bluuebunny/crossref_metadata_2025 huggingface dataset:
Cotton/Polyester Blends with Improved Dyeability and Physical Performance via Gamma Rays
Authors: Nasr H. I. , Etman M. H. , El-Karadly E. A.
Published: January 2017

A cotton/polyester blend is radiation-grafted with a copolymer (allylamine + acrylic acid) to varied add-ons at different doses of Co-60 gamma rays. The amphoteric character imparted to this radiation-chemically-treated blend is due to the fixation of carboxyl and amino groups on the polyester and cotton cellulose chains by a radiation-induced free-radical mechanism. The treated blend acquires new remarkable dyeing affinity towards basic and acid dyes, to which originally both the untreated blend components have no affinity. Hence, dyeing the blend with a single dye, to a desirable solid color, by a one-bath process is feasible. Moreover, an additional improvement in the wrinkle-resistance performance of the treated blended fabrics is recorded, due to the formation of crosslinks between the components chains, accompanied by a significant increase in tensile strength and elongation-at-break.

Parameters investigated during this work are radiation dose (0.2–1.6 Mrad for 1/2 to 4 h), composition of treating monomer solutions, effect of pH, and role of neutralizing acids. Textile evaluations reported are visual dyeing affinity, crease-recovery, tensile strength, and elongation-at-break.
Movement of the Winding Point on Warp-Wound Yarn Packages Using Tilted Rings
Authors: Elbert D. L.
Published: January 2017

A theoretical description of the winding path of yarn on a warp-wind ring and traveler package with a tilted ring is derived. Amplitude and maximum helix angle of the periodic motion of the winding point are given in terms of ring tilt, ring diameter, yarn speed, spindle speed, and instantaneous bobbin diameter.
Characterization of Cotton-Polyester Blends by Electron Spectroscopy (ESCA)
Authors: Soignet D. M. , Berni R. J. , Janssen H. J.
Published: January 2017

Electron spectroscopy for chemical analyses (ESCA) was used to determine the percentage composition of cotton/polyester blend fabrics. The ratio of the C1s/O1s signal strengths was directly related to the composition of the blend. Additionally C1a and O1a peak shapes and full widths at half height varied as the amount of cotton in the blend changed.
The Effect of a Method of Dissolution of Graft Copolymer of Polyacrylonitrile and Poly(Methyl Acrylate) on Drawability and Properties of Spun Fibers
Authors: El-Garf Samy Abdel Monem
Published: January 2017

It was found that dissolution of the graft copolymer has an effect on drawability and other properties of fibers spun from this graft copolymer. The resistance to double bending and abrasion resistance are considerably decreased with the increase of the dissolution temperature. The breaking properties were not greatly changed. The maximum loop and knotted yarn strength was reached when the polymer was dissolved by heating. These values are 100% and 99% of the original, respectively—higher than those obtained from PAN and PANM. The presence of 5% PMA in the side chains of the graft copolymer increased the flexibility of these chains. This is evident from the decrease of the initial modulus of elasticity from the values obtained for PANM and PAN.
Thermal Decomposition of Polypyrrolidone in the Solid State
Authors: Kakar S. K.
Published: January 2017

Polypyrrolidone was thermally degraded in the solid state at 180, 200, 210, and 220°C. Kinetic parameters for overall degradation were determined. Analysis of volatile products showed that 2-pyrrolidone was the major product of decomposition. Infrared analysis of nonvolatile products showed that bands in the region of 900–1130 cm-1 were sensitive to thermal energy. Various possible reactions that lead to the formation of 2-pyrrolidone are discussed briefly.
Multidrug-Resistant Typhoid Fever
Authors: Kabra S K , Madhulika  , Talati A , Soni N , Patel S , Modi R R
Published: January 2017

One hundred children (consecutive) with positive blood culture for Salmonella typhi were studied for clinical profile and complications. The common clinical features were fever (100%), vomiting (58%), abdominal pain (48%), cough (22%) and loose stools (14%) and the Widal test was positive in 75% patients. Eighty per cent of the salmonella isolates were resistant to amoxycillin, chloramphenicol and co-trimoxazole drugs, but all were sensitive to ciprofloxacin and ceftriaxone. Forty patients developed complications: encephalopathy (18), melaena (12), haematemesis (10), epistaxis (4), hepatitis (4), acalculous cholecystitis (4), bowel perforation (3) and nephritis (2). Complications were more frequent in children with multidrug-resistant typhoid. The final antibiotic required to render the children afebrile included ciprofloxacin (80), ceftriaxone, amoxycillin (4), chloramphenicol (4), amoxycillin and gentamicin (4), amoxycillin with chloramphenicol (2), and furazolidone (2). The defervesence time was least with ceftriaxone and greatest with amoxycillin. All the affected children made a complete recovery.
Suicide Incidence in the Lalitpur District of Central Nepal
Authors: Thapa Beki , Carlough Martha C
Published: January 2017

Suicide is an important cause of death in developing and developed countries. Because of its multifactorial nature it is often difficult to study. Suicide also brings with it social stigma and, in some cases, legal repercussions. Suicide is generally underreported and, therefore, services directed at decreasing its incidence are not given priority. This retrospective study of suicide deaths over a period of 2 years in the Lalitpur district of rural Nepal demonstrates the complicated issues involved, and suggests some appropriate strategies for addressing suicide risk.
Towards a Rational Malaria Management at District Hospital Level: Exploratory Case Series of Febrile Adult Patients in a Holoendemic Area of Tanzania
Authors: Oster N , Krause E , Hatz Ch
Published: January 2017

