Ear-related problems among children attending the paediatric and otorhinolaryngology out-patients clinics of the University of Nigeria Teaching Hospital,Enugu

BackgroundEar related diseases are commonly seen in clinics worldwide especially among children. They are associated with significant morbidity and frequent hospital visits. Limited data exists regarding the burden of ear disease among Nigerian children.ObjectiveTo determine the prevalence of ear-related problems among children presenting at the Paediatric and Otorhinolaryngology clinics of the University of Nigeria Teaching Hospital, Enugu.ResultsThree thousand and twenty-one children were seen during the study period. Out of these, 248 children (8.2%) presented with ear-related problems. Chronic otitis media (30.5%), acute otitis media (29.9%), cerumen auris (11.3%), otitis externa (10.1%), hearing impairment (7.3%) and foreign body in the ear (5.7%) were the most commonly diagnosed ear-related problems.ConclusionEar-related problems among children presenting at the UNTH Enugu were not uncommon. However, otitis media was the most commonly diagnosed ailment affecting the ears in children.     

P45 Microbiological culture analysis of the tongue microflora in subjects with and without halitosis

Objective  Determination of the microflora present on the tongue dorsum of subjects with and without halitosis using conventional microbiological culture methods.
Methods  Twenty-one halitosis and 20 control patients were recruited using a strict clinical protocol. Samples were collected from the posterior dorsum of the tongue using a sterile brush. Each sample was vortex mixed for 30 s and serial 10-fold dilutions to 10⁻⁷ were carried out. Samples were plated onto fastidious anaerobe agar (FAA) and FAA enriched with vancomycin. These were incubated under anaerobic conditions for 10 days at 37°C. Strict anaerobes were identified by metronidazole sensitivity and bacteria were identified to genus level by a combination of colony morphology, Gram staining and biochemical and enzymatic tests (rapid ID 32 A).
Results  The predominant species in test and control groups were Veillonella and Prevotella . Greater species diversity was found in the halitosis samples compared to controls. The halitosis samples contained a larger number of unidentifiable gram-negative rods, gram positive rods and gram negative coccobacilli.
Conclusions  There was no obvious association between halitosis and any specific bacterial genus. The increased species diversity found in halitosis samples suggests that halitosis may be the result of complex interactions between several bacterial species. The role of uncultivable bacteria may also be important in contributing to this process.     

Nursing care of patients with severe acute respiratory syndrome in the intensive care unit: case reports in Hong Kong

Severe acute respiratory syndrome (SARS) was diagnosed in more than 8437 patients in 25 countries between February and July 2003. During this period the World Health Organisation issued a global alert about SARS and together with the Centre for Disease Control have coordinated their efforts to investigate its pathogenesis and treatment. The outbreak in Hong Kong has been dramatic due to its geographical proximity with Guangdong province, China where the first case of SARS was reported. SARS has been described as a rapidly progressive, sometimes fatal pneumonia with a case fatality rate of 7.6% requiring intensive care. The four case reports illustrate a number of important points concerning the recognition, treatment, management and prevention of SARS, and highlights the importance of considering vigilant assessment and monitoring of patients with SARS. The purpose of this paper is to share our experiences in caring for critically ill patients with SARS in the intensive care unit to nurses globally in order to reduce SARS' morbidity and mortality as well as to protect nurses and other healthcare workers from this disease that is so far threatening the community at large.     

Analysis of clonal expansions through the normal and premalignant human breast epithelium reveals the presence of luminal stem cells

It is widely accepted that the cell of origin of breast cancer is the adult mammary epithelial stem cell; however, demonstrating the presence and location of tissue stem cells in the human breast has proved difficult. Furthermore, we do not know the clonal architecture of the normal and premalignant mammary epithelium or its cellular hierarchy. Here, we use deficiency in the mitochondrial enzyme cytochrome c oxidase (CCO), typically caused by somatic mutations in the mitochondrial genome, as a means to perform lineage tracing in the human mammary epithelium. PCR sequencing of laser‐capture microdissected cells in combination with immunohistochemistry for markers of lineage differentiation was performed to determine the clonal nature of the mammary epithelium. We have shown that in the normal human breast, clonal expansions (defined here by areas of CCO deficiency) are typically uncommon and of limited size, but can occur at any site within the adult mammary epithelium. The presence of a stem cell population was shown by demonstrating multi‐lineage differentiation within CCO‐deficient areas. Interestingly, we observed infrequent CCO deficiency that was restricted to luminal cells, suggesting that niche succession, and by inference stem cell location, is located within the luminal layer. CCO‐deficient areas appeared large within areas of ductal carcinoma in situ, suggesting that the rate of clonal expansion was altered in the premalignant lesion. © 2017 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.     

Psychiatry,psychology, law and homosexuality — uncomfortable bedfellows

The author analyses the history of the classification of homosexuality as a psycho‐sexual disorder and looks to the role of the law in propagating misunderstandings about sexual orientation. Looking to the causes of homophobia, he highlights the need for it to be eliminated, contending that until this occurs hatred, discrimination, disadvantage and violence will persist He argues that those who cause these feelings, and not those whom they target are the ones who need the assistance of scientific psychology and psychiatry and that those who are their targets need the strong assistance, protection and equal justice of the law.     

Seasonal variation in the acute presentation of urinary calculi over 8 years in Auckland,New Zealand

Study Type – Symptom prevalence (retrospective cohort)
Level of Evidence 2b

OBJECTIVE

To determine the incidence of acute presentation of urinary calculi (UC) in Auckland, New Zealand, during the period 1999–2007, and whether there was any significant seasonal variation.

PATIENTS AND METHODS

The details of all UC within the population presenting acutely to public hospitals in Auckland between 1999 and 2007 were collected using clinical coding searches International Classification of Disease 10th revision (Australian Modification) N132 and N20. Climatic variables for the Auckland region were obtained from the National Institute of Water and Atmospheric Research, New Zealand. The mean atmospheric temperature, hours of sunshine and humidity data were calculated monthly for this period.

RESULTS

During the study there were 7668 acute presentations of UC in the Auckland region. A Poisson regression model showed that the number of presentations was significantly related to temperature (P < 0.001) and hours of sunshine (P = 0.004) but not humidity (P = 0.14). For each degree increase in temperature the number of presentations increased by 2.8% (95% confidence interval 1.3–4.3%). For each 1‐h increase in sunshine, the number of presentations increased by 0.2% (0.06–0.33)%.

CONCLUSION

The acute presentation of UC in Auckland, New Zealand, varies significantly with temperature and hours of sunshine. Humidity was not a significant factor.     

Feature development in Cantonese

The phonetic inventories of 122 typically developing Cantonese-speaking children, aged from 0;10 to 4;7, were examined in terms of feature distinctions. The applicability of Dinnsen, Chin, Elbert and Powell's implicational feature hierarchy to these data was investigated. Results show that modifications to the hierarchy are necessary for the Cantonese phonetic system. A revised hierarchy for Cantonese is proposed. Differences between this proposal and the original work are discussed. The implicational nature of the proposed hierarchy was also tested on longitudinal data from ten children (aged from 0;10 to 3;5 at the beginning of the study) over a 1 year period. The proposed hierarchy successfully predicted the route of sound change of these inventories. Implications for further research on feature development are discussed.