Axial length measurement using optical versus immersion ultrasound: Impact on predicted refractive outcome following cataract surgery

Objective: To evaluate optical vs immersion ultrasound biometry to measure ocular axial length (the distance between the anterior surface of the cornea and the fovea). Design and Methodology: The axial length of the eye is usually measured by A-scan ultrasonography or optical coherence biometry. Optical biometry is the gold standard, but cannot be used for patients with dense cataracts, when immersion ultrasound biometry is utilized. Both optical and immersion ultrasound biometry were performed on patients scheduled to undergo cataract surgery between November 2017 and November 2018. Statistical difference was determined using a two tailed t-test. Results: There was no statistical difference between mean axial length measured using optical biometry (23.83 mm ± 1.34) vs immersion ultrasound biometry (23.80 mm ± 1.30); t(46)= -0.05, p=0.96. Conclusion: Accurate axial length measurement is essential for reliable intraocular lens power calculation, minimizing refractive error following cataract surgery. The cost of optical coherence biometry equipment is prohibitive and this technology is not readily available in the public hospital eye clinics. There was no statistical difference in axial length measured using optical biometry and immersion ultrasound. This suggests that in low resource settings, immersion biometry can be utilized without compromising surgical outcome.

Prevention of needle stick injury in the clinical setting among new registered nurses

Background: Needle stick injury is one of the greatest work-related health hazard, that registered nurses encounter on an everyday basis for example the risk of being exposed to dangerous and deadly blood borne pathogens through contaminated needle sticks such as human immunodeficiency virus (HIV) and hepatitis viruses. New registered nurses' lacking knowledge and skills regarding standard precautions are exposed to needle stick injuries from unsafe practices such as recapping of needles, manipulating used needles such as bending, breaking or cutting hypodermic needles and passing needles from one nurse to another (American Nurses Association 2002). Methods: This was a quantitative descriptive study. The dependent variable was the needle stick injury and the independent variables consisted of factors which influenced the occurrence of needle stick injuries among new registered nurses. The factors are practice, knowledge, resources and attitudes. The population was new registered nurses with less than three years' experience at the San Fernando General Hospital. A total of 120 new registered nurses were employed during the period under review and the entire population was used as the sample. A 26 item instrument was used to collect data which were analyzed using SPSS version 20. Findings: Most of the respondents 59 (49.2%) were between the ages 20-<30 years and 88 (73.4%) were female. The most common years' experience was 53 (44.2%). Almost half 54 (45%) respondents had experienced a needle stick injury with the most common exposure being while in use (17.5%) and recapping needles (215%). A total of 49 (40.8%) respondents had at least one to less than 3 needle sticks since employment and this was most common among staff on the medical wards. There was a moderate correlation between respondents knowledge about institution's policies and need for training (r0.409, p0.01) and strong correlation between their perception of the need to be more vigilant and the quality of the sharps that they are provided with (r0.913, p0.01). Conclusion: Avoidable practices such as non-adherence to standard precautions while using hypodermic needles are contributing factors to needle stick injuries. Prevention of NSI's should be an integral part of occupational health programs in the work place. Therefore, mandatory training and evaluation of health care worker's, knowledge and attitude regarding safety practices and proper use of available resources should be enforced when carrying out their duties in the clinical area.

Emergence of Zika Virus Epidemic and the National Response in Jamaica.

BACKGROUND: Jamaica, along with the Americas, experienced major epidemics of arboviral diseases transmitted by the Aedes aegypti mosquito in recent years. These include dengue fever in 2012, Chikungunya fever in 2014 and Zika virus infection (ZIKV) in 2016. We present the emergence of the ZIKV epidemic in Jamaica and outline the national response. METHODS: The Ministry of Health's preparedness included: heightened surveillance, clinical management guidance, vector control and management, laboratory capacity strengthening, training and staffing, risk communication and public education, social mobilization, inter-sectoral collaboration, resource mobilization and international cooperation. RESULTS: The first case of ZIKV was confirmed on January 29, 2016 with date of onset of January 17, 2016. From January 3 to July 30, 2016 (Epidemiological Week (EW) 1-30), 4648 cases of ZIKV were recorded (4576 suspected, 72 laboratory-confirmed). Leading symptoms were similar among suspected and confirmed cases: rash (71% and 88%), fever (65% and 53%) and joint pains (47% and 38%). There were 17 suspected cases of Guillain Barre syndrome; 383 were reported in pregnant women, with no reports of microcephaly to date. Zika and dengue viruses were circulating predominantly in 2016. At EW30, 1744 cases of dengue were recorded (1661 suspected and 83 confirmed). Dengue serotypes 3 and 4 were circulating with 121 reports of dengue haemorrhagic fever. CONCLUSION: The possibility exists for endemicity of ZIKV similar to dengue and chikungunya in Jamaica. A ZIKV vaccine, similar to the dengue and chikungunya vaccines, is needed to be fast-tracked into clinical trials to mitigate the effects of this disease.