One hundred and sixty eight febrile adult outpatients were investigated at St Francis Designated District Hospital in Ifakara, a holoendemic area in Tanzania. We wanted to assess the potential anamnestic and clinical risk indicators for malaria and to establish a rational strategy for malaria management. Blood slide investigations showed that 14% of all patients were positive for P. falciparum. All the positive cases were found during the rainy season. No reliable criteria for malaria were found in the history taking and physical examinations. Signs and symptoms of respiratory tract infection such as difficulties during breathing, sore throat, chest pain, cough, pathological findings in lung auscultation and combinations of these were negatively associated with malaria parasitaemia. The same was true for lymph node swelling and a clinical diagnosis other than malaria. Quality control of blood slide results from the hospital revealed a sensitivity of 55%, a specificity of 72%, and positive and negative predictive values of 24% and 91%. The main recommendations for malaria management in adults were to improve the quality of blood slide examinations and to use a different diagnostic strategy during the dry and rainy seasons. During the dry season blood slides of febrile adult patients should only be performed if there is a suspicion of malaria and antimalarial drugs should only be administered if blood slide results are positive. During the rainy season all febrile adults without obvious cause of fever other than malaria should be treated with antimalarials without previous blood slide examination.
Childhood Non-Drug Poisoning in Nnewi, Nigeria
Authors: Orisakwe O E , Egenti L , Orish C
Published: January 2017

While poisonings from developed nations have been extensively described there is a dearth of information on poisoning in societies which have different patterns of daily life, customs, products and beliefs. This study surveys childhood non-drug poisoning, the circumstances of exposure, prevalence demographics and products as well as therapy. The commonest poisoning is kerosene (paraffin), incidence was 2/1000 and the age at highest risk is 12–24 months. Often cases were inappropriately managed at home before arriving at the hospital.
Cholecystectomy in Jamaican Children with Homozygous Sickle-Cell Disease
Authors: Duncan N D , McDonald A H , Mitchell D I G
Published: January 2017

Twenty-seven children aged 18 years and under with homozygous sickle-cell disease had open cholecystectomy for symptomatic gallstones over the 12-year period 1985–1997. Emergency procedures (done during period of acute exacerbation of symptoms) were performed on 16 patients. Four with haemoglobin levels greater than 1 g/dl below their steady state received a simple blood transfusion preoperatively designed to raise haemoglobin levels to 10 g/dl. All had acute or acute on chronic cholecystitis based on histological examination of gallbladder specimens.

Twelve had common bile duct stones. In two patients calculi were missed intraoperatively but these subsequently passed into the duodenum after a period saline irrigation via an in-situ t-tube. Six developed the acute chest syndrome (aetiology not determined) and this progressed to multi system failure and death in one. This high level of postoperative mobility and mortality may in part be due to the high proportion of emergency procedures.
Operative Management of Thyroid Abnormalities in a General Medical Practice Hospital in Sub-Saharan Africa
Authors: OlaOlorun David A , Meier Donald E , Tarpley John L
Published: January 2017

This is a retrospective analysis of 82 patients undergoing thyroid operations in a general medical practice hospital in sub-Saharan Africa. All patients complained of neck swelling, and in 75% of patients this was the only symptom. Indications for operation included cosmesis in 74%, suspected malignancy in 13%, hyperthyroidism in 7% and pressure symptoms in 5%. Operative complications included recurrent laryngeal nerve injury in two (2.4%), wound haematoma in two (2.4%), wound infection in three (3.6%) and hypoparathyroidism in one (1.2%). There were no deaths and no instances of thyroid storm. Thyromegaly can be operatively managed in a hospital such as ours with a relatively low morbidity rate using conservative gland extirpation techniques. This conservative approach may result in under treatment for thyroid maligancies but should result in a lower incidence of recurrent nerve damage and hypoparathyroidism in the majority of people who undergo thyroidectomy solely for cosmetic indications.
Caregivers' Perceptions and Experiences of ‘Kangaroo Care’ in a Developing Country
Authors: Kambarami R A , Mutambirwa J , Maramba P P P
Published: January 2017

The widespread use of ‘kangaroo care’ is yet to be realized despite strong evidence to suggest that this method of preterm care is safe, effective and affordable. We need to understand users' perception of this method of care. We studied, through focus group discussions, caregivers' experiences and perceptions of this method in a tertiary level hospital of a developing country. We conclude that, in this hospital, caregivers preferred kangaroo care to conventional methods. Communities' awareness of this method of care and its advantages must be improved.
Reasons for Non-Immunization of Children in an Urban, Low Income Group in North India
Authors: Mathew Joseph L , Babbar Harsh , Yadav Sangita
Published: January 2017

