bluuebunny/crossref_metadata_2025 huggingface dataset:
The Provision of Clinical Psychology Services within a General Hospital: An Analysis and Interpretation of Referral Rates
Authors: Wild M R , Bowden K , Bell N
Published: January 2017

A semi-structured interview was administered to fifteen hospital based medical and surgical consultants. This aimed to assess the level of knowledge and understanding regarding the activities of clinical psychologists and to evaluate the perception of need for the clinical psychology service within a general hospital in Central Scotland. Differences between high/regular and occasional/non-referring departments were examined. Results indicated that high/regular referring departments displayed a greater level of knowledge and understanding of clinical psychology practice than occasional/non-referring departments. The occasional/non-referring departments demonstrated more cautious attitudes regarding psychological input to the care of patients than high/regular referring departments. This study suggests that lower referral rates were more likely to be a result of generally low levels of awareness and understanding of psychological issues rather than mistrust of psychological methods. This highlights the need for education about the role of clinical psychology in general hospitals and improved communication between the psychology service and other departments in the hospital.
An Audit of Sports Injuries in Children Attending an Accident & Emergency Department
Authors: Boyce S H , Quigley M A
Published: January 2017

Objective: To assess the incidence of attendance, type of injury, sport involved and management of sports injuries in children attending an Accident & Emergency (A&E) department. Method: Children, aged between 5–16 years, presenting with an injury related to sport, were studied over a period of three months. Results: 1858 children attended the A&E department during the three month period. 238 (12.8%) were classified as sports injuries. Boys (71%) were injured more frequently than girls (29%). Injury rates in boys peaked at 14 years whereas in girls a peak occurred earlier at 12 years. Football was the most common sport implicated in injuries (39%). Rollerblading (14%), Rugby (8%), Basketball (7%) and Physical Education at school (7%) were the next most frequently involved sports. Soft tissue injuries dominated (61%). The upper limb was the most common anatomical area injured (46%). Other injuries involved the lower limb (36%), head and neck (15%) and the trunk (3%). Injuries to the wrist were the most frequent presentation accounting for 30 fractures and 30 soft tissue injuries (23%). The majority of children were discharged from the A&E department after treatment (71%). 16% were reviewed at out-patient clinics and 3% required hospital admission. No children were referred for physiotherapy. Conclusion: Children participate in sport and can be injured. The majority of sports injuries presenting to an A&E department appear to be of a minor nature and could be managed with simple first aid techniques by parents, teachers and coaches at the scene or by attending primary care in the first instance. Supervision of children, participation in organised sport and the use of protection devices may help to prevent serious injury.
Claude's Syndrome in Association with Posterior Cerebral Artery Stenosis
Authors: Dhanjal T , Walters M , MacMillan N
Published: January 2017

Background: We report a case of a 61 year old man with midbrain infarction causing Claude's syndrome attributable to stenosis of the posterior cerebral artery. Case description: The patient presented with a pupil-sparing left third nerve palsy and contralateral ataxia. A background history of treated hypertension and cigarette smoking was obtained. Magnetic resonance imaging revealed an area of infarction involving the left medial midbrain. Magnetic resonance angiography revealed significant stenosis of the left posterior cerebral artery. Antiplatelet therapy was instituted and the patient made a satisfactory recovery. Conclusions: This is the first reported case of Claude's syndrome arising in association with stenosis of the posterior cerebral artery. Intracranial large vessel disease should be considered as a potential aetiologic factor in patients with similar midbrain ischaemia.
Peritoneal Dialysis and Haemodialysis in Methaqualone (Mandrax) Poisoning
Authors: Proudfoot A. T. , Noble J. , Nimmo J. , Brown S. S. , Cameron J. C.
Published: January 2017

The clinical and toxicological features, and treatment, of a case of severe methaqualone poisoning are described. The patient presented with a plasma methaqualone level of 23 mg. per 100 ml. Alternate peritoneal dialysis and haemodialysis, carried out during 2 days, reduced the plasma level to 11 mg. per 100 ml., with a recovery of 6.5 g. of methaqualone, and restored some neurological functions. Comparable dialyses over a further 2 days yielded 3.3 g. more of drug, and reduced the plasma level to 4.4 mg. per 100ml., but the patient then died of respiratory and peripheral circulatory failure.

Mean values of 7.5 and 29 ml. per min. were found for the clearance of methaqualone by peritoneal dialysis and haemodialysis respectively. It is concluded that these techniques are at least as effective in the clearance of methaqualone as of the common barbiturates, and that they may be of value in treating gross Mandrax overdosage.
Characteristics and Response to Treatment of an Unselected Group of Alcoholics
Authors: Freeman T. , Hopwood S. E.
Published: January 2017

This paper gives an account of the characteristics of 100 unselected alcoholics who were admitted to Royal Dundee Liff Hospital, and their response to treatment. The study lasted 20 months from the Spring of 1966 to the Autumn of 1967.
Steroid Hormones and Cancer
Authors: Engel Lewis L.
Published: January 2017

