A Retrospective Operative and Early Outcome Comparison of Suprapubic Transvesical Prostatectomy and Transurethral resection of the Prostate

Background

BPH is the major cause of bladder outlet obstruction over the age of 40 years. Multiple surgical management options have been described of which STVP and TURP are the oldest and widely available procedures. The objective of this study is to describe and compare the intraoperative and early outcome situations of STVP and TURP.

Methods

This is a hospital-based retrospective descriptive study that compares intraoperative and early outcomes of STVP and TURP in Menilik II Hospital from January 2017 to December 2019. The study samples were 72 STVP and 72 TURP patients.

Results

The mean duration of surgery in the STVP group was 97.8 minutes which is significantly longer than TURP group (66.15 minutes). Duration of post-op catheterization and hospital stay are significantly longer in STVP than TURP.

Conclusion

The duration of surgery, length of hospital stays and post op catheterization are longer in STVP. There was no significant difference in intra-op and early complications from STVP and TURP.

Plant species used in traditional smallholder dairy processing in East Shoa, Ethiopia

Plant species used in traditional dairy processing were studied in three districts (Bosset, Ada, and Gimbichu) in Eastern Shoa, Ethiopia, from October 2007 to March 2008. A total of 300 smallholders were interviewed using semi-structured questionnaires, and three focus group discussions were conducted, followed by plants specimen collection and identification. A total of 36 plant species, falling under 24 plant families, were identified. Nearly half of the identified plant species had more than one use types. Eleven plant species were/are used for washing (scrubbing) dairy utensils, ten plant species for smoking dairy utensils, 12 plant species in butter making, 15 plant species in ghee making, and five plant species for packaging (wrapping) butter and cheese. The plant species that had the highest overall citations from each use category were Ocimum hardiense, Olea europaea subspecies africana, Trachyspermum copticum, Curcuma longa, and Croton macrostachyus. The plant species used in the three study districts, representing different agro ecologies, showed some similarities, but levels of uses differed significantly (P < 0.05). Higher informant citations might indicate their better efficacy, however need to be further investigated to determine their effects on milk and milk product quality and to make sure that they are innocuous to human and animal health. Finally, as the present study tried to document natural products used in traditional dairy processing, it could be considered as part of the global efforts aimed at promoting organic food production.

The effect of body condition on ovarian activity of free ranging tropical jennies (Equus asinus)

Serial ultrasonography was performed on seven jennies to study the effect of seasonally fluctuating body condition on ovarian activity during the dry, short rainy and long rainy seasons. Kendall Tau correlations and differences of least square mean values were compared. A distinct seasonal pattern was observed both in body condition and ovarian activity. The mean (+/-SD) Body Condition Score (BCS) was lowest during the dry season 2.6 +/- 0.45 when compared with 3.5 +/- 0.52 and 3.9 +/- 0.58 during the short and long rainy seasons, respectively. The mean (+/-SD) number of total follicles was also proportionally low 7.3 +/- 1.6 during the dry season compared with 9.6 +/- 2.4 and 11.3 +/- 3.3 found during the short and the long rainy seasons, respectively. The BCS was positively correlated to the total number of follicles and the diameter of the largest follicle during all seasons. Periods of increasing BCS and transition between seasons with both increasing and decreasing body conditions were strongly correlated to the number and size of ovarian follicles. Seasonal fluctuation in the body condition was found to be the result of variation in feed resource and ovarian activity was also closely following this seasonal pattern. The improvement in body condition has generally, a positive impact on emergence of small growing follicles there by having influence on the total count of ovarian follicles.

Application of ultrasonography in the study of the reproductive system of tropical jennies (shape Equus asinus)

The use of high-frequency (5 MHz) ultrasonography was studied in 11 jennies (7 non-pregnant and 4 pregnant) to characterize the reproductive organs and follicular activities at different stages of reproduction. The result showed close similarity with the mare. The visibility of endometrial folds increased towards ovulation. A positive correlation (p < 0.001; tau = 0.79) was found between the score of the folds and the size of the dominant follicle. The diameter of the uterus and the size of the dominant follicle were significantly correlated (p < 0.001; r = 0.80). In pregnant jennies, an embryonic vesicle was detectable at 14 days. Follicular growth was characterized by more than one wave. The smallest ovarian follicle was 2 mm and the largest 40mm. Depending on the reproductive stage, up to 13 follicles were detected per ovary. After monitoring 84 cycles, a mean (+/- SD) diameter of 34.4 +/- 3.6 mm (27.5-40.2 mm) of the preovulatory follicle and 67.85% incidence of single ovulation were found. The mean (+/-SD) interovulatory interval was 25.7 +/- 6 days. This study proved that high-frequency ultrasonography is highly effective in characterizing the reproductive organs and follicular activity of jennies and could be useful in the reproductive management of donkeys.

