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Epidemiology of Road Traffic Crash Injuries as Seen in the Emergency Room of a Tertiary Hospital in Delta State, Nigeria 尼日利亚三角洲州三级医院急诊室中道路交通碰撞伤害的流行病学研究
Pub Date : 2017-01-10 DOI: 10.9734/bjmmr/2017/32752
D. Odatuwa-Omagbemi, A. Oruma, R. Enemudo, C. Otene, G. Iwegbu, M. Okeke, E. Akpojevwe
Background/Objective: Road traffic crashes are an important source of frequent trauma with resultant morbidities and mortalities in Nigeria and worldwide. We aim to highlight important epidemiological characteristics and injury patterns in road traffic crash victims presenting at our centre and make suggestions on possible ways to alleviate the problem. Patients and Methods: Consecutive adult road traffic crash victims who presented with various injuries at the emergency room in our health facility within the study period and agreed to participate in the study were included. Data on age, sex, type of vehicle and circumstances of crash, types of injuries etc were collected on already prepared forms by attending emergency room physicians. Data analysis was carried out using SPSS version 17 (SPSS Inc. Chicargo, Illinois. USA). Results: Data were collected for 88 eligible adult road crash victims during the study period. There were 53 males and 35 females (M:F = 1.5:1). Mean age was 37 ± 14 years. Most of the victims fell within the age groups of 20 -29 years (33.3%) and 30 – 39 years (22.7%). Motorcycles were the most commonly involved (40.4%). Sixty five point two per cent (65.2 %) of the crashes involved commercial vehicles. Over speeding was adjudged as the most probable cause of crashes by 30.1% of victims. Passengers were the victims in 46.6% of cases and drivers in 37.5% of cases the rest being pedestrians. The head was injured in more than 40% of cases followed by lower extremity injuries. The victims sustained a total of 58 fractures the tibia and fibula being the most frequently fractured bones. Most of the victims (70.5%) were conscious and stable at presentation. Nearly all the victims (95.5%) were rescued and brought to hospital by other road users, fellow passengers and relatives. Conclusion: Road traffic crashes frequently affect males and the most productive age groups with its attendant dire consequences on the socio-economic life of the people. Human related factors such as over speeding significantly contribute to its occurrence. There is almost non-existence of rescue and pre-hospital care in our environment. The need for drivers / road user’s education, road maintenance and putting in place a well organized rescue and pre-hospital care team is emphasized.
背景/目的:在尼日利亚和世界范围内,道路交通碰撞是经常造成创伤的一个重要原因,造成发病率和死亡率。我们的目标是强调到我们中心来的道路交通意外受害者的重要流行病学特征和伤害模式,并就可能的缓解问题的方法提出建议。患者和方法:纳入研究期间在我们医疗机构急诊室出现各种损伤并同意参加研究的连续成人道路交通事故受害者。年龄、性别、车辆类型和碰撞情况、受伤类型等数据由急诊医生收集在已准备好的表格上。数据分析使用SPSS version 17 (SPSS Inc.)进行。伊利诺斯州的芝加哥的。美国)。结果:在研究期间收集了88名符合条件的成年道路交通事故受害者的数据。男性53例,女性35例(M:F = 1.5:1)。平均年龄37±14岁。大多数受害者年龄在20 -29岁(33.3%)和30 - 39岁(22.7%)之间。摩托车是最常见的(40.4%)。65.2%(65.2%)的事故涉及商用车。30.1%的受害者认为超速是最可能的交通事故原因。46.6%的受害者是乘客,37.5%的受害者是司机,其余的是行人。头部损伤超过40%,其次是下肢损伤。受害者共有58处骨折,胫骨和腓骨是最常见的骨折部位。大多数患者(70.5%)在就诊时意识清醒且稳定。几乎所有受害者(95.5%)都是由其他道路使用者、同行乘客和亲属救出并送往医院的。结论:道路交通事故经常影响到男性和最具生产力的年龄组,并对人民的社会经济生活造成严重后果。超速驾驶等人为因素对其发生有重要影响。在我们的环境中,几乎不存在急救和院前护理。强调需要对驾驶员/道路使用者进行教育、道路养护和建立组织良好的救援和院前护理小组。
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引用次数: 3
