Australasian Medical Journal
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Renal transplantation: Sonography and Doppler assessment of transplanted kidneys in adult Sudanese patients
Get PDFBackgroundEvery year, thirty-five thousand patients receive renal transplants worldwide. Kidney transplant provides better quality of life and reduced morbidity. Doppler and sonography were the best imaging modalities for evaluation.AimsTo assess the sonographic findings of renal allograft and to determine the correlation between Doppler resistive index and size of allograft and echogenicity. Methods This was a cross-sectional study conducted in Khartoum State from January to August 2016. A total of 86 patients with known transplanted kidneys were scanned with ultrasound using 3MHz and 5MHz transducers. The age was categorized into four groups and so the Doppler indices. Descriptive statistics used to analyse quantitative and qualitative variables (percent and means ± SD). Spearman's rho test was used to find the correlation between RI of renal vessels and allograft size. The Qui-square test was used to find an association between RI and echogenicity of the graft. Results Renal transplantation was common at the age of 20 to 50 years. The mean Doppler index of the renal artery was 0.68±0.11 in renal allografts. Renal transplantation was common in professionals and homemakers (30.2 per cent and 20.93 per cent respectively). Hypertension and diabetes were the most common causes (44.1 per cent and 18.6 per cent). A significant correlation was found between RI and allograft size (p-value=0.012). There was no statistical association between RI and echogenicity of allograft (p-value=0.106). ConclusionThe Doppler resistive index is significantly correlated with allograft size and had no association with echogenicity. Patients with enlarged allograft had raised resistive indices. The study recommended that Duplex ultrasound should be used in the initial assessment and follow-up of renal transplant
Are Australian general practice patients appropriately screened for colorectal cancer? A cross-sectional study.
Get PDFBackgroundAustralia has one of the highest rates of colorectal cancer (CRC) in the world. Data from the National Bowel Cancer Screening Program (NBCSP) suggests that only one third of Australians eligible for CRC screening are up-to-date with CRC screening; however screening occurring outside the program is not captured.AimsThis study examines the self-reported CRC screening practices of general practice patients, and the factors associated with being under-screened for CRC.Methods A cross-sectional study conducted in five general practice clinics in NSW from 2015-2017. Participants were aged 50–75 and at average risk of CRC. Participants reported whether they had a faecal occult blood test (FOBT) in the past two years, including the source of FOBT; and whether they had a colonoscopy in the past five years and the reason for colonoscopy.Results Forty-nine per cent of participants completed a FOBT in the past two years. Of these, 62 per cent sourced their FOBT from the NBCSP and 25 per cent from their general practitioner. Thirty-seven per cent of participants reported colonoscopy in the past five years. Of these, 29 per cent received potentially inappropriate colonoscopy. Thirty-two per cent of the samples were classified as under-screened. Older adults were less likely to be under-screened.ConclusionCRC screening rates were higher than those reported by the NBCSP, however a significant proportion of participants remain under-screened. Over one-quarter of participants reporting colonoscopy in the past five years may have undergone unnecessary colonoscopy. These findings indicate that more needs to be done at a general practice level to facilitate risk-appropriate CRC screening
Reduction of breast tumor burden in mice by a prenylated flavonoid, Artonin E
Get PDFBackgroundBreast cancer is still a leading cause of cancer death among women. Thus, therapeutic alternatives from nature should be explored to lessen this burden. This is vital owing to the common occurrences of resistance in conventional therapies alongside their alarming side effects.AimsThis study was carried out to investigate the inhibitory effect of Artonin E in female mice bearing 4T1 mammary tumour.Methods 4T1 cells in 100µL PBS were injected into the right mammary fat pad of each female Balb/c mice aged between six to eight weeks. Treatment was commenced when the palpable tumour attained a size of 50–200mm3. The treatment groups included Artonin E, at dosages of 25mg/kg, 50mg/kg and 100mg/kg per oral bi-weekly, 10mg/kg of paclitaxel weekly and 5 percent tween 20 bi-weekly. Tumour volume and body weight changes were recorded at the staging day and then twice every week throughout the study period. At the end of the study, the vital tissues were collected for histopathologcal assessment and blood samples were taken for serum biochemical analyses.Results From the results, the group treated with either 50mg/kg or 100mg/kg of Artonin E showed a significant (p < 0.05) reduction in tumour volume. Artonin E delayed quadruple tumour growth by more than five days in comparison to the untreated control group. Histopathology and biochemical analysis revealed no toxicity in the dosages of artonin E used in this study. Secondary tumour, which had metastasized to distant organs were seen to reduce upon treatment with Artonin E.ConclusionWith the capacity to reduce in vivo tumour growth, Artonin E has a great prospect to be developed into an anticancer agent
The report of double lumen tube anaesthesia in National Cancer Centre of Mongolia
Get PDFIf we can successfully place a double lumen tube, then it will ensure safety for our patients throw out the use of one lung anaesthesia. We could achieve adequate oxygen saturation (Spo2 or SaO2) with maintenance of PaO2 the level of 100-150mm Hg
