikasi, listrik, konstruksi, keuangan dan lainnya. Badan Usaha Milik Negara dimana badan usaha ini berperan besar yang tidak hanya untuk mensejahterakan masyarakat saja namun juga untuk meningkatkan pendapatan negara. Tujuan dari pendirian BUMN ini diantaranya: 1. Memberi sumbangsih bagi pertumbuhan dan perkembangan ekonomi nasional 2. Menambah penerimaan negara dari berbagai sektor usaha BUMN 3. Untuk memperoleh keuntungan dari semua sektor usaha BUMN 4. Bertanggungjawab atas penyediaan barang dan jasa yang berkualitas untuk memenuhi hajat hidup orang banyak 5. Menjadi pionir berbagai kegiatan usaha yang belum dilakukan oleh pihak swasta dan koperasi 6. Berpartisipasi aktif dalam membimbing dan membantu pengusaha ekonomi lemah, koperasi, dan masyarakat Kelebihan perusahaan BUMN ini meliputi penguasaan berbagai sektor yang vital bagi kehidupan masyarakat Indonesia, mendapat jaminan dan dukungan dari negara, Permodalan BUMN berasal dari negara, Kelangsungan hidup perusahaan BUMN lebih terjamin dan menjadi sumber pendapatan negara

Is bioelectrical impedance accurate for use in large epidemiological studies?

Percentage of body fat is strongly associated with the risk of several chronic diseases but its accurate measurement is difficult. Bioelectrical impedance analysis (BIA) is a relatively simple, quick and non-invasive technique, to measure body composition. It measures body fat accurately in controlled clinical conditions but its performance in the field is inconsistent. In large epidemiologic studies simpler surrogate techniques such as body mass index (BMI), waist circumference, and waist-hip ratio are frequently used instead of BIA to measure body fatness. We reviewed the rationale, theory, and technique of recently developed systems such as foot (or hand)-to-foot BIA measurement, and the elements that could influence its results in large epidemiologic studies. BIA results are influenced by factors such as the environment, ethnicity, phase of menstrual cycle, and underlying medical conditions. We concluded that BIA measurements validated for specific ethnic groups, populations and conditions can accurately measure body fat in those populations, but not others and suggest that for large epdiemiological studies with diverse populations BIA may not be the appropriate choice for body composition measurement unless specific calibration equations are developed for different groups participating in the study

Essential Medicines at the National Level : The Global Asthma Network's Essential Asthma Medicines Survey 2014

Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013-2020 sets an 80% target for essential NCD medicines' availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013-2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system's capacity to address NCDs.Peer reviewe

Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

[This corrects the article DOI: 10.1186/s13601-016-0116-9.]

Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

[This corrects the article DOI: 10.1186/s13601-016-0116-9.]

Positioning the principles of precision medicine in care pathways for allergic rhinitis and chronic rhinosinusitis - A EUFOREA-ARIA-EPOS-AIRWAYS ICP statement.

Precision medicine (PM) is increasingly recognized as the way forward for optimizing patient care. Introduced in the field of oncology, it is now considered of major interest in other medical domains like allergy and chronic airway diseases, which face an urgent need to improve the level of disease control, enhance patient satisfaction and increase effectiveness of preventive interventions. The combination of personalized care, prediction of treatment success, prevention of disease and patient participation in the elaboration of the treatment plan is expected to substantially improve the therapeutic approach for individuals suffering from chronic disabling conditions. Given the emerging data on the impact of patient stratification on treatment outcomes, European and American regulatory bodies support the principles of PM and its potential advantage over current treatment strategies. The aim of the current document was to propose a consensus on the position and gradual implementation of the principles of PM within existing adult treatment algorithms for allergic rhinitis (AR) and chronic rhinosinusitis (CRS). At the time of diagnosis, prediction of success of the initiated treatment and patient participation in the decision of the treatment plan can be implemented. The second-level approach ideally involves strategies to prevent progression of disease, in addition to prediction of success of therapy, and patient participation in the long-term therapeutic strategy. Endotype-driven treatment is part of a personalized approach and should be positioned at the tertiary level of care, given the efforts needed for its implementation and the high cost of molecular diagnosis and biological treatment