The Pattern and Outcome of Severe Trauma Using the Trauma and Injury Severity Score (TRISS) Methodology in a Dedicated Trauma Centre in Nigeria 在尼日利亚的一个专门的创伤中心,使用创伤和损伤严重程度评分(TRISS)方法研究严重创伤的模式和结果
Pub Date : 2017-01-10 DOI: 10.9734/BJMMR/2017/33392
S. Ibeanusi, S. Harcourt
Background: Trauma is a leading cause of mortality and a major contributor of disability as measured by Disability Adjusted Life years lost to inury in various parts of the world. Pattern of injuries and quality of care given to trauma patients differ in various parts of the world. The quality of care given in a particular centre can be assessed and compared with that from other centres by utilising an established standard method of assessment such as the Trauma Research and Injury Severity Score (TRISS). In this observational study, the pattern of presentation of severe trauma and quality of care given to severely injured patients at a trauma centre in Nigeria is evaluated using the TRISS methodology. The findings are compared with those reported from other countries. Methods: Data required for trauma demographics and TRISS calculation was extracted from the trauma registry of Teme Hospital, Port Harcourt Nigeria and analysed. Trauma demographics, type of care and the probability of survival of included patients were evaluated using the TRISS methodology. Results: Seven hundred and sixty two patients were seen with severe trauma but 746 patients had enough information required for analysis. Most of the trauma patients seen at the centre were males with a mean age ± standard deviation of 28.5 ± 11.3 years. Road traffic collision was the commonest cause of injury (41.2%) but gunshot injuries contributed a sizable number of the injuries (36.7%). The median Injury Severity Score (ISS) was 20 (range = 16 – 75) while the mean Revised Trauma Score (RTS) ± SD was 7.1 ± 1.3. The median probability of survival was 0.98 with a range between 0.00 and 0.99. The M, Z, and W statistics were 0.87, - 8.5, and -7.0 respectively. From TRISS analysis, 38 patients (5.1%) were expected to die but the observed mortality was 12.4%. Most mortality was related to severe head injuries. Conclusion: Trauma burden is an identified problem at Teme Hospital Nigeria. Severe trauma constitutes only 12% of trauma cases seen at the centre but it is the main contributor to trauma deaths. The observed mortality is higher than the expected as calculated using TRISS methodology and this call for improvement in the quality of care at the centre.
背景:在世界各地,创伤是导致死亡的主要原因,也是造成残疾的主要原因。世界各地对创伤患者的伤害模式和护理质量各不相同。可以利用创伤研究和损伤严重程度评分(TRISS)等既定的标准评估方法,对特定中心提供的护理质量进行评估,并与其他中心的护理质量进行比较。在这项观察性研究中,使用TRISS方法评估了尼日利亚创伤中心严重创伤的表现模式和对严重受伤患者的护理质量。研究结果与其他国家的报告进行了比较。方法:从尼日利亚哈科特港特梅医院的创伤登记处提取创伤人口统计学和TRISS计算所需的数据并进行分析。使用TRISS方法对纳入患者的创伤人口统计学、护理类型和生存概率进行评估。结果:762例有严重外伤,746例有足够的信息进行分析。创伤患者以男性居多,平均年龄±标准差为28.5±11.3岁。道路交通碰撞是最常见的伤害原因(41.2%),其次是枪伤(36.7%)。损伤严重程度评分(ISS)的中位数为20(范围= 16 - 75),修订创伤评分(RTS)的平均值±SD为7.1±1.3。中位生存概率为0.98,范围在0.00 - 0.99之间。M、Z、W统计量分别为0.87、- 8.5、-7.0。从TRISS分析,38例患者(5.1%)预计死亡,但观察到的死亡率为12.4%。大多数死亡与严重的头部损伤有关。结论:创伤负担是尼日利亚特梅医院的一个明确问题。严重创伤仅占该中心创伤病例的12%,但却是创伤死亡的主要原因。观察到的死亡率高于使用TRISS方法计算的预期死亡率,这要求改善中心的护理质量。
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引用次数: 2
An Evaluation of Risk Factors for Cerebral Palsy in Children in Jos, Nigeria 尼日利亚乔斯市儿童脑瘫危险因素评估
Pub Date : 2017-01-10 DOI: 10.9734/BJMMR/2017/33226
E. Ejeliogu, A. Ebonyi, C. John, E. Yiltok, B. Toma