A study was undertaken on 500 children under the age of 5 years belonging to a low income group. All were attending the paediatrics outpatient department of a large teaching hospital in New Delhi, India. Only 25% were found to have received complete primary immunization as per the National Immunization Schedule (bacille Calmette-Guérin at birth, three doses of diphtheria, pertussis and tetanus and oral poliovirus vaccine at 6, 10 and 14 weeks and measles vaccine at 9 months). The major reasons for non-immunization of the children were: migration to a native village (26.4%); domestic problems (9.6%); the immunization centre was located too far from their home (9.6%); and the child was unwell when the vaccination was due (9%). Twelve per cent of mothers could not give any reason for non-immunization. In addition to the migration of children to rural areas, the other significant finding was an indirect effect of intensive OPV administration as part of polio eradication initiative. The lack of awareness and fear of side effects constituted a small minority of reasons for non-immunization.
Mosquito Bed Nets: Implementation in Rural Villages in Zambia and the Effect on Subclinical Parasitaemia and Haemoglobin
Authors: McClean Karen L , Senthilselvan A
Published: January 2017

Malaria continues to be an increasing health concern in many endemic areas where it remains a major contributor to childhood morbidity and mortality. Chemoprophylaxis and treatment are increasingly compromised by drug resistance. Vaccination for malaria is not yet available outside clinical trials. In clinical trials bed nets have been shown to be effective in reducing malarial morbidity and mortality. Their efficacy outside of the clinical trial setting has been less well documented. We describe our experience with the introduction of bed nets in a remote rural Zambian village and document the effect on malarial parasitaemia, spleen rates and haemoglobin. Children were evaluated at the end of the rainy seasons in April 1998 and April 1999. Insecticide impregnated nets were made available for purchase to the village in July 1998. Rates of parasitaemia and anaemia were significantly reduced.
Ability of Mothers to Assess the Presence of Fever in Their Children without Using a Thermometer
Authors: Alves João Guilherme Bezerra , Correia Jailson de Barros
Published: January 2017

Fever is a common complaint in paediatrics and the ability of mothers to identify high temperatures in their children when there is no thermometer available needs to be assessed. A total of 169 mothers from a low social and economic background were studied to assess the accuracy of fever diagnosis in their children by palpation. In 137 children with axillary temperatures ≤ 38°C as measured by a mercury glass thermometer, mothers were able to detect fever by palpation in 104 cases (sensitivity of 75.9%). In another 32 children without fever, 29 were correctly identified (specificity of 90.6%). Only 21% of mothers in the study had a thermometer in their home and only 44% of these knew how to use it properly. Results show that mothers use palpation to assess the presence of fever in their children and are able to do it correctly in most cases.
Discharge against Medical Advice
Authors: Ohanaka E C
Published: January 2017

An audit of surgical patients who requested discharge against medical advice over a 5 year period (July 1996–July 2001) at the University of Benin Teaching Hospital showed that 78 patients (66 males and 12 females) were involved. The age range was 3 days to 85 years (mean 37.86 years). The 21–40 age group was the most involved. Trauma in general accounted for the most common clinical condition that caused a patient to discharge against medical advice (64 or 82%), while fracture involving the long bones was the most common condition (37 or 47.4%). The plausible reasons for this practice have been outlined including measures that may help to reduce discharge against medical advice in a developing country.
Reproductive Health in Mongolia: Results from Three Provinces and One Urban District
Authors: Kipp Walter , Sodnompil T , Tuya M , Erdenchimeg E , Nymadawa P
Published: January 2017

The purpose of this study was to obtain data for facilitating the planning, monitoring and evaluation of reproductive health services in Mongolia. The survey was carried out in 17 randomly selected health facilities where health professionals were graded on their reproductive health knowledge and also in 64 adjacent households where 162 women of childbearing age were interviewed for their comments on reproductive health services and to obtain their reproductive health knowledge/behaviour. We rated the reproductive healthcare delivery system, using the methodology of Kielmann et al. The results from the women's interviews are encouraging and show a high acceptance of and satisfaction with family planning services.
Marking of Wire-Localized Breast Biopsies for Mammographically Detected Microcalcifications
Authors: Shirley Suzanne E , Soares Deanne P
Published: January 2017

Impalpable breast lesions that are detected during screening mammography for breast cancer must be accurately identified and adequately sampled in biopsy specimens. Open wire-localized breast biopsy using hookwires remains the main method of sampling these lesions in centres without expensive stereotactic facilities. However, the hookwires can shift or become dislodged in the biopsy specimen. We have successfully modified a simple technique for the localization of impalpable lesions in these biopsies. The insertion of a small hypodermic needle into the fixed specimen with the assistance of the compression paddle and crosshairs on the mammography machine resulted in the precise localization of clusters of microcalcifications in 15 of 16 (94%) cases. In contrast, calcifications were identified in sections taken in the plane of the hookwire in only three cases (19%). The rate of detection of malignancy was 50% and the majority of malignant lesions were represented by ductal carcinoma in situ.
The Diagnosis of Extrapulmonary Tuberculosis in Malawi
Authors: Harries Anthony D , Hargreaves Nicola J , Kwanjana John H , Salaniponi Felix M
Published: January 2017

There is little information on a country-wide basis in sub-Saharan Africa about how the diagnosis of extra-pulmonary tuberculosis (EPTB) is made. A country-wide cross-sectional study was carried out in 40 non-private hospitals in Malawi which register and treat (TB) patients in order to assess diagnostic practices in adults registered with EPTB. All patients aged 15 years and above in hospital on treatment for EPTB were reviewed using TB registers, case note files and clinical assessment.