Minimum local anaesthetic dose (MLAD) of intrathecal levobupivacaine and ropivacaine for Caesarean section*

We determined the minimum local anaesthetic dose (MLAD) of spinal levobupivacaine and ropivacaine for Caesarean section. Ninety women were randomly allocated to two groups and received 3 ml of study solution by a combined spinal/epidural technique. The initial dose was 12 mg for levobupivacaine and 17 mg for ropivacaine groups. To be considered effective, a test solution had to achieve a visual analogue pain score (VAPS) of 30 mm or less at skin incision, uterine incision, birth, peritoneal closure, and at the end of surgery. Effective or ineffective responses determined, respectively, a 0.3 mg decrease or increase of the same drug for the next patient in the same group, using up-down sequential allocation. The MLAD of levobupivacaine was 10.58 mg (CI 95%: 10.08-11.09) and the MLAD of ropivacaine 14.22 mg (CI 95%: 13.67-14.77), using the Dixon and Massey formula. The potency ratio between spinal levobupivacaine and spinal ropivacaine was 1.34.

High volume of subarachnoid levobupivacaine decreases drug requirement in first stage labor analgesia

AIM

Using the statistic method of sequential allocation, we realized a prospective double-blind study in order to establish the minimum local anesthetic concentration (MLAC) of large intrathecal volume of levobupivacaine, during the first stage labour analgesia in spontaneous and induced laboring women.

METHODS

Seventy-five nulliparous, at term, with cervical dilatation <5 cm parturients requesting combined spinal/epidural analgesia, were enrolled. The starting concentration was chosen according to recent literature. Total volume of study solution was 10 ml and efficacy was assessed with a visual analogue pain scale at the height of the uterine contraction.

RESULTS

We established that MLAC of levobupivacaine, in 10 ml intrathecal volume, during the first stage of spontaneous and induced labour was 0.0134% and 0.0195%, respectively. No complications occurred during the study and the only side effect was shivering, which is common even in other anesthetic techniques. We produced a very selective sensitive block. Neither sympathetic nor motor block occurred.

CONCLUSIONS

Low intrathecally concentration of local anesthetic allows the anesthetist to reduce the total amount of drug and improves not only the differential blockade between motor and sensitive but also between sympathetic and sensitive fibers.

Control of schistosomiasis in Adwa, Ethiopia, using the plant molluscicide endod (Phytolacca dodecandra)

Control of Schistosoma mansoni transmission in a town in northern Ethiopia was attempted using the natural product, endod (Phytolacca dodecandra), and its use compared with niclosamide. Within a five year period prevalence was reduced from 61.5 to 36.4% in the area where endod was used. Most of this decline was accounted for by the reduction in prevalence among 1-6 year old subjects. The practical use of endod as a molluscicide was demonstrated to have a performance which compared favourably with the commercial product, and although more expensive than niclosamide still at minimal annual cost (US + 0.06 per capita).

A comparison of skin-test responses using antigen from Leishmania donovani and a lizard trypanosome

261 individuals were skin tested with leishmanin from Leishmania donovani and with an antigen from a lizard trypanosome isolated in an area endemic for kala-azar in Ethiopia. 83 of the 261 responded positively, with indurations of 5 mm or greater, to one antigen but negatively to the other, and 42 reacted positively to both. Among the Afar people of the Awash valley in north-eastern Ethiopia and the Nyangatom people of south-western Ethiopia, positive response to both antigens was high, though many individuals responded to one antigen but not the other. Both these groups live as cattle pasturalists, a predominantly male occupation, in areas where known vectors of kala-azar as well as lizard-feeding sandflies exist. Among the Anuak and Suri people, who live in areas of south-western Ethiopia infested with tsetse flies, the lizard trypanosome antigen gave a markedly higher skin test positivity than did the leishmanin antigen. This suggests that the lizard trypanosome may give artificially high results in other immunological tests of exposure to trypanosomiasis in areas where lizard trypanosomes and man-biting sandflies co-exist with mammalian trypanosomes transmitted by Glossina.

