Malignant granular cell tumor of the lateral femoral cutaneous nerve: report of a case with cytogenetic analysis

Malignant granular cell tumors (MGCTs) are rare neoplasms of uncertain histogenesis. We report a case of MGCT involving a peripheral nerve with peritoneal and omental dissemination in which cytogenetic findings are available. Our results show that MGCTs share some cytogenetic abnormalities with malignant peripheral nerve sheath tumors (MPNSTs), supporting the hypothesis that they may represent histogenetically related lesions.     

Plasmid-mediated quinolone resistance determinants qnrA, qnrB, and qnrS among clinical isolates of Enterobacteriaceae in a Korean hospital

Screening of 368 consecutive nonreplicate clinical isolates of Enterobacteriaceae resistant to nalidixic acid and at least one extended-spectrum β-lactam revealed the presence of qnrA, qnrB, and qnrS determinants, and identified novel qnrB variants, in Citrobacter freundii isolates. This study also revealed, for the first time, the linkage of qnrB, armA, and extended-spectrum and/or AmpC-type β-lactamase genes on large conjugative plasmids.     

Cross‐sectional survey of the disaster preparedness of nurses across the Asia–Pacific region

Healthcare workers who have received disaster preparedness education are more likely to report a greater understanding of disaster preparedness. However, research indicates that current nursing curricula do not adequately prepare nurses to respond to disasters. This is the first study to assess Asia–Pacific nurses' perceptions about their level of disaster knowledge, skills, and preparedness. A cross‐sectional survey was conducted with 757 hospital and community nurses in seven Asia–Pacific countries. Data were collected using the modified Disaster Preparedness Evaluation Tool. Participants were found to have overall low‐to‐moderate levels of disaster knowledge, skills and preparedness, wherein important gaps were identified. A majority of the variance in disaster preparedness scores was located at the level of the individual respondent, not linked to countries or institutions. Multilevel random effects modelling identified disaster experience and education as significant factors of positive perceptions of disaster knowledge, skills, and management. The first step toward disaster preparedness is to ensure frontline health workers are able to respond effectively to disaster events. The outcomes of this study have important policy and education implications.     

Diabetes and Hypertension in Urban Bhutanese Men and Women

Background:

Bhutan is a mountainous country with 31% urban population. There is no information on prevalence of diabetes and hypertension in Bhutan yet. This was the first study of its kind conducted in the capital city.

Objective:

To determine prevalence of diabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and hypertension in urban Bhutanese population aged 25 to 74 years.

Materials and Methods:

Stratified two-stage sampling was adopted to include 2474 respondents (Males: 1132, Females: 1342) equally distributed among different age and sex groups. A questionnaire containing demographic, educational and social details and history of diabetes and hypertension was administered on the sampled population the previous evening and blood pressure measured the next morning in nearby camp where fasting blood samples were collected and an oral glucose tolerance test done.

Results:

Age and sex standardized prevalence of diabetes, IGT and IFG were 8.2.0, 21.6 and 4%, respectively. Only 66.5% of the population had normal blood sugar. Prevalence of diabetes and IGT increased progressively with increasing age. Prevalence of hypertension was 26% (Males: 28.3%, Females: 23.2%). It was observed that 54.1% of diabetes population had hypertension.

Conclusion:

The study shows that not only is prevalence of diabetes and hypertension high in the urban Bhutanese but also there is a high diagnosis and treatment gap in these disorders.     

The burden and treatment outcomes of extra-pulmonary tuberculosis in Bhutan

Setting:

All tuberculosis (TB) registration sites in Bhutan.

Design:

Cross-sectional study involving a retrospective review of TB registers and TB treatment cards.

Objectives:

To determine: 1) the number and proportion of all TB cases registered as extra-pulmonary TB (EPTB) from 2001 to 2010, 2) the age and sex of the patients and the categories and types of EPTB registered in 2010, and 3) their treatment outcomes.

Results:

The proportion of all TB cases registered as EPTB over a period of 10 years varied from 30% to 40%. In 2010, 505 patients were registered with EPTB, of whom 50% were male, 21% were children, and 96% were new EPTB cases. TB lymph node enlargement and pleural effusion were the two most common types of EPTB, accounting for 67%, followed by abdominal TB and spinal/bone/kidney disease. The overall treatment success rate was 90%, and was generally similar with respect to sex, age and different types of EPTB.

Conclusion:

Bhutan has a high proportion of patients registered as having EPTB, for whom treatment outcomes are satisfactory. Further work is needed to better understand how EPTB is diagnosed throughout the country.     

Alcohol and economic development: Observations on the kingdom of Bhutan

Bhutan is a small country undergoing rapid social change arising from income growth, urbanisation and Western cultural influence. Markers of poverty, namely infectious disease and infant mortality, have improved dramatically. The attention of health authorities is now focused on the non‐communicable disease and injury burdens, to which alcohol consumption is a major contributor. The paper draws on official data to characterise the consumption of alcohol and related harm, and the nature of the alcohol market, with commentary on crucial aspects of availability policies and drink‐driving regulation that need reform. Kypri K, Dorji G, Dalton C. Alcohol and economic development: Observations on the kingdom of Bhutan. Drug Alcohol Rev 2017;36:333?336.]