There were 244 patients, 132 men and 112 women whose mean age was 36 years. In 138 (57%) patients, all appropriate procedures and investigations, commensurate with hospital resources, had been carried out. Of 171 EPTB patients with cough for 3 weeks or longer, 138 (81%) submitted sputum specimens for smear microscopy of acid-fast bacilli (AFB). A confirmed diagnosis of TB was made in 15 (6%) patients based on finding AFB or caseating granulomas in specimens. In 157 (64%) patients, the diagnosis of EPTB was considered to be correct. In 46 (19%) patients the diagnosis was considered to be TB, although different from the type of EPTB with which the patient was registered. In 39 (16%) patients an alternative non-TB diagnosis was made and in two (1%) patients it was not possible to make a decision. Diagnostic practices need to be improved, and ways of doing this are discussed.
Contribution to the Surgical Treatment of Patients with Cervical Spine Cord Injury Using Simple Procedures
Authors: Leal Manoel B , Borges Guilherme , da Silva Benedito Borges , de Almeida Bruno Ribeiro
Published: January 2017

Thirty-nine patients with acute cervical spine fractures and/or dislocations between C3 and C7 were submitted to an anterior approach using bone graft fixation without screw and plate systems and three required a preliminary posterior approach to reduce a dislocation. Graft dislodgement due to technical problems occurred at a rate of 7.7% postoperatively and 2.8% 1 month later. No redislodgement occurred. All fusions became solid after 3 months. Their progress was based on the Frankel scale, before surgery, at the moment of the discharge, and at 6 months follow-up. This experience shows how patients with an acute cervical injury can improve even when admitted late after trauma.
Admission Troponin T as a Prognostic Marker and its Relationship to Streptokinase Treatment in Patients with Acute Myocardial Infarction
Authors: Kazmi Khawar A , Iqbal M Perwaiz , Rahbar Abdul , Mehboobali Naseema
Published: January 2017

The relationship between the admission troponin T (TnT) level and the response to streptokinase (SK) was examined in 76 patients with acute myocardial infarction (AMI). Of 27 TnT positive patients, 10 (37%) showed a response to SK as suggested by a non-invasive criterion for reperfusion, while 24 (49%) were ‘responders’ among 49 TnT negative patients. There appeared to be a trend towards a better response to SK in the TnT negative group but the difference lacked statistical power due to the small sample size.

The mean time-interval between the onset of symptoms and thrombolytic treatment among TnT positive ‘non-responders’ was significantly ( P <0.005) higher than the TnT negative ‘non-responders’ (5.23 ±3.42 h versus 2.38 ± 1.37 h). An 18 month follow up on 61 patients revealed a higher mortality (33%) among TnT positive patients than TnT negative patients (10%). Mortality among TnT positive ‘non-responders’ was significantly higher ( P=0.0494) than mortality among TnT-negative ‘non-responders’ (43% versus 9%), indicating that TnT positive patients, non-responsive to SK were at a greater risk of cardiac death. The data suggest that the admission TnT level can be of value in risk stratification of patients with AMI.
Alternative Medicine Use at Vila Central Hospital Vanuatu: A Survey of the Use of ‘Custom Medicine’ in Patients and Staff
Authors: Maden Christopher , McKendrick Sophie , Grace Robert
Published: January 2017

A structured questionnaire was developed to assess the use of custom (traditional or herbal) medicine in 50 medical and 50 surgical inpatients and 50 staff at Vila Central Hospital, Vanuatu. Eighty-six per cent of those interviewed had used custom medicine at least once, 60% within the last year. Twenty-one medical patients (42%) had used custom medicine for their current problem, 12% whilst in hospital. Eighteen surgical patients (36%) had used custom medicine for their current problem, 6% whilst in hospital. Fourteen of the staff (28%) interviewed had used custom medicine within the last year. Sixty-nine per cent of interviewees stated that custom medicine had improved their condition. Whilst custom medicine use was common across all attained education levels, there was a trend for those with higher levels of education to use less custom medicine. The most common form of custom medicine was leaf tea, followed by leaf applications, cutting, magic, massage and chanting. The majority of these were made/prescribed by local ‘Klevas’ (custom doctors). The cost of the ‘medicine’ was often substantial, generally many times the cost of a day in hospital. These findings indicate a high prevalence of custom medicine use within Vanuatu. Clinicians must be alert to the possibility of their patients using custom medicine even whilst in hospital and the potential for custom medicine to contribute to the clinical problems. Late presentation of patients to hospital is common in Vanuatu, and the use of custom medicine is partially a contributing factor to this. It also poses questions as to patient confidence in health services.
A Guide to Sending E-Mail Telemedicine Referrals
Authors: Vassallo D J
Published: January 2017

This article describes simple e-mail protocols that have proven their effectiveness in the telemedicine links established by the Swinfen Charitable Trust. They are presented here as a guide for the benefit of those doctors who may be considering setting up their own telemedicine links.
Convexity Meningioma Presenting as Postpartum Eclampsia
Authors: Shehu Bello B , Ismail Nasiru J
Published: January 2017