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引用次数: 3
Maternal and Fetal Outcome after Assisted Conception in Port Harcourt, Nigeria 尼日利亚哈科特港辅助受孕后的母婴结局
Pub Date : 2017-01-10 DOI: 10.9734/BJMMR/2017/30044
N. Orazulike, J. Alegbeleye
Background: The introduction of assisted reproductive technology (ART) has played a major role in reducing the burden of infertility among couples. Although most pregnancies following assisted conception will progress normally without any increased risk to the mother or baby, studies have shown that some women who conceive in this manner as well as their babies are indeed at increased risk of complications. Objective: To evaluate the maternal and neonatal outcome after assisted reproductive technique (ART) in Port Harcourt, Nigeria. Materials and Methods: A retrospective case control study of 51 women who conceived via ART (subjects) and 51 women who conceived spontaneously (control) managed at the obstetric unit of the University of Port Harcourt Teaching Hospital, (UPTH), Nigeria over an 8-year period was conducted. Data obtained from theatre records and case notes of patients were analysed using the statistical package SPSS 20. Results: The rate of multiple pregnancy was 47% (24 women) in the ART group compared with Original Research Article Orazulike and Alegbeleye; BJMMR, 19(7): 1-9, 2017; Article no.BJMMR.30044 2 6% (3 women) in the control group and this was statistically significant (p = 0.001). Thirty-one (61%) of the women had adverse outcomes in the ART group compared to 9 (18%) in the control group and this was statistically significant (p = 0.001). Early pregnancy bleeding (p =0.03), hypertensive disorders of pregnancy (p = 0.05), pre term delivery (p = 0.002) caesarean delivery (p = 0.001), low birth weight (p = 0.001) neonatal admission (p = 0.02) and perinatal deaths (p = 0.03) were significantly commoner in the assisted conception group. The rates of antepartum haemorrhage, diabetes mellitus, postpartum haemorrhage, maternal death and mild birth asphyxia were not statistically different between the two groups. Conclusion: ART pregnancies are associated with more adverse feto-maternal outcomes compared with spontaneously conceived pregnancies.
背景:辅助生殖技术(ART)的引入在减轻夫妇不育负担方面发挥了重要作用。虽然大多数辅助受孕后的怀孕会正常进行,对母亲或婴儿没有任何风险增加,但研究表明,一些以这种方式怀孕的妇女及其婴儿确实面临着并发症的风险增加。目的:评价尼日利亚哈科特港辅助生殖技术(ART)后孕产妇和新生儿的预后。材料和方法:对尼日利亚哈科特港大学教学医院(UPTH)产科部门管理的51名通过抗逆转录病毒治疗怀孕的妇女(受试者)和51名自然怀孕的妇女(对照组)进行了回顾性病例对照研究,为期8年。从医院记录和患者病例记录中获得的数据使用SPSS 20统计软件包进行分析。结果:与Orazulike和Alegbeleye相比,ART组多胎妊娠率为47%(24例);地球物理学报,19(7):1-9,2017;文章no.BJMMR。对照组为30044266%(3名女性),差异有统计学意义(p = 0.001)。ART组有31名(61%)妇女出现不良后果,对照组为9名(18%),差异有统计学意义(p = 0.001)。妊娠早期出血(p =0.03)、妊娠期高血压疾病(p = 0.05)、早产(p = 0.002)、剖宫产(p = 0.001)、低出生体重(p = 0.001)、新生儿入院(p = 0.02)和围产期死亡(p =0.03)在辅助受孕组中较为常见。两组产前出血、糖尿病、产后出血、产妇死亡、轻度出生窒息发生率比较,差异均无统计学意义。结论:与自然妊娠相比,ART妊娠与更多的不良胎母结局相关。
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引用次数: 0
Prevalence, Isolation and Detection of Virulent Gene in Escherichia coli from Duck 鸭源大肠埃希菌流行、分离及毒力基因检测
Pub Date : 2017-01-10 DOI: 10.9734/BJMMR/2017/32003
S. Majumder, M. Akter, Islam, K. Hussain, Shobhan Das, I. Hasan, K. Nazir, Marzia Rahman
