Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH,Addis Ababa,Ethiopia: A Six-Months Prospective Study

BackgroundSurgical Site Infection (SSI) and wound dehiscence are two early complications of laparotomy causing significant morbidity and mortality. This study was conducted to determine the prevalence and risk factors of SSI and wound dehiscence in pediatric surgical patients.MethodsWe performed a prospective observational study of all pediatric surgical patients who underwent laparotomy at Tikur Anbessa Specialized Hospital, Ethiopia, from December 2017 to May 2018. Data collected included demographics, operative indication, nutritional status, prophylactic antibiotics administration, and duration of operation. Primary outcome was SSI; secondary outcomes were hospital stay and other postoperative complications, including wound dehiscence and mortality. Data were analyzed using SPSS, Version 23. Fisher''s exact and Chi-squared tests used to report outcomes. Multivariable logistic regression was used to identify variables associated with SSI, wound dehiscence and other outcomes.ResultsOf 114 patients, median age was 46 months [range: 1day-13 years]; 77(67.5 %) were males. Overall SSI rate was 21.05%. Nine (7.9%) developed wound dehiscence while 3(2.6%) had abdominal contents evisceration. Overall mortality rate was 2.6%. In multivariate analysis, prophylactic antibiotics administration (AOR=13.05, (p=0.006)), duration of procedure (AOR=8.62, (p=0.012)) and wound class (AOR=16.63, (p=0.034)) were independent risk factors for SSI while SSI was an independent predictor of prolonged hospital stay, >1 week (AOR=4.7, p=.003,) and of wound dehiscence (AOR=33. 96, p=0.003). Age (p=0.004) and malnutrition (p<0.001) were significantly associated with wound dehiscence.ConclusionSSI and wound dehiscence are common in this setting. Wound contamination, antibiotics administration >1 hour before surgery and operative time >2 hours are independent predictors of SSI.     

Burden and determinants of undernutrition among young pregnant women in Ethiopia

Undernutrition is a major public health concern due to its association with the mortality and disease burden of women and children. This study aimed at identifying the extent and determinants of undernutrition among young pregnant women in Ethiopia. A multivariable regression analysis was fitted to identify determinants of undernutrition and anaemia in a sample of 1,393 pregnant women. Risk ratios (RRs) with 95% confidence interval (CI) were estimated. All the analyses were performed using STATA version 14 and adjusted for clustering. The study revealed that 38% of the women were undernourished and 22% were anaemic. Improved maternal education, RR = 0.94, 95% CI [0.89, 0.98]; higher wealth status, RR = 0.72, 95% CI [0.47, 0.95]; higher minimum dietary diversity for women, RR = 0.87, 95% CI [0.77, 0.98]; increased maternal height, RR = 0.96, 95% CI [0.94, 0.98]; and protected water source, RR = 0.93, 95% CI [0.86, 0.96], have decreased the risk of undernutrition while using unimproved toilet, RR = 1.31, 95% CI [1.06, 1.63], and depression, RR = 1.33, 95% CI [1.14, 1.55], increased the risk of anaemia. Animal source food consumption decreased both the risk of undernutrition, RR = 0.85, 95% CI [0.77, 0.94], and anaemia, RR = 0.91, 95% CI [0.85, 0.95]. The burden of undernutrition is still high. Although improved socio‐economic status and dietary practices decreased the risk of undernutrition, poor health and environmental conditions were still significant risk factors. These findings suggest the need to target this set of important determinants to significantly decrease the burden of undernutrition among young pregnant women.     

Khat Use is Associated with Tobacco,Alcohol, and Illicit Drug Use: A Cross-Sectional Examination in the United States

No study has systematically examined khat (Catha edulis) use and its linkages with other substance use in the United States. This study provides novel findings related to the associations of khat with other substance use among immigrants in metropolitan areas of Minnesota where large East African communities reside. Using a convenience sampling, a total of 261 individuals completed a brief face-to-face interview during which demographic information and substance use were assessed. The proportion of lifetime and current use were 30% and 6.6% for khat, 35% and 18% for tobacco, 35% and 21% for alcohol, and 13% and 10% for other illicit drugs. Self-report history of khat use was associated with tobacco, alcohol, and other drug use. Tobacco use was related to alcohol and use of other drugs. The results suggest that a history of khat use is useful in identifying individuals who are vulnerable to substance-use-related problems. The findings indicate the need for more research on khat in the U.S.     

Oligodendrocytes: from development to demyelinated lesion repair

Spontaneous but incomplete remyelination is observed after a demyelinating lesion. We know since ten years now that oligodendrocyte progenitors, (OP) and totipotent neural stem cells remain present in the central nervous system of adult mammals. Moreover, these OP are more likely the cellular source of remyelinating cells. Here, we intend to demonstrate that the understanding of the myelination process that occurs during development might lead to new treatments aimed at inducing remyelination: stimulation of resident OP or grafting of purified perinatal OP.     