It is clear that certain neoplasms are not wholly autonomous and may under specific circumstances be temporarily returned by hormone therapy to the jurisdiction of the normal controls on cell growth and division. One biochemical approach to the problem of cancer involves the study of the mode of action of steroid hormones and the nature of the interaction between the hormone and its target site in the cell. Fundamental in such studies is the identification of structural features in the target site which enable it to distinguish closely related compounds from one another. Two experimental models are described which together with X-ray crystallography make it possible to construct a theoretical model of the binding site on a protein molecule which interacts with a steroid hormone. The experiments provide a small beginning to the definition of the sites on macromolecules that recognise steroid hormones and are involved in their action. Through the combined efforts of steroid and protein biochemists further advances in this field may yield information which may be applied directly to the problem of preventing or retarding the growth of neoplasms.
Radiological Presymptomatic Surveys in the Diagnosis of Cancer
Authors: Samuel Eric
Published: January 2017

Many techniques, including mass radiography, the gastric camera, mammography and thermography are now available for screening populations for early detection of malignant disease. In some circumstances, e.g. carcinoma of breast or of cervix of uterus, the value of such techniques is undoubted. However, population screening studies are expensive of medical time and of equipment, and in this country relatively few screening programmes have been carried out. Greater efforts in finance and manpower devoted to such schemes might be most rewarding and in the long-term both lighten the burden on the medical profession and improve the well-being of the community.
Cytodiagnosis
Authors: Schade R. O. K.
Published: January 2017

Cytology is now widely used as a ‘search’ method to detect early cancer, still contained within the epithelial lining and not yet displaying the classical features of a tumour. The applications and limitations of the technique in the diagnosis of malignant disease in various sites are described. Success depends on a variety of factors including collaboration and understanding between clinician and laboratory worker.
Infantile Pyloric Stenosis
Authors: Dougall A. J.
Published: January 2017

A series of 200 cases of infantile pyloric stenosis is presented. Amongst other clinical features reported are a family history of the condition in 6 per cent of the patients; a male: female ratio of 3.8: 1; no increased incidence amongst firsborn babies; no significant evidence of a seasonal variation; and a normal distribution of birth weights. 99.5 per cent were treated by a Ramstedt's pyloromyotomy with a mortality of 0.5 per cent. The duodenal mucosa was opened in 3.5 per cent and in 3.5 per cent there was no definite pyloric tumour at operation. The incidence of ruptured wounds was 1.5 per cent, of incisional hernias 3 per cent, and of some type of infection 14 per cent. The varying incidence of the condition in time and place, the aetiology, and the treatment are also discussed.
Serum Iron Values following Myocardial Infarction
Authors: Gibson Iris I. J. M. , Kelly Anne M. , Wang Ian
Published: January 2017

This is a study of serum iron levels following myocardial infarction in a series of 18 male and 10 female patients. All showed hypoferraemia, which was variable in time of onset, intensity and duration, but was commonly sustained and severe. This was not of prognostic significance, and the Victoria Infirmary coronary prognostic index remains the most reliable prognostic guide.
Ophthalmia Neonatorum in Glasgow
Authors: Smith J. A.
Published: January 2017

A retrospective clinical and epidemiological comparison was made between gonococcal and non-gonococcal ophthalmia neonatorum in Glasgow from 1963 to 1968. Both forms of the disease were fairly mild, responding well to either topical or systemic antibiotic therapy. Neisseria gonorrhoeae was the commonest cause of ophthalmia neonatorum during the period studied. Illegitimate babies, those born in certain hospitals or in their own homes and those whose homes were in the inner suburbs had the highest incidence of gonococcal ophthalmia, and it is suggested that prophylaxis be re-introduced for those babies at greatest risk.
Problems in the Diagnosis of Cushing's Syndrome
Authors: Thomson J. E. , Thomson J. A. , Beastall G. H.
Published: January 2017

The diagnosis of florid Cushing's syndrome is usually made without difficulty but diagnostic problems may arise. Five such cases are described.

Difficulties may occur when the features of the syndrome are incomplete. Three such cases were encountered. In each only one clinical feature was present; these respectively were hypertension, osteoporosis and obesity. The diagnosis was confirmed, however, biochemically and eventually histologically and there was a good response to surgery in each case.

Another diagnostic problem, both clinically and biochemically is the obese, hirsute, hypertensive female. Two such cases are described, in whom Cushing's syndrome was diagnosed clinically and biochemically but in whom there was no response to adrenalectomy. Retrospectively the validity of the original diagnosis is questioned.