Aims: This study was conducted to determine virulent genes in Escherichia coli prevalent in duck population by multiplex Polymerase Chain Reaction. Methodology: A total of 60 cloacal swab samples were collected from two duck farms of Bangladesh Agricultural University and Shamvuganj. Initially the samples were screened for the detection of E. coli on the basis of cultural, staining and biochemical properties, followed by molecular detection of E. coli using genus specific primers to amplify 16s RNA. Results: According to the results, out of 60 samples, 26 (43.33%) were confirmed to be E. coli positive. Among the E. coli positive samples, 12 (46.15%) samples were found positive for Stx -1 and 11 for Stx -2. Among 26, 11 (42.31%) samples possess both Stx -1 and Stx -2 genes, whereas only one isolate had Stx -1 gene. The prevalence of both Stx -1 and Stx -2 in Bangladesh Agricultural University Poultry Farm was 41.66%, and the prevalence of Stx -1 and Stx -2 in Shamvuganj was 50% and 42.86%, respectively. Conclusion: This is the first report on the detection of virulence genes in E. coli of duck origin in the context of Bangladesh. This study indicates that duck may play role for the transmission of Shiga-like toxin producing E. coli (STEC) to human or its environment through fecal contamination or eggs or meat.
目的:采用多重聚合酶链反应法测定鸭群中流行的大肠杆菌毒力基因。方法:从孟加拉国农业大学和Shamvuganj的两个鸭场共收集60份粪拭子样本。首先根据培养、染色和生化特性对样品进行筛选检测大肠杆菌,然后利用属特异性引物扩增16s RNA对大肠杆菌进行分子检测。结果:60份样本中,大肠杆菌阳性26份(43.33%)。在大肠杆菌阳性样本中,Stx -1阳性12份(46.15%),Stx -2阳性11份。26份样品中,同时携带Stx -1和Stx -2基因的有11份(42.31%),携带Stx -1基因的仅有1份。孟加拉国农业大学家禽养殖场的Stx -1和Stx -2的流行率为41.66%,Shamvuganj的Stx -1和Stx -2的流行率分别为50%和42.86%。结论:这是孟加拉国首次检测到鸭源大肠杆菌毒力基因的报告。本研究表明,鸭可能通过粪便污染或鸡蛋或肉类将产志贺样毒素大肠杆菌(STEC)传播给人类或其环境。
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引用次数: 3
Effect of Plasma-leptin on Cardiac Disorders with Type 2 Diabetes-patients 血浆瘦素对2型糖尿病患者心脏疾病的影响
Pub Date : 2017-01-10 DOI: 10.9734/BJMMR/2017/29482
N. Al-Aama
Background: The net mechanism by which visceral fat concentration is still unclear because of its interference with autonomic dysfunction which could be simply modified by leptin through the dorosomedical hypothulumus. This work studies the potential correlations between visceral fat concentration, cardiac autonomic dysfunction having diabetic disorder (type 2) and leptin. Methods: The present work includes 90 cases with cardiovascular risk parameters and diabetic patients and 90 (age- and gender-matched) non diabetic. Typical measurements for cardiovascular risk factors have been measured in addition to plasma visceral fat area, heart variability, leptin and soluble leptin receptor standards. Results: Visceral fat area is highly inversely dependant on the parameters of heart rate variability (p < 0.05 and standard deviations of NN (normal RR) intervals during the 24-hour period r = -0.239, p =0.003 . Similarly, the plasma standard of leptin is also important (p < 0.05) showing reverse dependence with the parameters of heart rate variability standard deviations of NN (normal RR) intervals during the 24-hour period r = -0.238, p = 0.017 . In case of non diabetic patients, Data Article there are almost zero dependence between leptin and any of heart rate variability parameters. Conclusions: Patients having visceral obesity and type 2-diabetes are strongly affected with hyper-leptinemia which may lead to cardiac autonomic dysfunction. recorded for minutes: Estimated glomerular filtration rate, presence of hypertension and dyslipidemia, the age, male gender, hemoglobin A1c, and duration of diabetes as covariates, duration of diabetes.