Epidemiologic evaluation of toxoplasmosis and leading risk factors in HIV/AIDS patients in Arak City, Iran
Get PDFBackgroundToxoplasmosis is a common opportunistic infection that can be fatal in immunocompromised individuals, such as those with HIV/AIDS.AimsConsidering the rising incidence of HIV/AIDS in human populations worldwide and the high risk of toxoplasmosis among these patients, the current epidemiologic study was conducted to identify the characteristics and leading risk factors of toxoplasmosis among HIV/AIDS patients in Arak City, Marzaki Province, Iran.Methods This cross-sectional study was conducted in HIV patients under the care and counselling of the local health centre of Arak City. We included a total of 49 patients with HIV/AIDS who completed a written informed consent form and a two-part questionnaire. Demographic data and information about various risk factors were collected in the questionnaire. Blood samples were collected from each patient. Anti-Toxoplasma gondii IgG and IgM antibody assays and PCR were conducted on serum samples. Logistic regression and chi-squared (χ2) tests were used for statistical analysis. P values less than 0.05 (p < 0.05) were considered significant.Results Of the study participants, 22.4 per cent were Toxoplasma seropositive, with 20.4 per cent and 2 per cent being IgG- and IgM-positive, respectively. Among the participants, those who had occupational exposure to soil had the highest risk for toxoplasmosis (p < 0.043, OR=7.243).ConclusionThe seroprevalence of toxoplasmosis in HIV/AIDS patients is lower in Arak than in the general population in most parts of Iran. This is possibly owing to racial and geographic differences
The South African traditional health practitioner as a beneficiary of and provider to medical funds and schemes through the Traditional Health Practitioners Act (Act No 22, 2007)
No full textBackgroundPayments to traditional health practitioners for services rendered from medical funds and schemes, as envisaged by the Traditional Health Practitioners Act (Act No 22, 2007), is controversial and a point of contention. Such policy was followed before in South Africa in the 1990s when some funds and schemes offered limited alternative healthcare benefits for members consulting traditional healers.AimsThe study aimed to offer a contemporary view of the South African traditional health practitioner as a provider to and beneficiary of the medical funds and schemes through the Traditional Health Practitioners Act (No 22, 2007). Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the South African traditional health practitioner as a provider to and beneficiary of the medical schemes and funds through the Traditional Health Practitioners Act (No 22, 2007). The findings are offered in narrative form.Results It seems as if the South African authorities completely misunderstand the future implications of the Traditional Health Practitioners Act (No 22, 2007) on healthcare. This is specifically true when it comes to the right to claim from medical funds and schemes for services rendered by traditional health practitioners and the possible extra costs for these medical schemes and funds.ConclusionThe implications of Section 42(2) of the Traditional Health Practitioners Act (No 22, 2007) which aims to set up a claiming process for traditional health practitioners, seems to be very problematic. The fact that Act No 22 (2007) has not been enacted properly nine years after its promulgation has put a halt on the professionalization of traditional healers until 2015. This also affected their status as a beneficiary of and service provider to the various medical funds and schemes. At present there seems to be no clear and justified reason why the South African traditional health practitioner cannot be accepted as a beneficiary of and provider in the medical insurance industry
Outcomes, safety and staging of multivisceral resection for locally advanced primary colorectal cancer
No full textBackgroundMultivisceral resection is often required in the treatment of locally advanced colorectal cancer. AimsThe present study provides an analysis of the perioperative and oncological outcomes of multivisceral resection for locally advanced primary colorectal cancer.Methods Between January 2001 and December 2013, 58 patients who underwent multivisceral resection for locally advanced colorectal cancers were retrieved from a prospective database. 22 patients met the criterion of confirmed positivity of invasion or metastasis in pathologic findings after surgery (Group I) and 36 patients met the criterion of just adhesion at a nearby organ without confirmed positivity of invasion or metastasis after surgery (Group II). They were compared with respect to patient demographics, peri- and postoperative morbidity, and pathologic and oncological outcomes.Results The actual distribution of stage was pathologically reported as follows: IIa (n=21, 58.3 per cent), IIb (n=2, 5.5 per cent), IIIb (n=9, 25.0 per cent), and IIIc (n=4, 11.2 per cent) in Group II (initial clinical T4bNxM0) and IVa (n=21, 95.5 per cent), (n=1, 4.5 per cent) in Group I. With a median follow-up of 47.7 months, the five-year overall survival rate for Group I and Group II was 38.0 per cent and 62.9 per cent, respectively (p=0.100). The five-year disease free survival rate was 36.8 per cent (Group I) versus 61.9 per cent (Group II) (p=0.200).The local recurrence rate was 4.5 per cent (Group I) versus 5.6 per cent (Group II) (p=0.278). The mean length of patients’ hospital stay was 18.1 days and 15.9 days (p=0.049). The rate of morbidity was 10.3 per cent in Group I and 28.4 per cent in Group II (p=0.204).ConclusionBased on the present data, multivisceral resection for locally advanced colorectal cancer (clinically T4b) has acceptable perioperative and oncologic outcomes and may be a feasible procedure