It is concluded that Cushing's syndrome may present in a very incomplete form and should be considered in the differential diagnosis, even if only one feature is present. It is stressed that obesity, hirsutism, hypertension and depression are commonly found in association with normal adrenal function. Urinary free Cortisol and cortisol response to insulin induced hypoglycaemia may be of value in distinguishing these cases from those with endocrine disease.
The Use of Serology in Patients with Suspected Hydatid Disease
Authors: Moir I.L. , Ho-Yen D.O.
Published: January 2017

Screening tests (IHA, LA and ELISA) and confirmatory tests (CF, CCEP and IEOP) on blood samples from 443 patients referred to the Scottish Hydatid Reference Laboratory are reviewed. The ELISA test was the most sensitive. All of 9 confirmed cases of hydatid disease were positive by ELISA. Positive ELISA results were obtained in 10/158 (6.3%) of patients with a suspected cyst(s) and 12/149 (8.1%) patients with a clinical illness suggestive of Hydatid disease. This compared with 6/136 (4.4%) asymptomatic individuals residing in an endemic area, and 1/138 (0.7%) residing in a non-endemic area. The significance of cross-reactions in patients with malignancies or liver disease and the difficulties of serological diagnosis in suspected Hydatid disease are discussed.
Smoking Habits, Sales of Fat and Antihypertensives Fail to Explain the High Coronary Mortality in Cold Regions of Sweden
Authors: Gyllerup S. , Lanke J. , Lindholm L.H. , Schersten B.
Published: January 2017

A previous study has shown a strong regional association between cold climate and coronary mortality in Sweden. The present study intended to elucidate further this association, in particular whether or not it could be attributed to smoking, hypertension and fat consumption.

The 284 Swedish municipalities were used as units. The outcome was mortality (SMR) from acute myocardial infarction in men aged 40–64. Prevalence of smoking and use of snuff was estimated by interviews. Sales of antihypertensive drugs were used to estimate prevalence of hypertension. Sales of butter and estimates of consumption of saturated fat by interviews were used to estimate the consumption of fat. Weighted determination coefficients (D) were calculated. Apart from the strong association between cold climate and coronary mortality (D=0.39), an association was shown between fat consumption and coronary mortality (D=0.22). A weaker association was found between prevalency of snuffing and coronary mortality (D=0.15) and between sales of butter and coronary mortality (D=0.10) and the weakest between sales of antihypertensives and coronary mortality (D=0.06). No association was found between prevalence of smoking and coronary mortality. When the other explanatory factors were added to cold climate in the model no substantial enhancement of the association was achieved. Cold exposure was correlated to the other explanatory factors. To conclude, this study showed that the strong association between cold exposure and coronary mortality was not affected by the regional variation in the estimates of fat consumption, hypertension or tobacco use.
Trends in Lung Cancer Mortality in Scotland and Their Relation to Cigarette Smoking and Social Class
Authors: Williams F.L.R. , Lloyd O.
Published: January 2017

This paper describes the trends in lung cancer rates in Scottish men and women during 1959–85, the relationship between lung cancer and cigarette consumption, and between lung cancer and social class, and the urban-rural gradient of lung cancer. Lung cancer rates in Scottish men have declined in all age groups under the age of 74 for at least the past two decades; the most notable decrease was in men aged 40–44 years, whose rates halved between 1970 and 1980. In women, who began smoking in large numbers only after World War II, lung cancer mortality declined slightly in those between 40–54 years and rose in those over 54 years. Trends in cigarette consumption did not fully explain the decline in lung cancer. Marked urban-rural gradients in the SMRs for lung cancer were evident in all periods, and these strengthened over time. Correlations between lung cancer and social class differed markedly from those found in previous studies, except for those with social classes II and V.
A Case of Sinusitis Presenting with Sphenocavernous Syndrome: Discussion of the Differential Diagnosis
Authors: Watson N.J. , Dick A.D. , Hutchinson C.H.
Published: January 2017

A 60 year old gentleman presented with a left sphenocavernous syndrome resulting in impaired ocular motility, proptosis and visual loss in an otherwise clinically quiet eye. The history led to a clinical suspicion of posterior ethmoiditis, which was confirmed on C.T. scanning. Surgical drainage and antibiotic treatment resolved the symptoms, but visual impairment persisted. The differential diagnosis and management of sphenocavernous syndrome is discussed in context with this atypical presention of orbital cellulitis.
Mucinous Endometrial Carcinoma in a Patient with Previous Ovarian Endometrioid Adenocarcinoma Presenting Some 18 Years after Initial Bilateral Ovariectomy: A Case Report
Authors: Beattie G. J. , Livingstone J. R. B. , Cornbleet M. A. , Smyth J. F. , McLaren K. M.
Published: January 2017

The association of endometrioid carcinoma of the ovary and primary carcinoma of the endometrium is well recognised. These tumours are often synchronous in occurrence. Oestrogen stimulation is often postulated as a significant factor in the development of the endometrial carcinoma in such cases. We describe the case of a patient who developed a mucinous endometrial carcinoma 18 years after initial bilateral ovariectomy. The aetiology and pathogenesis of the uterine tumour is discussed.
Investigation of the antimicrobial and wound healing properties of silver nanoparticle-loaded cotton prepared using silver carbamate
Authors: Kim Tae-Sung , Cha Jae-Ryung , Gong Myong-Seon
Published: January 2017