A 37-year-old woman, Para 5+0 presented with a 1 year history of recurrent convulsions and progressive weakness of the right side of the body. She had been treated for postpartum eclampsia in her last delivery but symptoms recurred 3 months later. Evaluation including computerized tomography scan of the brain suggested a parieto-temporal meningioma, which was completely excised at craniotomy. Histology confirmed this to be a meningioma. The patient was well at 8 months of follow up. The growth of meningiomas may increase during pregnancy due to presence of receptors for progestational hormones in the tumour and the meningioma may become symptomatic in pregnancy, presenting as eclampsia. Close follow up of patients with eclampsia is necessary to identify neurological features that may lead to a diagnosis of meningioma. Early diagnosis is essential if a good outcome is to be ensured.
Fluid Management of Severefalciparum Malaria in African Children
Authors: Pamba Allan , Maitland Kathryn
Published: January 2017

Most African children with severe malaria who die do so on the day of admission as a result of the complications of falciparum malaria. We highlight the value of a rapid structured triage assessment to look for emergency signs that will prioritize initial management and implementation of basic life support. This can be delivered with few resources and by non-specialist medical personnel. Reduction in case fatality can only come through the wider appreciation of the need for and application of supportive therapies to treat the life-threatening complications. Hypovolaemia has emerged as a common feature of children presenting with severe malaria complicated by acidosis. Early recognition and prompt treatment may lead to improvements in outcome. We discuss the new evidence supporting the role of hypovolaemia in severe malaria and potential treatment options whilst awaiting the results of clinical trials.
Management of Seizures in Children with Falciparum Malaria
Authors: Ogutu B R , Newton C R J C
Published: January 2017

Falciparum malaria is the most common cause of convulsions in children admitted to hospital in malaria endemic areas. Detection of convulsions requires close monitoring and one should be on the look out for signs of subtle convulsions. About a third of acute seizures in children with cerebral malaria, do not manifest as convulsions, but as changes in eye deviation, salivation and/or eye deviation. It is important to terminate convulsions lasting more than 5 min, since prolonged convulsions are associated with neurological deficits in survivors of children with severe malaria. Initial management should include putting the child into the left lateral position, checking the blood glucose and administering oxygen if hypoxic. The benzodiazepines, particularly diazepam, are used as the initial anticonvulsants. Phénobarbital and Phenytoin are used as second-line treatments. Prompt and effective management of falciparum malaria associated convulsions may contribute to a better outcome in children with severe malaria.
Epidemiology of Dog Bites: A Community-Based Study in India
Authors: Agarwal N , Reddajah V P
Published: January 2017

Rabies is a deadly disease with no cure which is mainly caused by dog bites. Data on dog bites and knowledge, attitude and practices (KAP) related to dog bites are not generally available to rural communities.

We made a cross-sectional study of a rural community of ten villages served by a primary health centre selected by random sampling. Ten per cent of households selected by systematic random sampling were interviewed for KAP regarding dog bites.

The dog bite rate was 25.7/1000 population per year. The rate for males was higher than for females; half of the bites were in summer; 40% did not go for any prophylaxis; half of the victims treated their wounds with chilli powder. Eighty per cent of the bites were class II or III and leg bites were most common. The majority of the community knew dog bites can cause death but they did not know the correct incubation period. Most knew that injections were available to prevent rabies. Only half said they would visit a hospital for treatment. Around 50% received tetanus toxoid.
Traditional Healers' Practices and the Spread of HIV/AIDS in South Eastern Nigeria
Authors: Peters E J , Immananagha K K , Essien O E , Ekott J U
Published: January 2017

A 3-year (1997-1999) prospective study was carried out to evaluate the possible role of traditional healers (THs) in the spread of HIV/AIDS in south eastern Nigeria. Their patients' knowledge of HIV infection was also ascertained during the review period. Four contiguous states in south eastern Nigeria with high prevalent rates of HIV infection were chosen for the survey. Sixtynine patients of THs were randomly selected and contacted from the patients' list of five selected THs in each state. Thus, a total of 20 THs and 69 patients formed subjects of the study.

The study involved a face-to-face interview of the subjects by trained health personnel in each state using a prepared structured questionnaire. The questionnaire elicited information on their biodata, past/present medical history, social/family history, nature and mode of treatment received or administered, and their knowledge of HIV infection, where applicable.

The results showed that there was a serious HIV/AIDS related risk inherent in the practices of Nigerian THs patronized by over 60% of the population. This was suggested by the continuous usage of unsterilized instruments and crosscontamination with patients' blood and body fluid in their practices. It was further revealed that, the patients' HIV/AIDS related knowledge was poor (30%).

Basic education on HIV/AIDSmust be given to all groups in Nigeria inciudingTHs, their patients and general public. The World Health Organization and other agencies involved in the fight against HIV infection should focus on the safety of THs' practices as a possible mode of transmission of HIV infection in Africa. Unlessthis aspect is taken seriously along with other preventive strategies already adopted, the epidemic of the disease condition may continue to spread in Africa.
Community Perception and Readiness for Anti-Helminth Programmes in Rural Nepal
Authors: Poudyal Amod Kumar , Jimba Masamine , Murakami Izumi , Sherchand Jeevan B , Silwal Ram Chandra , Wakai Susumu
Published: January 2017

