Clinical management of dietary induced urolithiasis associated with balanoposthitis in a Boer goat

A Boer-Kajang cross male goat was presented to the Veterinary Hospital, University Malaysia Kelantan with a history of dysuria, hematuria and restlessness. The goat was intensively managed (confined to the pen) and fed with only palm kernel cake for the last three months. Physical examination revealed that the goat was dull, depressed, having an inflamed penis and prepuce with blood stained urine dripping from the penis. The differential diagnoses were obstructive urolithiasis, urinary tract infection and balanoposthitis. Based on the history, clinical signs, physical examination, urinalysis, ultrasonagraphy and feed analysis, the goat was diagnosed with obstructive urolithiasis and balanoposthitis. Treatment was instituted by amputation of the urethral process and retrograde urohydropulsion to relieve the blockade. Sulfadiazine-trimethoprim (Norodine(®)24) 15mg/kg, I.M; flunixin meglumine 2.2mg/kg, I.M; vitamin B complex 1ml/10kg, I.M and ammonium chloride 300mg/kg orally were administered. The goat responded well to treatment and was recovering well during a follow up visit.

Energy-efficient stirred-tank photobioreactors for simultaneous carbon capture and municipal wastewater treatment

Algal based wastewater treatment (WWT) technologies are attracting renewed attention because they couple energy-efficient sustainable treatment with carbon capture, and reduce the carbon footprint of the process. A low-cost energy-efficient mixed microalgal culture-based pilot WWT system, coupled with carbon dioxide (CO2) sequestration, was investigated. The 21 L stirred-tank photobioreactors (STPBR) used light-emitting diodes as the light source, resulting in substantially reduced operational costs. The STPBR were operated at average optimal light intensity of 582.7 μmol.s(-1).m(-2), treating synthetic municipal wastewater containing approximately 250, 90 and 10 mg.L(-1) of soluble chemical oxygen demand (SCOD), ammonium (NH4-N), and phosphate, respectively. The STPBR were maintained for 64 days without oxygen supplementation, but had a supply of CO2 (25 mL.min(-1), 25% v/v in N2). Relatively high SCOD removal efficiency (>70%) was achieved in all STPBR. Low operational cost was achieved by eliminating the need for mechanical aeration, with microalgal photosynthesis providing all oxygenation. The STPBR achieved an energy saving of up to 95%, compared to the conventional AS system. This study demonstrates that microalgal photobioreactors can provide effective WWT and carbon capture, simultaneously, in a system with potential for scaling-up to municipal WWT plants.

Identification of a novel co-transcription of P450/1A1 with telomerase in A549

A novel co-transcription of CYP1A1 with hTERT, the active subunit of telomerase has been identified in alveolar epithelial cancer cell line (A549). This correlation was confirmed by chemically inducing the transcription of CYP1A1 in four cell lines: control normal lung cells (CCD-32Lu); alveolar epithelial cancer cell line (A549); large cell carcinoma (H460) and drug resistance large cell carcinoma (COR-L23/5010) observing a concomitant increase in hTERT mRNA level. In addition, siRNA was used to silence CYP1A1 transcription in A549 observing a decrease in the level of hTERT mRNA. The transcription correlation between CYP1A1 and hTERT may suggest a possible new mechanism for cancer therapy based on alternative gene targets. The co-transcription showed that the AhR pathway plays an active role in the activation of CYP1A1 which subsequently activates hTERT transcription. This study showed that the expression of CYP1A1 and CYP1A2 are cell specific and CYP2E1 and GSTM1 may not play a significant role in lung carcinogenesis.

Impact of a face-to-face educational intervention on improving the management of acute respiratory infections in private pharmacies and drug shops in Uganda

BACKGROUND

In Uganda, although private retail pharmacies and drug shops are the most common sources of drugs for the majority of the population, the quality of care received from these outlets has been reported as suboptimal. It is believed that lack of adequate knowledge is an important underlying factor to such practices.

OBJECTIVES

In this study, we investigated the impact of a face-to-face educational intervention on counter attendants' dispensing behaviour for mild and severe acute respiratory infections (ARI) in children at private pharmacies and drug shops.

STUDY DESIGN AND SETTING

We used a quasi-experimental research design with comparison groups to analyse counter attendants' management of ARI before and after an intervention. The study was conducted in Kampala District, and used a sample of 191 registered drug outlets (27 pharmacies and 164 drug shops), stratified into two groups: 1) An experimental group that received training; 2) A control group unexposed to training. Data on the practices in the drug outlets from both groups were collected at two time-points: seven months before the intervention, and at one-month after the intervention.

OUTCOME MEASURES

Two main outcome measures were considered: a) Assessment of the child's condition. b) The dispensing practices of counter attendants.

RESULTS

The study found that despite the training, the assessment of the child's condition remained inadequate in both groups, where the child's age was the only question asked in more than 90% of cases. High levels of inappropriate dispensing practices for both mild and severe ARI were still persistent in both groups after the intervention. Antibiotic prescribing for both conditions was very common, and barely any advice or instruction was given with dispensed drugs. Client demand for particular drugs, competition among drug outlets, and inability of most clients to afford the recommended treatments were the main reported barriers that emerged from the focus group discussions with the counter attendants.

CONCLUSIONS

The evaluation of the practices one month after the face-to-face educational intervention showed that the management of ARI did not improve in the drug outlets. While study design issues may have contributed to such findings, there are many other factors not related to knowledge and education that may indirectly hamper the promotion of appropriate dispensing in the private pharmacies and drug shops in Uganda. It is possible that a combination of interventions may contribute to improved management of ARI by counter attendants in the private drug shops and pharmacies in Uganda.