In this paper, silver nanoparticle (AgNP)-coated cotton wool with sustained antibacterial properties was produced using a convenient solution-dipping method that involves soaking the cotton in a silver 2-ethylhexylcarbamate solution, followed by thermal reduction at 120℃. The silver-coated cotton was characterized by scanning electron microscopy, energy dispersive X-ray spectroscopy, and X-ray diffraction patterns. AgNPs with a uniform and high deposition density formed on the surface of the cotton and ranged in size from 20 to 80 nm. The antibacterial activity, blood clotting, and other physical properties, such as saline absorption and ultraviolet (UV)-blocking of Ag/cotton wool with different silver content were examined. All Ag/cotton fabrics exhibited excellent antibacterial activity against Staphylococcus aureus and Escherichia coli. AgNP-loaded cotton demonstrated faster blood clotting rates and better absorption of 0.9% (w/v) saline solution than unmodified cotton. In addition, AgNP-loaded cotton showed excellent UV protection properties.
Crystallite Orientation in Natural Cellulose Fibers
Authors: Radhakrishnan T. , Patil N. B. , Dweltz N. E.
Published: January 2017

Experimental methods are described for measuring the azimuthal intensity distribution of the 040 meridional reflection from cellulose fibers. The recording of the profile has been carried out with a tilted fiber diffractometer. Methods are given for correcting the recorded profile for the effect of other contaminating reflections which happen to be at nearly the same Bragg angle. The results so obtained for ramie and a number of cottons are compared quantitatively with the azimuthal profiles of the 002 equatorial diffraction from these fibers by making use of the Kratky formula. It is shown that the details of the spiral structure of cotton are more clearly brought out in the 040 profile than in that of the 002 reflection. The Kratky formula does not appear to hold good for cottons. It is shown that the usual practice of estimating the degree of orientation of the b-axis of crystallites from equatorial profiles can give rise to misleading results.
An Investigation of Fiber Geometry in Card Webs
Authors: Trott David W. , Scardino Francis L.
Published: January 2017

A study was made of a set of parameters which, in an average or statistical sense, would validly describe the fiber geometry of a textile card web. In addition, this work included the development of methods for the measurement of these parameters, the standardization of test procedures, and the collection and use of web samples for measurements. All chosen parameters were measured on the same web at three different strain levels, thus providing an intuitive check on the significance of the measured parameters
Utilization of Fiber Strength in Jute Yarns
Authors: Banerjee B. L. , Lahiri A.
Published: January 2017

From a study of the relationship between the breaking strength and the corresponding mass per unit length at thefracture zone of a yarn, the expected strength of a perfectly even yarn of identical fiber composition has been derived. The ratio between the observed strength and this estimated value has been taken as a measure of utilization of fiber strength in yarn. The dependence of this utilization factor on the diameter irregularity of yarn has been examined on the basis of test results obtained on a number of yarn samples of different qualities. The yarn tenacity at the fracture zone is also found to be related with its diameter irregularity; the causes of this are discussed
The Dimensional Stability of Carpets in Installations
Authors: Gentry David R.
Published: January 2017

Dimensional stability of floor coverings to forces encountered under end-use conditions has not been investigated extensively, although problems of wrinkling and puckering of carpets in stretch installations arise frequently. Mechanical actions from the stretching procedure during installation and from pedestrian traffic are a major source of forces which carpets must resist. A test method validated prior to adoption by the British Standards Institution was used to characterize a large number of carpets for dimensional stability to mechanical actions. A number of properties measured by this method were found to be highly correlated. Several carpet construction characteristics—total weight, gage, and stitch density—were found to have little relationship to stability to mechanical action. Woven carpets were found to have better stability than tufted carpets, with the stability of tufted carpets being highly dependent upon primary and secondary backing type. Generally, woven backings provided more stability than nonwoven backings.
A Study of Lea-Strength Variation of Ring-Spun Cotton Yarns
Authors: Gupta A. K. , Ganesh K. , Subramanian T. A.
Published: January 2017

The findings from an investigation to identify the contribution of factors that affect lea-strength variation are presented. The within-bobbin strength variation is more or less independent of the within-bobbin count variation, so that this component of strength variation can be regarded as arising largely from inherent testing errors. However count variation is the major contributor to between-bobbin strength variation. The actual contribution of count variation to strength variation decreases as the level of twist in the yarn is increased, a fact which is explained on the basis of the well-known shape of the twist-strength curve. Different methods for isolating the effect of count variation on between-bobbin strength variation were tried. Analysis of covariance was found to be a suitable technique for this purpose. This technique was used to identify the factors that contribute to the residual strength variance that is the variance left unaccounted by count variation. An interesting finding in this regard is the fact that even wide differences in preparatory processes do not by themselves lead to significant differences in the residual variance if the materials from these processes are spun in isolation.
The Response of Textured Yarn Properties to Process Variables in Relation to Barré
Authors: Mcgregor R. , Adeimy J. A.
Published: January 2017

The dyeing behavior of conventional false-twist pin-textured polyester yarns has been studied as a function of the texturing variables. Three different dyes and three different dyeing procedures were employed. The data obtained are discussed in relation to existing quality-control procedures for textured yarns and the role of feed-yarn non-uniformity in barré problems.
Pyrolysis Products from Cellulose Treated with Flame Retardants
Authors: Garn P. D. , Denson C. L.
Published: January 2017