We report on the community perception of helminth infection and readiness to participate in and pay for a community-based anti-helminth programme in rural Nepal. For data collection, 28 focus group discussions (FGDs) were conducted in 28 communities. The FGD results revealed that community members were lacking in scientific knowledge about helminth infection. They also had an unusual perception about it - they believed that a ‘mul juka’ (vital worm) should reside in every person's stomach from birth, and must never be killed. Nonetheless, the results showed that the community members were willing to participate in and were ready to contribute their resources to the anti-helminth programmes as long as modern medicine would not kill the ‘mul juka’. Such community readiness provides us with hope for developing a sustainable anti-helminth programme at the community level through effective health education.
Atraumatic Sutures Can Be Made Locally
Authors: van Oosterwyk Arie
Published: January 2017

The usefulness of fishing line in surgical practice has previously been described in this journal. Now, this usefulness is further enhanced by the possibility of producing an atraumatic suture using a pair of modified pliers.
Adhesion Intestinal Obstruction in Children in Northern Nigeria
Authors: Ameh E A , Nmadu P T
Published: January 2017

In developing countries, reports on adhesion intestinal obstruction in children are scanty. We report 30 children managed for adhesion intestinal obstruction during a 16-year period. The age range was 10 weeks-14 years (median 9 years). There were 24 boys and 6 girls. Postoperative adhesion was the cause in 13 (43%) patients, inflammatory in 11 (37%), and in 5 (17%) no cause could be identified. In one patient, adhesion followed missed ileal perforation from blunt abdominal trauma. Duration of symptoms was 1–21 days (median 4 days). Only four of the 13 patients with postoperative adhesion obstruction were managed conservatively initially, but this failed in all; one was found to have an intestinal perforation at laparotomy. The remaining nine had immediate laparotomy owing to presence of features of strangulation at presentation; two required intestinal resection for gangrene. All other patients had laparotomy soon after resuscitation. The resection rate for gangrene was 13% and 3% required closure of perforations. Postoperatively six (20%) patients developed eight infective complications. There was recurrence in three of 27 (11%) surviving patients within 3 months. Mortality was three (10%). The presentation of adhesion intestinal obstruction in children in northern Nigeria is late and morbidity and mortality are high. Early presentation should improve the outcome.
Reference Values for Peak Expiratory Flow Rate in Adults of African Descent
Authors: Njoku C H , Anah C O
Published: January 2017

Substantial racial differences in the values of peak expiratory flow (PEF) rate have been noted by several workers in the past. It has also been noted that applying prediction formulae derived from a Caucasian population overestimated the PEF values in Black Africans by 12%–15%. Yet reference values used up until the present, even among Black populations, are based on such formulae. This study provides new reference values for use in the Black population. They were obtained by using curvilinear formulae derived from the study of 1009 normal adult Nigerians (668 men and 341 women) between the ages of 15 years and 82 years, living and/or working in Port Harcourt, Nigeria and its hinterland.
Stroke Subtypes in Black Tanzanians: A Retrospective Study of Computerized Tomography Scan Diagnoses at Muhimbili National Hospital, Dar es
Authors: Matuja W , Janabi M , Kazema R , Mashuke D
Published: January 2017

Limited data are available on the stroke subtypes in Tanzania and sub-Saharan Africa. The present study was aimed at determining retrospectively the pattern of confirmed strokes in all patients in our hospital who had been given a computerized tomography (CT) brain scan during the study period (April 2001 to May 2002). Over the 12-month period 371 CT brain scans were taken, of which 148 showed stroke, 89 (60.1%) showed haemorrhage and 59 (39.9%) showed infarcts ( P<0.05). Among the haemorrhagic group 48 (53.9%) were men and 41 (46.1%) women, while 31 (52.5%) men and 28 (47.5%) women had infarction. We concluded that there were relatively more cases of cerebral haemorrhage than infarction. Hypertension and diabetes mellitus were common risk factors in both subtypes of stroke.
Histological Spectrum of Chronic Hepatitis in Precore Mutants and Wild-Type Hepatitis B Virus Infection
Authors: Sakhuja Puja , Malhotra Veena , Gondal Ranjana , Sarin Shiv K , Guptan R , Thakur Varsha
Published: January 2017

This study compares the histology of liver biopsies in precore mutant (PCM) and wild-type hepatitis B virus (HBV) infection. Thirty cases of PCM and 60 cases of wild-type HBV infection were included. Patients were diagnosed on the basis of serological profile and HBV DNA assessment. Liver biopsies in each case were assessed for histological activity and stage of fibrosis using a modification of Knodell's scoring system. There was no statistically significant ( P=0.14) difference in histological activity in the two groups. The difference in stage of fibrosis in the two groups was statistically significant ( P=0.001). Quantitative estimation of viral load did not show any correlation with liver histology. PCM HBV showed greater stage of fibrosis compared with wild-type infection, and this may be related to disease progression and lack of response to therapy.
Androgens in Childhood Acquired Aplastic Anaemia in Chandigarh, India
Authors: Marwaha R K , Bansal Deepak , Trehan Amita , Varma Neelam
Published: January 2017