Tongue paresthesia and dysgeusia following operative microlaryngoscopy

OBJECTIVES: This study was performed to assess the overall incidence and duration of alterations in tongue sensation and taste after operative microlaryngoscopy, and the relation of these symptoms to operative time. METHODS: We performed a retrospective review of information regarding tongue symptoms in patients who completed standard post-microlaryngoscopy follow-up at 1 week, 1 month, and 3 months. RESULTS: One hundred patients (54 male and 46 female; mean age, 46 years; age range, 14 to 83 years) met the inclusion criteria. Eighteen patients had positive findings at 1 week: 15 complained of paresthesia and 3 of dysgeusia. The symptoms decreased over time without treatment (4% of patients at 1 month and 1% of patients at 3 months). Only 1 case of dysgeusia persisted past 3 months. Gender was found to be a significant independent risk factor for the development of symptoms (odds ratio, 5.63; 95% confidence interval, 1.36 to 31.29; p = .013). Patients whose operations lasted longer than 1 hour were almost 4 times more likely to develop tongue-related symptoms than those with an operative time less than 30 minutes, although these findings did not achieve statistical significance (odds ratio, 3.91; 95% confidence interval, 0.62 to 30.95; p = .182). CONCLUSIONS: Alterations in tongue sensation and taste, most likely due to lingual nerve injury, are common after microlaryngoscopy, especially in female patients. They also tend to be associated with longer operative times. Although transient in nearly every case, lingual paresthesia and dysgeusia should form part of the preoperative discussion with the patient.     

3D mesoporous structure assembled from monoclinic M-phase VO2 nanoflakes with enhanced thermochromic performance

Monoclinic M-phase VO₂ is a promising candidate for thermochromic materials due to its abrupt change in the near infrared (NIR) transmittance along with the metal-to-insulator transition (MIT) at a critical temperature ∼68 °C. However, low luminous transmittance (T_lum), poor solar energy modulation ability (ΔT_sol), and high phase transition temperature (T_c) can limit the application of VO₂ for smart windows. To overcome these limitations, 3D mesoporous structure can be employed in VO₂ films. Herein, 3D mesoporous structures assembled from monoclinic M-phase VO₂ nanoflakes with a pore size of about 2–10 nm were synthesized by a hydrothermal method using Ensete ventricosum fiber (EF) as a template followed by calcination at 450 °C. The prepared film exhibited excellent thermochromic performance with balanced T_lum = 67.3%, ΔT_sol = 12.5%, and lowering T_c to 63.15 °C. This is because the 3D mesoporous structure can offer the uniform dispersion of VO₂ nanoflakes in the film to enhance T_lum, ensure sufficient VO₂ nanoflakes in the film for high ΔT_sol and lower T_c. Therefore, this work can provide a green approach to synthesize 3D mesoporous structures assembled from monoclinic M-phase VO₂ nanoflakes and promote their application in smart windows.

Herein, 3D mesoporous structures assembled from monoclinic M-phase VO₂ nanoflakes were successfully synthesized for enhanced thermochromic performance.     

Longitudinal study of the uterine body and cavity with three-dimensional ultrasonography in the puerperium

Objective. To describe uterine involution in the puerperium with three-dimensional ultrasound. Design. Prospective, longitudinal study. Setting. Fetal medicine unit, department of obstetrics and gynecology, university referral hospital, Uppsala, Sweden. Population. Fifty women with uncomplicated deliveries and puerperium between February 2009 and February 2010. Methods. Three-dimensional ultrasound was used to measure the uterine body and cavity volumes. The volume data set was analysed using virtual organ computer-aided analysis (VOCAL) with a 30 degree rotation step. Measurements were performed transabdominally on days 1, 7 and 14 and transvaginally on days 28 and 56 postpartum. Parity, gestational age, birthweight, smoking, breastfeeding and blood loss were recorded. Main outcome measures. Uterine body and cavity volumes. Results. Median uterine body volume was 756 cm(3) on day 1, 440 cm(3) on day 7, 253 cm(3) on day 14, 125 cm(3) on day 28 and 68 cm(3) on day 56. Median cavity volume was 22 cm(3) on day 1, 18 cm(3) on day 7, 6 cm(3) on day 14, 1 cm(3) on day 28 and not measurable on day 56. The interindividual variation of uterine body and cavity volumes was most pronounced on day 1 and decreased throughout the observation period. Intrauterine content was found in 36% of the women on day 1, 95% on day 7, 87% on day 14 and 28% on day 28. Conclusions. Three-dimensional ultrasound is a non-invasive tool suitable for measurement of the uterine body and cavity volumes during the puerperium. The volumes decreased in a similar pattern in the study population.