Cellulose treated with phosphorus-halogen flame retardants was thermally decomposed and the products separated and identified with a GC-MS combination. Addition of more phosphorus compounds to the mixtures caused changes in both the number and amounts of halogen compounds observed. The phosphorus apparently has an effect on how the decomposition of the halogen-containing retardant occurs.
Friction and Lubrication of Synthetic Fibers
Authors: Schick M. J.
Published: January 2017

The frictional properties of a two-component model system comprising a volatile lubricant, a polyoxyethylene fatty acid, and a nonvolatile antistat, a phosphate ester of polyoxyethylene aryl phenol, have been studied over the entire concentration range. These data in the speed range from 10-4 to 50 m/min for high-tenacity polyester, polypropylene, and acrylic fibers exhibit a family of curves that starts to diverge in the semiboundary region with the lowest friction for the low-viscosity component and the highest friction for the high-viscosity component. Thus, the consistent pattern of the curves observed for all fiber materials, including those covered in Part II, must be attributed to the lubricant rather than to the fiber material.
An Application of the Amidomethylation (Tscherniac-Einhorn) Reaction in Dye Synthesis
Authors: Guise G. Bruce , Bühler A.
Published: January 2017

The amidomethylation (Tscherniac-Einhorn) reaction of the anthraquinones I-III (R = II) was examined in an attempt to introduce 3-halogenopropionamidomethyl groups into dyes for subsequent conversion into isothiuronium salt dyes. Methods described in the literature using 3-halogenopropionamides or propionitriles and various formaldehyde sources gave poor yields due to the reaction of formaldehyde with the anthraquinones. Satisfactory methods have been developed using bis(chloromethyl)ether to amidoalkylate I-III (R = H). Reaction of the 3-bromo- or 3-iodopropionamido-methyl derivatives of I-III (R = H) with thiourea or tetramethylthiourea gave poor yields of unstable isothiuronium salts, which were unsatisfactory wool dyes.
Buckling in Fiber-Reinforced Elastomers
Authors: Schaffers W. J.
Published: January 2017

A peculiar phenomenon of in-plane fiber buckling has been observed in rubber beams reinforced with layers of parallel fibers when they are subjected to severe bending with a moment vector perpendicular to the fiber direction parallel to the width of the beam. The shape of the fibers on the inside of the bend, which appears to be independent of the boundary conditions, suggests fiber buckling under elastic support. It is shown here that this buckling phenomenon is unrelated to the case of buckling of an elastically supported rod under pure compression and can be explained only by taking into account the combined action of (a) the support each fiber experiences from fibers in adjacent layers (interlayer support) and (b) the support each fiber experiences from adjacent fibers in the same layer (interlayar support).
A Robotic Therapy Case Study
Authors: Charron Nancy , Lewis Lundy , Craig Michael
Published: January 2017

The purpose of this article is to describe a possible methodology for developing joint attention skills in students with autism spectrum disorder. Co-robot therapy with the humanoid robot NAO was used to foster a student’s joint attention skill development; 20-min sessions conducted once weekly during the school year were video recorded and analyzed for joint attention. Robot therapy may be a viable method to improve communication skills in individuals identified with autism spectrum disorder. This particular student was clearly motivated by working with a humanoid robot.
A critical evaluation of Heidegger’s criticism of aesthetics in ‘The Origin of the Work of Art’
Authors: Süner Ahmet
Published: January 2017

This paper examines and critiques Heidegger’s repudiation of aesthetics in his essay ‘The Origin of the Work of Art’ and claims that his alternative approach to artworks in the essay must be understood as a theory of aesthetics and, more particularly, of aesthetic use, which delineates the inseparability of senses and sensations. The paper analyses Heidegger’s explicit remarks on aesthetics in the epilogue, discusses his criticism of the aesthetic thing-interpretation at the beginning of the essay and concludes with some critical observations on Heidegger’s own aesthetics. While critical of Heidegger’s separation of the equipment from the artwork, the paper claims that Heidegger’s significant contribution to the field of aesthetics must be sought in his focus on the attenuation of the subjective element in aesthetic experience.
HIV in Nepal: Is it Rare or the Tip of an Iceberg?
Authors: Bharadwaj Anurag , Biswas Rakesh , Shetty K J
Published: January 2017

Acquired immunodeficiency syndrome (AIDS) has reached alarming proportions in SE Asia. The magnitude of the epidemic is projected to exceed that of sub-Saharan Africa as we enter the 21st century. Nepal has much in common with India geopolitically and socially and the prevalence of HIV is expected to be no different from the rest of SE Asia. However, evidence thus far paints a different picture altogether — a very low prevalence of HIV even in high-risk population groups. This is surprising, particularly since high-risk behaviour is evidenced by a high rate of drug abuse. In addition, other communicable diseases commonly associated with HIV infection, such as tuberculosis and HBV/HCV infection, are common in Nepal and yet still the prevalence of HIV infection in these patients and in the general population is reported to be low.