Kala-azar in Ethiopia: survey of south-west Ethiopia. The Leishmanin skin test and epidemiological studies

The Leishmanin skin test was performed on 1353 people in a kala-azar endemic region of south-west Ethiopia. Physical examinations were also carried out on 2723. Two of these individuals, both males, had active visceral leishmaniasis with Leishmania organisms demonstrated by spleen puncture. Two other males, including one member of the research team, had parasitologically proven cutaneous leishmaniasis. Because there was negligible migration and little movement of individuals outside of their tribal territories, the geographical distribution of skin test positivity and clinical findings could be determined and correlated with environmental parameters. The level of positive skin tests for the groups tested ranged from over 64% for the three tribes collectively inhabiting the lower regions of the Omo Valley (altitude approx. 500 m) to 6.4% for the Suri tribe, which lives at 1400 m. Skin test positivity was highest in areas of deeply fissuring montmorillonite soils and where Phlebotomus langeroni orientalis have been collected. Termite mounds of the pipe-organ type seemed to occur independently of the proportion of positive skin tests, possibly because alternative resting and breeding sites for sandflies were available in the cotton clay soil or because of the cultural patterns of the people. Almost always, males had a markedly higher prevalence of positive skin tests than did females. The degree of positivity was strongly correlated with increasing age, most positive conversions occurring in the ten to 20 year olds, the age at which males join cattle camps as part of their herding activities. Splenomegaly reached a prevalence of nearly 50% among the Hamar speaking people to the east of the Omo River, where the pattern of disease suggests malaria as the principal cause. Hepatomegaly, however, was highest in the lower Omo Basin among the Nyangatom, Dassanetch and Kerre, where hydatid disease was a major cause of liver enlargement, but seemed unrelated to the proportion of positive Leishmanin skin tests.

Schistosomiasis in Omo National Park of southwest Ethiopia

Schistosomiasis mansoni infection was found in more than 50 tourists who had visited Omo National Park, Ethiopia, and bathed and swum in the Mui River. A survey revealed Schistosoma mansoni infection in 41% of Park residents and in 33% of the neighboring Suri people. Eggs were found in stools and adult worms at autopsy of wild Papio anubis and Cercopithecus aethiops. Trematode larvae were found in 27% of Biomphalaria pfeifferi snails found in the Mui River. The source of the disease and the implications of its spread with the future development of the Omo Valley are discussed.

Schistosoma haematobium in the Wabi Shebelle Valley of Ethiopia

A survey of the lower Wabi Shebelle Valley of southeastern Ethiopia was made to assess the presence of schistosomiasis haematobia in the modernized plantation of Gode and adjacent areas. The disease is present in Kellafo, Mustahil, and in the Burukur flood plain 100 km downstream from Gode, and absent further north. This is related to the ecology of the different areas.

Haematobium schistosomiasis among seminomadic and agricultural Afar in Ethiopia

Parasitological and malacological surveys were made in the Afar tribal area on the flood plains of the Awash River. S. haematobium--infections are most prevalent among seminomadic Afar living around the swamps and lakes in the middle part of the Awash Valley. Infection rates between 6 and 52% were found among seminomadic Afar and between 0 and 27% in agricultural groups. The highly localised distribution of vesical schistosomiasis is maintained by the distribution of the swamps, lakes and the human population and by migration patterns. On the marshy plain near Gewani significantly higher infection rates occur among Afar females than males. This is apparently due to sex differences in water contact patterns.