背景:由于内脏脂肪浓度干扰自主神经功能障碍,其具体机制尚不清楚,而自主神经功能障碍可以通过瘦素简单地通过多侧垂体调节。这项工作研究了内脏脂肪浓度、2型糖尿病患者心脏自主神经功能障碍和瘦素之间的潜在相关性。方法:90例有心血管危险参数的糖尿病患者和90例(年龄和性别匹配)非糖尿病患者。除了血浆内脏脂肪面积、心脏变异性、瘦素和可溶性瘦素受体标准外,还测量了心血管危险因素的典型测量。结果:内脏脂肪面积与心率变异性参数呈高度负相关(p < 0.05), 24小时内NN(正常RR)间隔标准差r = -0.239, p =0.003。同样,血浆瘦素水平也很重要(p < 0.05),与24小时内心率变异性NN(正常RR)区间标准差r = -0.238, p = 0.017呈负相关关系。在非糖尿病患者中,瘦素与任何心率变异性参数之间的相关性几乎为零。结论:内脏型肥胖和2型糖尿病患者易发生高瘦素血症,高瘦素血症可导致心脏自主神经功能障碍。记录分钟:估计肾小球滤过率,高血压和血脂异常的存在,年龄,男性性别,糖化血红蛋白,糖尿病持续时间作为协变量,糖尿病持续时间。
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引用次数: 0
Co-relative Study of Serum Prolidase Activity and Oxidative Status in Patients with Diabetic Neuropathy 糖尿病性神经病变患者血清脯氨酸酶活性与氧化状态的相关研究
Pub Date : 2017-01-10 DOI: 10.9734/BJMMR/2017/30938
R. Kumari, R. Srivastava, A. Verma, N. Agarwal
Objective: Diabetic neuropathy is one of the most common long term complication of diabetes. Associaton of oxidative stress have been reported in diabetes. The study was aimed to evaluate oxidative status in diabetic neuropathy patients by estimation of serum total oxidative status (TOS), total antioxidant status (TAS) and prolidase activity. Methods: Sixty (60) patients of diabetic neuropathy were included in the study and 60 normal subjects were taken as control. TOS and TAS were measured in serum extract by colometric test. Along with these laboratory parameters, demographic and neurological examination was also done. Original Research Article Kumari et al.; BJMMR, 20(1): 1-9, 2017; Article no.BJMMR.30938 2 Results: The activity of TOS, TAS, oxidative stress index (OSI) and serum prolidase activity were higher in cases as compared to control.TOS (p<.0001) has a weak positive correlation with very low density lipoprotein (VLDL). TAS (p>.05) is negatively correlated with basal metabolic index, serum triglyceride (STG), serum cholesterol (SC), very low density lipoprotein (VLDL), high density lipoprotein (HDL), fasting blood sugar (FBS), post prandial blood sugar (PPBS) and HbA1c. In our study prolidase activity was elevated in cases as compared to control that was not significantly different (P>.001). A significant positive correlation with HDL (r= .418) and moderate negative correlation with HbA1C (r = -.318), VLDL (r = -.308), STG (r = -.301) was found. Conclusion: Thus, our study concludes that TOS and OSI have a significant role in diabetic neuropathy. In addition to this increased serum prolidase activity in diabetic neuropathy patients may be due to increased collagen turnover. Increase in TAS activity needs to be further investigated as the sample size of this study was small and although it was an accidental finding.