This paper identifies some of these anomalies and attempts to analyse the reasons for this discrepancy. We emphasize the need for extended survey and strict surveillance to avoid an explosion of this dreaded infection.
A Clinical Manifestation of AIDS with Cryptococcal Meningitis in Equatorial Guinea
Authors: Wang Wenqi , Carm A R
Published: January 2017

Eighteen cases of confirmed AIDS with cryptococcal meningitis in Bata Regional Hospital, Equatorial Guinea from January 1997 to November 1999 were analysed. The associated morbidity and mortality rates were very high. Contributory factors were the failure to note the occurrence of AIDS with cryptococcal meningitis, late presentation, serious illness and severe complications, and delayed and inadequate therapy.
Perinatal Mortality in Breech Delivery
Authors: Nkata Mulumba
Published: January 2017

Single babies delivered by breech at Mansa General Hospital (Zambia) during a 12 month period from September 1993 to August 1994 were studied retrospectively. Breech delivery accounted for 2.44% single births. The perinatal mortality rate was high (341/1000) and involved mainly the low birth weight babies. This study confirms previously published reports of higher perinatal mortality in breech presentation. However, with proper selection of clients, intrapartum fetal monitoring and skilful birth attendants, a substantial proportion of breech presentations could have been safely delivered vaginally.
Radiological Features of Hepatocellular Carcinoma in Southern Pakistan
Authors: Sharieff Saleem , Burney Ikram A , Ahmad Nadeem , Salam Abdul , Siddiqui Tariq
Published: January 2017

We describe the radiological features of 201 patients diagnosed as having hepatocellular carcinoma (HCC) in Southern Pakistan. The cases of biopsy-proven HCC were analysed retrospectively for years 1994–1998. Age, sex, underlying cirrhosis, hepatitis markers, and radiological description were recorded. The mean age was 56 years. There were 149 males and 52 females. 82% patients had underlying cirrhosis. The tumour size was measured in at least two dimensions, and the maximum mean tumour size at the time of diagnosis was 8.3 ± 4.0 cm. Of the tumours 79.5% were more than 5 cm; 56% of primary HCC were multifocal; 51% involved the right lobe only; 15% involved the left lobe; 34% involved both lobes of liver. Portal vein thrombosis was detectable in 17%. There were no significant differences in the radiological patterns amongst patients who had hepatitis B virus related and hepatitis C virus-related HCC except for age.
Treatment of Malaria in Ethiopian Folk Medicine
Authors: Gedif Teferi , Heinz-Jürgen Hahn
Published: January 2017

Key informant interviews of herbalists were conducted to document the traditional management of malaria in Ethiopia. The perceptions of the cause and symptoms of malaria, the use of plants, their preparation and administration were recorded. Interviews were performed in rural Butajira and Addis Ababa (the main city). The result showed that 33 (75%) of the interviewed healers treat malaria using herbal drugs. Sixteen plants were reported to have been used of which eight were used as a single remedy and the rest as composite remedies with other plants. The ethnopharmacological data generated in this study on antimalarial plants is useful for further evaluations of the traditional claims of antimalarial plants in Ethiopia.
Surgical Bypass is Still Relevant in the Palliation of Malignant Obstructive Jaundice
Authors: Sharma Dhananjaya , Bhansali Manish , Raina V K
Published: January 2017

Malignant tumours of the biliopancreatic system causing obstructive jaundice are not curable in most of the patients, and palliation plays a very important therapeutic role. The role of surgery in palliation of malignant obstructive jaundice has been questioned in the light of availability of endoscopic techniques. In developing countries, however, exploratory laparotomy and palliative surgery (when possible) is the only option available as sophisticated instruments and the expertise to use them is limited to a very few centres.

This was a retrospective study of 83 consecutive cases with malignant obstructive jaundice admitted to the Department of Surgery, NSCB Government Medical College, Jabalpur, MP, India from January 1996 to December 2000.
Outbreak of Beri-Beri in a Prison in West Africa
Authors: de Montmollin Dominique , MacPhail Julie , McMahon Jenny , Coninx Rudi
Published: January 2017

The International Committee of the Red Cross investigated an outbreak of beri-beri in a prison in West Africa. Twenty-five prisoners out of a total of 1020 died over a period of 11 weeks — exceeding the crude mortality rate of 1/10 000/day, a threshold for serious concern. Two hundred and eleven prisoners had clinical signs of beri-beri. An immediate response to treatment with thiamine was seen and no further deaths occurred. The triad of a positive squatting test, oedema and a diet consisting exclusively of white rice should lead to the diagnosis of beri-beri. The disease is more common than generally assumed, also in Africa and especially in prisons.
Bacteriology of Prostatectomy Patients' Urine in a Drug-Abused Community
Authors: Ofili O P , Wemambu S N C
Published: January 2017

About 75% of patients admitted for prostatectomy to the University of Benin Teaching Hospital, presented in acute urinary retention and carried indwelling vesical catheters preoperatively. The overall incidence of urinary infection was 55.4% preoperatively, falling to 42.2% postoperatively. The predominant organisms cultured in the urine pre and postoperatively were organisms normally found in the colon.