Management of acute respiratory infections in drug shops and private pharmacies in Uganda: a study of counter attendants' knowledge and reported behaviour

BACKGROUND

In Uganda, private pharmacies and drug shops are important sources of drugs for the majority of the population. In addition to selling drugs, these outlets often serve as primary sources of information about illness and drug therapy. However, the appropriateness of dispensing by staff in these drug outlets has been found to be suboptimal. Yet there has been no study documenting the determinants that underlie the dispensing pattern at these outlets. This study evaluated counter attendants' training background, their knowledge of acute respiratory infections (ARI), and their reported behaviour in the management of ARI in order to identify factors associated with dispensing behaviours.

STUDY DESIGN AND SETTING

This descriptive study was conducted in Kampala District, Uganda and used a cross-sectional survey research design to analyse the practice of 197 drug outlets including 28 pharmacies and 169 drug stores.

MAIN OUTCOME MEASURES

Counter attendants' training background; their knowledge of the causes, signs and symptoms of ARI; their perception of the dangers of ARI; and the drugs and advice offered for the management of mild and severe ARI.

RESULTS

Majority of the counter attendants had medical or pharmacy training. Most of them were nurses. The attendants' workload was generally low. High levels of self-medication among clients were reported at the outlets. Staff at a management level had low knowledge of the aetiology, signs and symptoms, and dangers of ARI. Prescribing an antibiotic was found to be the usual practice for managing ARI cases. Counter attendants at those outlets seldom gave advice or referrals for ARI cases. In particular, patient demand was a main barrier to appropriate dispensing. Strategies suggested by attendants for improving rational dispensing were to educate the public, provide training for the attendants, and re-enforce government supervision of drug outlets.

CONCLUSIONS

This study identified several self-reported inappropriate behaviours in the outlets. The formal training background and workload of counter attendants at drug shops and pharmacies were not found to be important contributors to irrational prescribing. The results of this study suggest that a combination of regulatory and educational interventions may yield to improvement in counter attendants' practices in private drug outlets.

Cryoglobulinaemia

Cryoglobulins are proteins, usually immunoglobulins that precipitate at temperatures less than 37 degrees C and redissolve on rewarming. Cryoglobulinaemias are classified according to the type of immunoglobulins and are associated with a number of disorders including plasma cell dyscrasias, lymphoproliferative disorders, autoimmune diseases and hepatitis C. The exact pathogenesis of the condition is not known. The clinical manifestations are varied and are due to ischaemia of tissues caused by the occlusion of vessel lumen. This review discusses the clinical manifestations, the current hypotheses of pathogenesis, the role of hepatitis C and finally the possibilities of treatment of the disease.

Low birthweight babies: socio-demographic and obstetric characteristics of adolescent mothers at Kenyatta National Hospital, Nairobi

OBJECTIVE

To compare some socio-demographic and obstetric factors between adolescent mothers (aged below 20 years) and older mothers of low birthweight (birthweight < 2000 gm) babies.

DESIGN

Cross sectional descriptive study.

SETTING

The Newborn Unit of the Kenyatta National Hospital.

RESULTS

Sixty nine adolescent mothers and 73 older mothers were studied. Adolescent mothers were more likely to be unmarried (p = 0.0001) have less formal education (p < 0.0001) be unemployed and be primigravida (76.5% compared to 36% of older mothers). Although the obstetric factors of antenatal clinic attendance, premature rupture of the membranes, pre-eclamptic toxaemia, infections and interventronal delivery tended to be more frequent among the adolescent mothers, non of these differences were significant probably due to the small numbers of patients studied.

CONCLUSION

This study does suggest mothers of very low birthweight babies tend to have unfavourable socio-demographic and obstetric factors like being single parents having less formal education, being unemployed and having obstetric risks for poor pregnancy outcome.

Morbidity and outcome of low birthweight babies of adolescent mothers at Kenyatta National Hospital, Nairobi

OBJECTIVE

To compare the morbidity and outcome of low birthweight babies (birthweight < 2000 gm) of adolescent (age < 20 years) and older mothers.

DESIGN

Cross sectional descriptive study.

SETTING

The newborn Unit of the Kenyatta National Hospital.

MAIN OUTCOME MEASURES

All babies weighing less than 2000 gm at birth whose mothers consented to the study had their gestational age verified using the Dubowitz scoring system. They were then followed up by daily clinical assessment until discharge, death or up to one month in the ward. The babies were divided into two groups according to their mother's age and then compared with respect to episodes of illness, duration of hospital stay, and overall outcome.

RESULTS

One hundred and forty two babies were studied. Of these, 64 were born to adolescent mothers. Babies of the adolescent mothers tended to be more premature (p = 0.0174), be lower in weight (p = 0.0078), had more occurrences of respiratory distress and anaemia (probably reflecting their increased prematurity) and had frequent multiple morbidity events They also had longer hospital stay and they were more likely to die (57.7% compared to 42.3% of babies of older mothers).

CONCLUSION

Low birthweight babies of the adolescent mothers were found to be more likely to have increased morbidity and adverse outcome compared to similar babies of older mothers.

Solitary fibrous tumour of the parotid gland

Solitary fibrous tumours are rare tumours originally described in the pleura. More recently there have been reports of these tumours arising at other sites including the parotid region. They are characterized histologically by a variety of growth patterns that can be confused by the unwary with other benign or malignant tumours particularly sarcomas. We present a case occurring in the pre-auricular region which presented diagnostic difficulties.