目的:糖尿病性神经病变是糖尿病最常见的长期并发症之一。氧化应激在糖尿病中也有相关报道。本研究旨在通过测定血清总氧化状态(TOS)、总抗氧化状态(TAS)和增殖酶活性来评价糖尿病神经病变患者的氧化状态。方法:选取60例糖尿病性神经病变患者作为研究对象,60例正常人作为对照。采用比色法测定血清提取物中的TOS和TAS。除了这些实验室参数外,还进行了人口统计学和神经学检查。Kumari等人;生物医学工程学报,20(1):1-9,2017;文章no.BJMMR。结果:患儿血清TOS、TAS活性、氧化应激指数(OSI)及血清脯氨酸酶活性均高于对照组。TOS与基础代谢指数、血清甘油三酯(STG)、血清胆固醇(SC)、极低密度脂蛋白(VLDL)、高密度脂蛋白(HDL)、空腹血糖(FBS)、餐后血糖(PPBS)、HbA1c呈负相关(p < 0.05)。在我们的研究中,与对照组相比,病例中增殖酶活性升高,差异无统计学意义(P> 0.001)。与HDL呈显著正相关(r= 0.418),与HbA1C (r= - 0.318)、VLDL (r= - 0.308)、STG (r= - 0.301)呈中度负相关。结论:本研究认为TOS和OSI在糖尿病神经病变中具有重要作用。此外,糖尿病神经病变患者血清脯氨酸酶活性升高可能是由于胶原蛋白周转增加所致。由于本研究的样本量很小,尽管这是一个偶然的发现,但TAS活性的增加需要进一步研究。
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引用次数: 2
Risk Factors for Infection of Staphylococcus aureus: Nasal Carriage, Skin Carriage and Multi-antibiotic Resistance in Healthy Individuals 金黄色葡萄球菌感染的危险因素:健康个体的鼻腔携带、皮肤携带和多种抗生素耐药性
Pub Date : 2017-01-10 DOI: 10.9734/BJMMR/2017/32307
E. Nmema
Aims: The study investigated the nasal and skin carriage of Staphylococcus aureus in healthy individuals and the antibiotic resistance profile. Study Design: A descriptive laboratory based surveillance study. Place and Duration of Study: Department of Biological Sciences, Ondo State University of Science and Technology, Okitipupa, between May and November 2016. Methodology: Eighty samples were obtained from anterior nares and skin of 40 healthy volunteers aged 19 to 35 years. Isolates were identified by cultural characteristics on Mannitol Salt Agar, biochemical tests. Percentage carriage of S. aureus was calculated separately for nasal and skin samples. Antibiotic susceptibility testing was performed by the disk diffusion method to determine the multi-antibiotic resistance (MAR) profile. Results: From 40 nasal samples, 17 (42.5%) yielded S. aureus from 12 (30.0%) female and 5 (12.5%) male volunteers. Out of 40 skin samples, 17 (42.5%) samples yielded S. aureus from 8 (20.0%) female and 9 (22.5%) male volunteers. There were no differences in the number/percentage of nasal and skin samples yielding S. aureus ; but there were differences in the number/percentage of nasal samples of male and female volunteers colonized by S. aureus , while little difference was found in the number/percentage of skin samples of male and female volunteers colonized by S. aureus . MAR for nasal isolates was 66.7% to 77.8%, and for skin isolates 66.7% to 88.9%. The isolates showed 100% resistance to six antibiotics; but zero resistance to ofloxacin. MAR index for nasal and skin isolates ranged from 0.67 to 0.89. Conclusion: S. aureus carriage of 42.5% in the nasal cavity and skin, combined with high MAR index of 0.67 to 0.89 are serious risk factors for infection when the immune system is compromised. Nasal decolonization, proper hand washing, use of hand gloves and appropriate use of antibiotics will reduce the risk of S. aureus colonization, transfer and infection, and the consequent high morbidity and mortality.
