Increased glucocorticoid response to a novel stress in rats that have been restrained

Rats exposed to repeated restraint stress (3 h of restraint on each of 3 days) lose weight during stress and do not return to the weight of nonstressed controls once stress ends. Others have reported that chronic stress raises the daily nadir of corticosterone release and increases the adrenal response to subsequent stress; therefore, we examined glucocorticoid release in rats that had been exposed to repeated restraint. Repeated restraint had no effect on the diurnal pattern of corticosterone or insulin release, measured 12 days after restraint had ended, indicating that the reduced weight of the rats is not associated with an elevated corticosterone-insulin ratio. In contrast, rats that had been exposed to repeated restraint, 12 days previously, showed a blunted corticosterone release during a second restraint stress, a normal response to the novel physiological stress of 2-deoxy glucose (2-DG) injection, but an exaggerated corticosterone response to the novel mild stress (MS) of either placement in a unfamiliar environment or an intraperitoneal injection of saline. Mice exposed to repeated restraint showed a similar hyperresponsiveness to novel MS, suggesting that repeated restraint lowers the threshold for stress-induced activation of the adrenal gland. MS caused a small, but significant, degree of hypophagia in rats that had been exposed to repeated restraint stress. Therefore, multiple aspects of the stress response may be exaggerated in these animals and contribute to the chronic reduction in body weight.     

Surgical management of bleeding esopageal varices: the Tikur Anbessa hospital experience

Surgery is one of the modalities of treatment of portal hypertension with bleeding esophageal varices. Between 1992 and 2003, a total of 33 patients with esophageal varices secondary to hepatic or pre-hepatic causes of portal hypertension underwent proto-azygeal disconnection surgery at Tikur Anbessa Hospital, Addis Ababa University. Twenty-five, (69. 7%) were men and 8 (24.3%) were women. Their age ranged between 13 and 54 years with a mean age of 24.3 years. Eighty two percent of the patients had hematemesis and melena. Thirty-two, (97%) patients had splenomegaly and of these; 27 (84%) had splenomegaqly with hyperslenism. Twenty-one, (63.6%) and 12 (36.6%) patients had child's A and B functional class, respectively. None of the patients was in class C. The condition of the liver as assessed macroscopically at surgery showed portal fibrosis in 22 (66.7%), cirrhosis in 3 (9.1%) and normal liver in 8 (24.2%) patients. There was no significant correlation between variceal bleeding episode and type of liver pathology. Four patients (12%) died after surgery and re-bleeding occurred in one (3%) patients. Porto-azygeal disconnection surgery can be done safely in patients with esophageal varices and good liver function in order to prevent further bleeding episode.     

Paleomagnetic constraints on the age of the Botucatu formation in Rio Grande do Sul, southern Brazil

Paleomagnetic and rockmagnetic data are reported for the aeolian Botucatu Formation, in the southern Brazilian State of Rio Grande do Sul. Oriented samples were taken from a section located between the cities of Jaguari and Santiago. After thermal and alternating field demagnetization, both normal and reversed characteristic remanent magnetizations were found. These results yielded 13 reversed and 5 normal polarity sites, composing a magnetostratigraphic column displaying a sequence of reversed-normal-reversed polarity events. The paleomagnetic pole calculated for 18 sites is located at 114.7 degree E, 78.5 degree S (dp=8.1 masculine; dm=1.2 masculine), after restoring the strata to the paleohorizontal. This paleomagnetic pole indicates a Late Jurassic-Early Cretaceous age to the Botucatu Formation in the investigated area, and places the sampling sites at paleolatitudes as low as 21 masculineS.     

The 'hit by a stick' disease: an epidemiologic study of the causes of trauma in a non-profit hospital in rural Ethiopia

Traumatic injuries are one of the leading causes of death and disability worldwide and represent a very important public health problem in countries like Ethiopia, where there are insufficient centres of trauma care and where an interest in prevention has only relatively recently been awakened. The aim of this study was to investigate the causes of trauma at St Luke Catholic Hospital. We conducted a one-year retrospective study on 2969 patients who suffered from trauma. Every traumatized patient was classified by age, sex, cause and site of the trauma. The admission rate and hospital stays were also analysed. The most common causes of injury were: interpersonal conflict (32.2%); falling (15.1%); and road traffic incidents (RTIs; 14%). Men (71.7%) and young adults (37.6%; range 15-29 years) were the most affected, while head and neck were the most affected sites (33%). Half of the 377 admitted patients stay in hospital for more than a week. The 'hit by a stick' disease can be reduced with appropriate public health campaigns on trauma prevention. This is a priority in trauma prevention, especially in the rural areas.     

Audit on Preoperative Fasting of Elective Surgical Patients in an African Academic Medical Center

Background

Preoperative fasting is a requisite before anesthesia. The main reason for preoperative fasting is to reduce gastric volume and acidity and thus decrease the risk of pulmonary aspiration. However, preoperative fasting is usually prolonged beyond the recommended time for various reasons. Despite the many adverse effects of prolonged fasting, patients sometimes fasted for a prolonged time when surgery was delayed for different reasons at the University of Gondar Hospital. The aim of this study was to assess the duration of preoperative fasting for elective surgery.

Methods

A cross-sectional study was conducted from March 10 to April 10, 2013. Patients were interviewed 24 h after surgery. All 43 patients who were under anesthesia while operated on during the study period were included.

Result

Of the 43 patients included in the study, 35 were adults and 8 were children. The minimum, maximum, and mean fasting hours for food were 5, 96, and 19.60, respectively, and more than 50 % of the patients fasted from food twice as long as recommended. The minimum, maximum, and mean fasting hours for fluid were 5, 19, and 12.72, respectively. More than 95 % of the patients fasted from fluid longer than recommended.