The sensitivity patterns of the organisms cultured revealed some differences in this drug-abused community when compared with some non-drug abused environments. In this and similar communities where facilities for urine cultures are also not readily available, carbenicillin alone or in combination with either nalidixic acid or nitrofurantoin are suggested as logical drugs of choice for the pre and postoperative manipulations.
Causes of Congenital and Acquired Total Sensorineural Hearing Loss in Ghanaian Children
Authors: Brobby G W
Published: January 2017

All cases of “deaf and dumb” children of school age seen in a 5-year period between 1979 and 1984 in Komfo Anokye Teaching Hospital, Kumasi are reviewed. The aetiology of 105 cases of congenital and acquired total sensorineural hearing loss is presented. The cause of congenital sensorineural hearing loss is unknown in nearly all cases. Of the 28 congenital cases, 4 mothers had rubella and 2 had icterus in the first trimester of pregnancy. Measles was the commonest cause of acquired sensensorineural hearing loss.
Postpartum Paraplegia Due to Spinal Tuberculosis
Authors: Nsofor B I , Trivedi O N
Published: January 2017

A case of postpartum paraplegia due to tuberculosis of the spine is reported. The patient presented with postpartum haemorrhage and paraplegia on the 8th postpartum day. She had weakness of both lower limbs on the 4th postpartum day and was unable to walk on the 7th day. Investigations revealed a tuberculous lesion of the thoracic spine. She was treated with chemotherapy and physiotherapy and recovered fully within seven months.
Primary School Health Education: A Practical Project for a Small Hospital Community Health Department
Authors: Mary Evelyn Rose , Velusamy S , Meena U , Lobithas L
Published: January 2017

A pilot project in a rural district of Tamil Nadu, India in which health is taught as a subject in primary schools by hospital-based staff is described.
Teaching Zimbabwean Medical Students an Awareness of Hidden Psychological Disorder in an Urban Outpatient Setting
Authors: Williams H , Reeler A P
Published: January 2017

A one-week attachment to an urban primary health care clinic was introduced into the eight-week psychiatric teaching block for fourth (penultimate) year medical students at the University of Zimbabwe. Its objective was to alert students to underlying psychological disorder in patients presenting, at primary health care level, with physical symptomatology. Students were required to screen patients using a 20-item questionnaire, take a psychosocial history of all high-scoring patients, and make one home visit. The attachment proved both popular and valuable, and it is anticipated that this will now become an integral part of the psychiatric teaching block.
Blood Dyscrasia in Unofficial Vendors of Petrol and Heavy Oil and Motor Mechanics in Nigeria
Authors: Niazi G A , Fleming A F , Siziya S
Published: January 2017

The risk of blood dyscrasia has been measured in Nigerians exposed to benzene in petrol through inhalation and ingestion while employed selling petrol syphoned from oil-drums at the roadside. Significant degrees of anaemia, hypochromia, neutropenia and thrombocytopenia were found in male vendors of heavy oil for motor scooters ( n = 20), vendors of petrol and heavy oil ( n = 52) and vendors of petrol alone ( n = 46) compared to adolescent ( n = 49) and adult ( n = 80) male controls. Motor mechanics ( n = 57) working at small repair workshops were also at risk of anaemia through exposure to petroleum products. Petrol pump attendants ( n = 38) at modern filling stations did not appear to have any such occupational hazard. The practices of unofficial roadside vendors of petrol and heavy oil, and to a less extent motor mechanics, in the developing world are dangerous to health, being associated with blood dyscrasia and probably with increased incidence of aplastic anaemia and leukaemia. Education of the public and legislation are required to stop these practices.
Otolaryngological Foreign Bodies: A Study in Jos, Nigeria
Authors: Bhatia P L
Published: January 2017

The incidence of foreign bodies in ears, nose and throat is quite high in Jos Community of Nigeria, 411 cases having been observed over a period of three years. These occurred most frequently in the ears, while the oesophagus was the second commonest site. The foreign bodies were removed in the outpatient or the casualty department in 270 cases (66.7%) while the remaining 141 cases had to be admitted to hospital.
Podoconiosis (Endemic Non-Filarial Elephantiasis) in Two Resettlement Schemes in Western Ethiopia
Authors: Kloos Helmut , Kello Abdulhamid Bedri , Addus Abdulaziz
Published: January 2017

In a population-based study of podoconiosis in two resettlement schemes in western Ethiopia, we found that 5% of 194 settlers and 9% of 222 indigenous people were affected. Prevalence rates were generally higher in males than females and increased with age, indicating sex differences in occupationally linked trauma to the feet and the cumulative effect of long-term exposure to volcanic soils. Persons wearing shoes had significantly lower rates than those usually walking barefoot. Suggestions are made for the control of podoconiosis.
Copper Sulphate Poisoning
Authors: Ahasan H A M Nazmul , Chowdhury M A Jalil , Azhar M A , Rafiqueuddin A K M
Published: January 2017

A number of cases of copper sulphate poisoning from the southern region of Bangladesh are presented. There was a high mortality (24.9%) in comparison to other forms of poisoning. Hepatotoxicity, acute renal failure and gastrointestinal bleeding were the main complications. This degree of copper sulphate poisoning in one particular area is cause for alarm.
The Quantitative Buffy Coat for the Diagnosis of Trypanosomes
Authors: Bailey J W , Smith D H
Published: January 2017