目的:研究健康人群中金黄色葡萄球菌的鼻腔和皮肤携带情况及耐药情况。研究设计:基于实验室的描述性监测研究。学习地点和时间:奥基提帕翁多国立科技大学生物科学系,2016年5月至11月。方法:选取40名年龄在19 ~ 35岁的健康志愿者的前鼻腔和皮肤80份样本。通过甘露醇盐琼脂培养特性和生化试验对分离菌株进行鉴定。分别计算鼻腔和皮肤样品的金黄色葡萄球菌携带百分比。采用纸片扩散法进行药敏试验,确定多种抗生素耐药谱。结果:40份鼻腔样本中,女性12例(30.0%),男性5例(12.5%),检出金黄色葡萄球菌17例(42.5%)。在40份皮肤样本中,来自8名(20.0%)女性和9名(22.5%)男性志愿者的17份(42.5%)样本产生了金黄色葡萄球菌。鼻腔和皮肤样品中产生金黄色葡萄球菌的数量/百分比没有差异;但男性和女性志愿者的鼻腔样本中金黄色葡萄球菌的定殖数量/百分比存在差异,而男性和女性志愿者的皮肤样本中金黄色葡萄球菌的定殖数量/百分比差异不大。鼻分离株的MAR为66.7% ~ 77.8%,皮肤分离株的MAR为66.7% ~ 88.9%。分离株对6种抗生素100%耐药;但对氧氟沙星没有耐药性。鼻分离株和皮肤分离株的MAR指数为0.67 ~ 0.89。结论:鼻腔和皮肤中金黄色葡萄球菌携带率为42.5%,且MAR指数高(0.67 ~ 0.89)是免疫系统受损时感染的严重危险因素。鼻腔去殖、正确洗手、使用手套和适当使用抗生素将降低金黄色葡萄球菌定植、转移和感染的风险,以及由此导致的高发病率和死亡率。
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引用次数: 2
5 Case Reports of Maternal Experiences during Pregnancy, Peripartum and Infancy Periods of their Profoundly Deaf Children under the Socioeconomic Situation in Nigeria 5例尼日利亚社会经济条件下重度聋儿妊娠、围生期和婴儿期母亲经历报告
Pub Date : 2017-01-10 DOI: 10.9734/BJMMR/2017/30785
R. Kalu, J. Fulton, K. Etim
The incidence of profound hearing loss is global, but the challenges and perception of mothers during pregnancy, peripartum and infancy of their children with profound hearing loss appear to differ from country to country and between developed and developing countries. The aim of this study was to investigate the experiences of five mothers of profoundly deaf children in Calabar, Southeastern Nigeria, during pregnancy, peripartum and infancy of such children, including how Case Report Kalu et al.; BJMMR, 20(5): 1-11, 2017; Article no.BJMMR.30785 2 these 5 mothers interpreted their children’s disability, relative to the socioeconomic situations in Nigeria. A qualitative methodology aimed at having a holistic and indepth understanding of the experiences of these 5 mothers, was employed. The results revealed that these 5 mothers were initially suspicious of their children’s disability when they noticed the children’s developmental delay, resulting in frustration and worry. There was no newborn screening test for the disability as done in developed countries, thus denying parents expeditious preventive measures. Mothers’ ignorance of the aetiological factors of the abnormality, wrong diagnosis by unskilled health workers in available hospitals and spiritual belief, coupled with socioeconomic factors such as poverty and very strange healthcare system, all were the experiences of mothers which of course, obstructed choices of solution to the abnormality. The information collected from these 5 mothers indicates socioeconomic impediments, ignorance and spiritual belief system will continue to negatively affect the management of profound deafness in Nigeria.