Conclusion

Most patients fasted from both food (92 %) and fluid (95 %) longer than the fasting time recommended by the AAGBI, ASA, RCOA, and RCN fasting guidelines. Anesthetists, surgeons, and nurses need to revise operation lists every day in the operating theatres and resuscitate the patients when surgery is delayed for various reasons. A preoperative fasting guideline should be developed and implemented in the University of Gondar Hospital.     

The knowledge level of final year undergraduate health science students and medical interns about cardiopulmonary resuscitation at a university teaching hospital of Northwest Ethiopia

BACKGROUND:

Cardiopulmonary resuscitation (CPR) is a life-saving technique which is used after cardiopulmonary arrest. Chance of survival after arrest will increase if it is coupled with sufficient knowledge. Final year undergraduate health science students and interns manage many trauma and critically ill patients in our hospital. Even though all students took CPR training in undergraduate course, we sometimes saw difficulties in the resuscitation of patients after cardiopulmonary arrest by undergraduate health professionals. This study was to assess the level of knowledge of undergraduate health science students and medical interns about cardiopulmonary resuscitation.

METHODS:

Hospital based cross-sectional study was conducted from February 1 to March 30, 2013. All undergraduate health professionals were included. The mean score of knowledge was compared for sex, original residence and department of the participants by using Student''s t test and ANOVA with Scheffe''s test. P values <0.05 were considered statistically significant.

RESULTS:

Four hundred sixty-one out of 506 students were included in this study with a response rate of 91.1%. The overall mean knowledge score of final year undergraduate health science students and interns was 11.1 (SD=0.2). The mean knowledge scores of nurses, interns, health officer, midwifery, anesthesia and psychiatry nursing students were 9.84 (SD=2.5), 13.34 (SD=2.8), 9.81 (SD=3.0), 8.77 (SD=2.6), 13.31 (SD=2.7) and 8.43 (SD=2.4) respectively.

CONCLUSIONS:

The knowledge level of undergraduate health professionals about cardiopulmonary resuscitation was insufficient. Training about CPR for undergraduate health professionals should be emphasized.KEYWORDS: Cardiopulmonary resuscitation, Knowledge, Undergraduate, Health professionals     

Knowledge and skills of neonatal resuscitation of health professionals at a university teaching hospital of Northwest Ethiopia

BACKGROUND:

Competency in neonatal resuscitation is critical in the delivery rooms, neonatology units and pediatrics intensive care units to ensure the safety and health of neonates. Each year, millions of babies do not breathe immediately at birth, and among them the majority require basic neonatal resuscitation. Perinatal asphyxia is a major contributor to neonatal deaths worldwide in resource-limited settings. Neonatal resuscitation is effective only when health professionals have sufficient knowledge and skills. But malpractices by health professionals are frequent in the resuscitation of neonates. The present study was to assess the knowledge and skills of health professionals about neonatal resuscitation.

METHODS:

An institution based cross-sectional study was conducted in our hospital from February15 to April 30, 2014. All nurses, midwives and residents from obstetrics-gynecology (obs-gyn), midwifery and pediatric departments were included. The mean scores of knowledge and skills were compared for sex, age, type of profession, qualification, year of service and previous place of work of the participants by using Student’s t test and ANOVA with Scheffe’s test. A P value <0.05 was considered statistically significant.

RESULTS:

One hundred and thirty-five of 150 participants were included in this study with a response rate of 90.0%. The overall mean scores of knowledge and skills of midwives, nurses and residents were 19.9 (SD=3.1) and 6.8 (SD=3.9) respectively. The mean knowledge scores of midwives, nurses, pediatric residents and obs-gyn residents were 19.7 (SD=3.03), 20.2 (SD=2.94), 19.7 (SD=4.4) and 19.6 (SD=3.3) respectively. Whereas the mean scores of skills of midwives, nurses, pediatric residents and obs-gyn residents were 7.1 (SD=4.17), 6.7 (SD=3.75), 5.7 (SD=4.17) and 6.6 (SD=3.97) respectively.

CONCLUSIONS:

The knowledge and skills of midwives, nurses and residents about neonatal resuscitation were substandardized. Training of neonatal resuscitation for midwives, nurses and residents should be emphasized.KEY WORDS: Neonatal resuscitation, Knowledge, Skill, Health professionals     

In vivo Antimalarial Activity of a Labdane Diterpenoid from the Leaves of Otostegia integrifolia Benth

In Ethiopian traditional medicine, the leaves of Otostegia integrifolia Benth. are used for the treatment of several diseases including malaria. In an ongoing search for effective, safe and cheap antimalarial agents from plants, the 80% methanol leaf extract O. integrifolia was tested for its in vivo antimalarial activity, in a 4‐day suppressive assay against Plasmodium berghei. Activity‐guided fractionation of this extract which showed potent antiplasmodial activity resulted in the isolation of a labdane diterpenoid identified as otostegindiol. Otostegindiol displayed a significant (P < 0.001) antimalarial activity at doses of 25, 50 and 100 mg/kg with chemosuppression values of 50.13, 65.58 and 73.16%, respectively. Acute toxicity studies revealed that the crude extract possesses no toxicity in mice up to a maximum dose of 5000 mg/kg suggesting the relative safety of the plant when administered orally. The results of the present study indicate that otostegindiol is among the antimalarial principles in this medicinal plant, and further support claims for the traditional medicinal use of the plant for the treatment of malaria. Copyright © 2013 John Wiley & Sons, Ltd.