Kala-azar in Ethopia I: Leishmanin skin test in Setit Humera, a kala-azar endemic area in northwestern Ethopia

Leishmannin skin test surveys were carried out on 1057 farmers and non-farmers in the low-lying Setit Humera area of northwest Ethiopia, a region known to be endemic for kala-azar. The population of the Humera area is composed mainly of new migrants, and the mean time of residence for the entire population is only 4-4 years. The corresponding periods for the urban and farm-owning population are 6-3 years and migrant farm labourers 2-6 years. Most of the population comes from the highland provinces of Begemdir, Tigre, and Wollo, areas where kala-azar is virtually unknown except for two recent cases (Ashford et al., 1973b). 45-6% of farmers were skin test positive, but only 8-3% of non-farmers. Women in this area are only rarely involved in farming, hence there is a concommitant marked sex difference. The skin test results seem to be correlated with the results for sex, age, and occupation of known kala-azar patients. The percentage of skin test positivity increases with age and, particularly among farmers, with the length of time spent in the Humera lowlands. This correlation is lacking among non-farmers. The annual rate of infection to Leishmania sufficient to result in skin test conversion is around 7% per annum in agricultural workers in the Humera area, but less than 1% per annum in the non-farming population. The infection rate for farm workers to Leishmania prior to coming to Humera is around 2%, compared to less than 1% for the non-farmers. There appears (significant at 10%) to be a weak correlation between the induration of positive skin test and the length of time spent in Humera, suggesting that the degree of induration is related to the degree of exposure to Leishmania. The positive skin test in kala-azar endemic areas is probably the result of (a) nonpathogenic Leishmania species, (b) L. donovani of low virulence and/or (c) human host resistance to L. donovani.

Studies on Schistosoma bovis in Ethiopia

Schistosoma bovis occurs in at least seven of the 14 rovinces of Ethiopia. Results of faecal and snail surveys in three foci are reported. Adwa. One collection showed that nine out of 26 bulinids were infected with S. bovis. The snail host was a tetraploid form of Bulinus (n = 36). The examination of 200 specimens of cattle faces revealed no S. bovis eggs, which was attributed to poor technique or light infection. Gewani. The snail host was Bulinus abyssinicus, which was also infected with S. haematobium, the combined infection rate being 60%. S. bovis eggs were seen in 1-5% (3/197) of specimens of cattle faeces. Lake Awassa. Among 715 bulinids(a mixture of diploid (n = 18) and tetraploid (n = 36) forms), 22 were infected with S. bovis. Infected snails all belonged to the tetraploid form. Infection in cattle faeces was 5-5%(11/200). The Fasciola infection rates in these three areas were 29%, 78% and 60% respectively. Susceptibility of laboratory and wild animals to the Gewani and Lake Awassa strains of S. bovis was investigated. Combined results show that there are at least five species of wild rodents in Ethiopia which are susceptible to S. bovis: Arvicanthis niloticus, Praomys albipes, Rattus rattus, Mastomys coucha and Lophuromys flavopunctatus, in addition to hamsters, white mice, rabbits and guinea pigs. Immature female worms resembling S. bovis were recovered from a goat and a sheep exposed to a mixture of S. bovis and S. haematobium cercariae shed by naturally infected snails. Using the same mixture of cercariae, a Gelada baboon (Theropithecus gelada) could be infected by both schistosomes, but a dog was completely refractory. ABSCESS. Some of these inconclusive results are thought to be due to a unisexual infection. The Gewani strain of SEWANI STRAIN OF S. bovis had a wider range of snail hosts than the Adwa and Awassa strains, covering the tropicus, truncatus and africanus groups of Bulinus. The Adwa and Awassa strains could infect only members of the truncatus group.

Laboratory and field evaluation of the molluscicidal properties of Phytolacca dodecandra

Dried berries of endod (Phytolacca dodecandra) (known also as soapberry) are widely used in Ethiopia instead of soap for laundering clothes. It was observed that in natural bodies of water where endod had been used there was a high mortality of snails. Subsequently, the molluscicidal potencies of various parts of male and female endod plants were determined and the berries were found to be the most potent. The potency of endod remained stable over a wide range of temperatures and pH values, in the presence of various concentrations of river-bed mud and after ultraviolet irradiation of solutions. The toxicity of endod to mammals and plants has been shown to be very low. Its toxicity to snail eggs also is low but it has been shown that this difficulty can be overcome in the field by repeated treatments. Endod kills leeches and schistosome cercariae and miracidia at very low concentrations. Comparative tests with endod and several standard molluscicides have given encouraging results.Being a natural product, endod could become a cheap and effective means of controlling schistosomiasis in certain areas since, under suitable climatic conditions, the plant grows rapidly and bears fruit twice a year.