This study assessed the efficacy of stanozolol in acquired aplastic anaemia (AA) in children, who were unable to opt for alternative therapies due to financial constraints. It uses a retrospective case-record analysis. Medical records of children with AA who received stanozolol were analysed. Their clinical and haematological profile was studied and the outcome assessed. Forty-nine children with acquired AA received stanozolol (1 mg/kg/day) in the period between January 1991 and December 2000. The median age at diagnosis was 9 years (range: 1.5–13). Thirteen (26.5%) defaulted therapy after periods of 1–4 weeks and 11 (22.4%) died within 2 months of starting treatment. Ten (20.4%) responded, whilst 15 (30.6%) did not. None of the patients with very severe AA responded, two (28.6%) with severe AA responded and eight (38%) with non-severe AA had a response. All responses were partial except one. Median time taken to respond was 11 weeks (range: 1–20). Responders were treated fora median duration of 25 weeks (range: 13-155), and they were followed-up for a median duration of 25 months (range: 3–144). Eight (80%) responders were off drugs for a median duration of 18 months (range: 6–110). Stanazolol is ineffective for severe and very severe AA. As it induced remission in 38% of our patients with non-severe AA, it can be tried in this group if other methods of treatment are unaffordable or have failed. A short history of presentation (<3 months) and ≥ 70% lymphoid cells in marrow correlated with poor prognosis.
Prevalence of HIV-Positives and Hepatitis B Surface Antigen-Positives among Donors in the University of Beninteaching Hospital, Nigeria
Authors: Oronsaye Francis E , Oronsaye J I
Published: January 2017

The purpose of this study is to determine the rate of human immunodeficiency virus (HIV) and hepatitis B surface antigen (HBsAg) among commercial blood donors in the University of Benin Teaching Hospital. Five thousand seven hundred and thirty-seven prospective commercial blood donors were screened for both HIV and HBsAg. Three hundred and eighty-three (7%) donors were positive for HIV while 609 donors (11%) were positive for HBsAg. Thirty-seven donors were positive for both HIVand HBsAg. The need to make the screening of blood donors for HIVand HBsAg compulsory in all hospitals is crucial so that the spread of HIV and HBsAg can be prevented.
Pattern of Intraocular Pressure in Epidemic Dropsy in India
Authors: Malik K P S , Dadeya Subhash , Gupta V S , Sharan Pratibha , Guliani  , Dhawan Munish
Published: January 2017

This study was conducted to report on the intraocular pressure (IOP) pattern in patients with epidemic dropsy. Two hundred and thirty proven cases of epidemic dropsy were sent for ocular examination. We measured IOP by applanation tonometry at different intervals. Patients were followed up until 24 weeks. Intraocular pressure of more than 22 mm of Hg was detected in 10.86% patients at the start of the study. However, at 12 weeks only 0.43% patients needed medication for control of IOP. None required medication for IOP control after 20 weeks. The rise of IOP in this case series of epidemic dropsy appeared to be a transient phenomenon and drugs needed to be titrated on a weekly basis.
Day-Case Adenotonsillectomy: Suitable in the Tropics?
Authors: da Lilly-Tariah O B
Published: January 2017

This study evaluates the outcome of offering day-case adenotonsillectomy in a hospital in the tropics. Seventy-seven patients with adenotonsillitis requiring surgery were admitted, operated upon and discharged within 12 h and were also evaluated for complications. There were no complications severe enough to warrant readmission. Day-case adenotonsillectomy is safe and acceptable in a developing country.
Abdominal Echinococcosis during Pregnancy: Clinical Aspects and Management of a Series of Cases in Chile
Authors: Manterola Carlos , Espinoza Rodolfo , Munoz Sergio , Vial Manuel , Bustos Luis , Losada Héctor , Barroso Manuel
Published: January 2017

Twelve pregnant women with hydatid disease are presented with median age of 29;11 (91.7%) had a liver cyst and one (8.3%) had a kidney cyst as the primary disease location. Four (33.3%) had additional cysts located in the pelvis, peritoneal cavity and/or spleen; eight (66.7%) had two or more abdominal cysts. Three patients (25.0%) had surgery at the 3rd month after delivery and nine (75.0%) during their pregnancy. There was no histological evidence of hydatid disease in placentas, and no serological evidence of echinococcosis in the newborns was confirmed. One patient died after surgery. After a mean follow-up time of 39.5 months, we found one recurrent case of pelvic hydatid disease. Management of abdominal echinococcosis during pregnancy is an uncommon and difficult problem owing to the serious potential risks for mother and child.
Necrotizing Fasciitis
Authors: Ogundiran T O , Akute O O , Oluwatosin O M
Published: January 2017

Necrotizing fasciitis (NF) is a rare but rapidly progressive and potentially fatal disease condition. It is characterized by progressive inflammation and extensive necrosis of the subcutaneous tissue and fascia, sparing the underlying tissue. It is a poly-bacterial infection and is associated with profound systemic toxicity, considerable morbidity and a high mortality rate. The outcome is influenced by early recognition and radical surgical debridement. We present a report of six cases of NF who presented to our surgical service within the past 5 years.
A Little Known Complication in an Obstructed Right Inguinal Hernia: Five Patients with Afferent Limb Strangulation
Authors: Wegdam Harry H J , Tetteh Alfred
Published: January 2017

Within a period of 6 months five cases of afferent limb strangulation in patients with an obstructed right inguinal hernia were seen and treated in our institution and are described in this report. Recommendations to avoid pitfalls in the management of similar cases are reported.
Propharmacies: A Problematic Means of Drug Distribution in Rural Cameroon
Authors: van der Geest Sjaak
Published: January 2017

Attention is drawn to two fundamental obstacles to an efficient functioning of government-supported drugstores (propharmacies) in rural Cameroon. These obstacles are mismanagement and high prices. Suggestions are offered as to how the drugstores can be made more efficient.
Acute Poisoning in the Emergency Room
Authors: Tunwashe O L , Odukoya O O , Atiba J O
Published: January 2017

This paper reviews 146 cases of acute poisoning seen and treated by us at the adult accident and emergency centre of Lagos University Teaching Hospital, Nigeria, between 1979 and 1982. Barbiturates (19%) and benzodiazepines (17%) were the commonest drugs used in acute poisoning. The highest incidence (41%) was found among persons aged 18–25 years. There were 67 males and 79 females (1:1.2). About 14% took a “cocktail” of more than one drug. Self-poisoning occurred in 74%; 8.6% were apparently suicidal; 15.8% were accidental; and 1.4% were homicidal. Fifty of the patients (33%) were unconscious on admission.