深度听力损失的发病率是全球性的,但在不同国家以及发达国家和发展中国家之间,母亲在患有深度听力损失的孩子的怀孕、围产期和婴儿期所面临的挑战和看法似乎有所不同。本研究的目的是调查尼日利亚东南部卡拉巴尔市5名重度失聪儿童的母亲在这些儿童怀孕、围产期和婴儿期的经历,包括病例报告Kalu等人;生物医学工程学报,20(5):1-11,2017;文章no.BJMMR。30785 .这5位母亲根据尼日利亚的社会经济状况来解释她们孩子的残疾。采用了一种定性方法,目的是全面和深入地了解这5位母亲的经历。结果显示,这5位母亲在注意到孩子的发育迟缓时,最初对孩子的残疾持怀疑态度,从而产生沮丧和担忧。没有像发达国家那样对新生儿进行残疾筛查,因此剥夺了父母迅速采取预防措施的权利。母亲对异常病因的不了解、现有医院医护人员的错误诊断、精神信仰,再加上贫困、医疗体系非常陌生等社会经济因素,这些都是母亲的经历,当然阻碍了异常治疗的选择。从这5位母亲那里收集到的信息表明,社会经济障碍、无知和精神信仰体系将继续对尼日利亚的深度耳聋管理产生负面影响。
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引用次数: 0
The Morphology of the Lumbosacral Articular Processes in Adult Chinese and Its Biomechanical Implication 成人中国人腰骶关节突的形态及其生物力学意义
Pub Date : 2017-01-10 DOI: 10.9734/bjmmr/2017/29233
Lilt Xin, Yuanyuan Xia, Qingyong Ma
Aim: The morphology of the lumbosacral intervertebral joints in the Chinese race was investigated in the present study to understand the relationship between the articular joint interface and intervertebral disc prolapses. Methods: Spine specimens (N=30) from both male and female adults with ages ranging from 30 to 60 years old were used. They were fixed with 3% formaldehyde, frozen and cut through the intervertebral joints and the intervertebral disc. The angle between the facet joint interface and the median sagittal line on both sides was measured for each joint. Results: The angle between the facet joint interface and the median sagittal line increased gradually from the L1-L2 joint to L5-S1 joint, and the angles in the L4-L5 and L5-S1 joints were both significantly wider than those of other lumbar intervertebral joints. When the angles on the left side were compared with those of the right side, those on the left side were significantly wider than those on the right side. Since the force acting toward the intervertebral disc can be decomposed into one component perpendicular to the facet joint interface and one parallel to the facet joint interface, when the facet joint interface is in a more sagittal position, it blocks less shearing force that acts to slide the vertebra anteriorly. When the facet joint interface is in a more coronal position, it blocks most of the force. Conclusion: Although the L1 –S1 are more coronal in positions on the left side, most disc prolapses happen on the left side, suggesting that some adaptive processes might contribute to the more coronal orientation of these facet joint interfaces or the shearing force act more along the facet joint interface on the other side.
目的:观察中华民族腰骶椎间关节形态,探讨关节界面与腰椎间盘突出症的关系。方法:选取30 ~ 60岁男性和女性成人脊柱标本30例。它们用3%的甲醛固定,冷冻并切开椎间关节和椎间盘。测量每个关节的小关节界面与两侧正中矢状线之间的夹角。结果:从L1-L2关节到L5-S1关节,关节突关节界面与正中矢状线夹角逐渐增大,且L4-L5和L5-S1关节夹角均明显宽于其他腰椎椎间关节。将左侧的角度与右侧的角度进行比较,左侧的角度明显比右侧的角度宽。由于作用于椎间盘的力可以分解为垂直于小关节界面的一个分量和平行于小关节界面的一个分量,所以当小关节界面处于更矢状的位置时,它阻挡的作用于椎体前滑动的剪切力较小。当小面关节界面处于一个更冠状的位置时,它阻挡了大部分的力。结论:虽然L1 -S1在左侧多呈冠状位,但大多数椎间盘脱垂发生在左侧,提示某些适应性过程可能导致这些小关节界面更呈冠状位,或者剪切力更多地沿另一侧小关节界面作用。
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British journal of medicine and medical research
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