The use of quantitative buffy coat (QBC®) tubes developed for malaria diagnosis is described in the diagnosis of African trypanosomiasis. One hundred and thirty-four patients with Trypanosoma gambiense were examined using QBC® plus either haematocrit (HCT) or mini anion exchange centrifugation (MAEC) or both. QBC® was the only method that detected all 134 patients. QBC® proved to be the most sensitive diagnostic test for the detection of trypanosomes in blood. It is simple to use, gives fast results and would be a useful test at the district hospital level.
The ‘Kangaroo-Method’ for Treating Low Birth Weight Babies in a Developing Country
Authors: Bergman N J , Jürisoo L A
Published: January 2017

The results of introducing the ‘kangaroo method’ (constant nursing of the baby skin to skin on the mother's chest), as the exclusive means of treating low birth weight (LBW) babies is reported, in the context of a mission hospital in a developing country without incubators and standard equipment for care of LBW neonates. Details of the method developed are described. The survival of babies born under 1500g improved from 10% to 50%, whereas that of babies 1500–1999 g improved from 70% to 90%. The method is well accepted by the community, and easily grasped by all hospital staff. Staff expectations concerning survival have dramatically improved, and a considerable saving in workload is experienced. The kangaroo method as described is strongly recommended to all units in developing countries treating LBW babies without modern equipment.
Evaluation of Vitamin A Deficiency in the Yelimane Circle of Mali, West Africa
Authors: Perkins Andrew L
Published: January 2017

Of 207 children (aged 4–7 years) in western Mali examined clinically and by conjunctival impression cytology (CIC), 2% had night blindness, no child had Bitot spots and 78% were found to have abnormal CIC suggesting deficiency in vitamin A.

In a cohort of 53 children examined by CIC pre- and post-harvest (June and December), abnormal CIC were seen in 77.4% and 54.7%, respectively ( P = 0.04).

Subclinical vitamin A deficiency is a problem in this area. A seasonal variation is demonstrated. CIC is a useful method for identifying communities with subclinical vitamin A deficiency. A variety of strategies for dealing with vitamin A deficiency are discussed.
Rubber Ring Clamping of the Umbilical Cord: A Randomized Trial
Authors: Mekbib Tekle-Ab , Mengistu Sophia
Published: January 2017

A randomized trial to compare two methods of umbilical cord tying in neonates, immediately after birth, was undertaken from February to April 1997 in the Department of Obstetrics & Gynaecology, Zewditu Memorial Hospital, Addis Ababa, Ethiopia. In less than 3 months, we investigated 300 neonates, of whom 150 infants were randomly assigned to the traditional ligation of the umbilical cord (using a piece of thread) and the rest to a rubber ring clamping method. Among the former group, 13.3% (20/150) of the neonates bled from their umbilical cords which necessitated re-tying, whereas in the later group, there was no sign of haemorrhage or infection within 12 h of clamping. We suggest that the rubber ring method described is a superior procedure and can easily replace the traditional, cumbersome and time-consuming umbilical cord ligation.
Religious Exemptions to the PPACA's Health Insurance Mandate
Authors: Grover Samuel T.
Published: January 2017

Arguably the most controversial change to the U.S. healthcare system written into the Patient Protection and Affordable Care Act (“PPACA” or the “Act”) is what has been colorfully termed the Act’s “individual mandate,” the provision that establishes tax penalties for those who do not maintain health insurance in 2014 and beyond. Though the health insurance mandate does not go into effect until 2014, it has already faced numerous constitutional challenges in district and circuit courts, with entirely inconsistent results. Conflicting decisions regarding the Act’s constitutionality at the circuit court level cry out for Supreme Court review. But while the individual mandate’s validity under either the Commerce Clause or Congress’s taxing power has been the focal point of litigation thus far, another aspect of the individual mandate may undermine the goal of establishing universal, affordable healthcare coverage for all Americans. As currently written, the religious conscience exemption from the PPACA’s individual mandate threatens the efficacy of the Act and potentially exposes it to legal challenges under the Constitution’s Religion Clauses.
Access to Elective Abortions for Female Prisoners under the Eighth and Fourteenth Amendments
Authors: Johnson Avalon
Published: January 2017

Victoria, a pregnant inmate housed in a Louisiana state prison, brought a civil rights action challenging the prison’s policy of requiring her to obtain a court order to receive an elective abortion. Although Louisiana state law purported to allow Victoria to obtain an elective abortion, Victoria was unable to obtain her abortion because of procedural delays. Victoria was released from prison before she gave birth but her pregnancy was too far along for her to legally obtain an abortion. She was therefore forced to carry her pregnancy to term and forced to place her newborn child with adoptive parents. Had she given birth in prison, she would have been shackled to her hospital bed, as Louisiana policies require.

Little information regarding pregnancy, prenatal care, perinatal outcomes, and access to elective abortions for female inmates exists. We know, however, that between six and ten percent of the women entering jail or prison are pregnant and that more women may become impregnated in prison as a result of rape by prison guards.