The centre's management technique is briefly discussed and the need for a poisons information centre in the country is highlighted.
Vaginal Trichomoniasis
Authors: Omer El-Fadil E , Catterall R D , Ali M H , El-Naeem H A , Erwa H H
Published: January 2017

At a sexually transmitted disease clinic at Khartoum 613 Sudanese women presenting with vaginal discharge were investigated. Specimens were examined by microscopy and culture. Trichomonas vaginalis infestation was found in 123 patients (20.1%), predominantly in the age groups 16–19 years (27.1%) and 46–65 years (27%). Frequency of trichomonal vaginitis was highest (35.9%) among divorced women. Of the pregnant women investigated, 16.3% were found to harbour the parasite. There was no significant difference in the parity of parasitized and non-parasitized patients.
Medico-Veterinary Collaboration
Authors: Cooper John E
Published: January 2017

There is a need for closer collaboration between the medical and veterinary professions, particularly in tropical countries. Fields in which such liaison is likely to prove most fruitful are zoonoses and public health, nutrition and disease prevention and the production and study of animal models of human disease.
Childhood Malnutrition
Authors: Eason Robert John
Published: January 2017

Cross-sectional anthropometric studies in the Western Province of the Solomon Islands indicate that over half the children become malnourished before the age of two years, regardless of the nutritional indicator used. Such malnutrition is primarily chronic and expressed as growth stunting. The principal aetiology, demonstrated by a concurrent dietary survey, is the low energy and protein content of an infrequently administered, bulky diet based on the staple sweet potato. On the basis of this data an appropriate intervention scheme has been designed and initiated.
Epidemics of Non-A, Non-B Hepatitis in Pakistan
Authors: Malik Iftikhar A , Qureshi M Shoaib , Luqman M , Qamar M Ashraf , Ahmed Aftab , Legters L J , Ahmad Manzoor , Akhtar Mahmud A
Published: January 2017

Three epidemics of acute viral hepatitis which occurred in different areas of Pakistan, namely Quetta, Mardan and Rawalpindi were studied. All the cases presented with jaundice, anorexia and nausea. The liver function tests showed raised serum bilirubin, alkaline phosphatase and ALT levels. In all the patients except one, the serology was consistent with non-A, non-B (NANB) hepatitis, which was most likely waterborne. This study shows that, as in some other parts of Asia and North Africa, epidemics of waterborne NANB hepatitis, clinically resembling hepatitis A, also occur in Pakistan. These epidemics are probably due to faecal contamination of the water supply systems in some areas of Pakistan.
Pattern of Burns Injury in Nigerian Children
Authors: Onuba O
Published: January 2017

During a 2-year period (January 1984 to December 1985), 87 Nigerian children with burns of 1–65% of body surface area were treated at the University of Calabar Teaching Hospital. Fifty-three adults were treated for burns over the same period. Fifty-two male children and 35 female children were involved, and their ages ranged from 3 months to 15 years. Although, there was no special burns unit, the cases were managed without fatality. Most of the burns resulted from domestic accidents caused by carelessness or inadequate precautions
Single Layer Closure of Abdominal Laparotomy Wounds
Authors: Nasher Abdulla A W
Published: January 2017

In single layer closure of laparotomy wounds, all layers including the peritoneum, but excluding the skin and subcutaneous tissue, are sutured together using continuous non-absorbable monofilament material. The experiences in 112 patients are described here. It was found that single layer closure was more effective than classical layered closure.
Traumatic Rupture of the Spleen in the Rural Tropics
Authors: Moran B J
Published: January 2017

Five patients with traumatic rupture of the spleen were treated in a rural 67-bed mission hospital during a one-year period. All had symptoms and signs of major intra-abdominal haemorrhage and were subjected to laparotomy. All five had splenectomy performed, as none were considered suitable for splenic preservation. The problems associated with splenic trauma in the tropics are discussed and suggestions made for its management.
External Cephalic Version at Term with Tocolysis
Authors: Hofmeyr G Justus
Published: January 2017

The problems associated with breech presentation are of particular importance in developing countries. The risk of vaginal breech delivery may be increased because of a high prevalence of cephalopelvic disproportion. Caesarean section presents specific risks to women who may not have medical care in subsequent pregnancies and may desire large families.

External cephalic version (ECV) before term has not been proved conclusively to influence the outcome of pregnancy. ECV performed at term (37 or more weeks gestation), using tocolytic agents to relax the uterus, has been shown in a technologically developed setting to reduce the incidence of breech presentation and of Caesarean section. The application of this procedure when technological facilities are limited is discussed and the technique is described.