Emergence of zika virus epidemic and the national response in Jamaica

BACKGROUND: Jamaica, along with the Americas, experienced major epidemics of arboviral diseases transmitted by the Aedes aegypti mosquito in recent years. These include dengue fever in 2012, Chikungunya fever in 2014 and Zika virus infection (ZIKV) in 2016. We present the emergence of the ZIKV epidemic in Jamaica and outline the national response. METHODS: The Ministry of Health's preparedness included: heightened surveillance, clinical management guidance, vector control and management, laboratory capacity strengthening, training and staffing, risk communication and public education, social mobilization, inter-sectoral collaboration, resource mobilization and international cooperation. RESULTS: The first case of ZIKV was confirmed on January 29, 2016 with date of onset of January 17, 2016. From January 3 to July 30, 2016 (Epidemiological Week (EW) 1-30), 4648 cases of ZIKV were recorded (4576 suspected, 72 laboratory-confirmed). Leading symptoms were similar among suspected and confirmed cases: rash (71% and 88%), fever (65% and 53%) and joint pains (47% and 38%). There were 17 suspected cases of Guillain Barre syndrome; 383 were reported in pregnant women, with no reports of microcephaly to date. Zika and dengue viruses were circulating predominantly in 2016. At EW30, 1744 cases of dengue were recorded (1661 suspected and 83 confirmed). Dengue serotypes 3 and 4 were circulating with 121 reports of dengue haemorrhagic fever...(AU) CONCLUSION:The possibility exists for endemicity of ZIKV similar to dengue and chikungunya in Jamaica. A ZIKV vaccine, similar to the dengue and chikungunya vaccines, is needed to be fast-tracked into clinical trials to mitigate the effects of this disease.

Perinatal autopsy rates at the University Hospital of the West Indies: 2002-2008.

OBJECTIVES: High perinatal autopsy rates are necessary for institutional management protocols and national policy-making. This study reviews perinatal autopsy rates and factors affecting these rates at the University Hospital of the West Indies. METHOD: All perinatal deaths (stillborn infants > or = 24 weeks gestation or 500 g; early neonatal deaths ie 0-7 days old) at the University Hospital of the West Indies, between January 2002 and December 2008, were reviewed retrospectively, using the annual perinatal audit records. The annual autopsy rates were calculated and the reasons why autopsies were not done examined. RESULTS: The average stillbirth (SB) autopsy rate was 59.6% (range 51.9 - 76.7%), while that for early neonatal deaths (ENDs) was 47.9% (range 34.4 - 63.2), with an overall average perinatal autopsy rate of 54.0% (range 42.2 - 62.2). Autopsies were requested in 79.3% and 51.7% of SBs and ENDs, respectively. Of those requested, 81.7% were done (75.2% stillbirths; 92.5% ENDs). In the ENDs, failure to request an autopsy was predominantly noted in premature infants weighing < 1000 g (75.2% of those not requested). In stillbirths, the reasons for failure to request were largely unknown with failure to gain permission accounting for only 20.3% of these cases. CONCLUSIONS: The average annual perinatal autopsy rate at the University Hospital of the West Indies between 2002 and 2008 was 54.0%. This is below the internationally recommended rate of 75%. Failure to request an autopsy was the most significant factor contributing to this. The reasons for this are not entirely clear and require further study.

Perinatal autopsy rates at the University Hospital of the West Indies: 2002-2008 / Tasas de autopsia perinatal en el Hospital Universitario de West Indies: 2002-2008

OBJECTIVES: High perinatal autopsy rates are necessary for institutional management protocols and national policy-making. This study reviews perinatal autopsy rates and factors affecting these rates at the University Hospital of the West Indies. METHOD: All perinatal deaths (stillborn infants > 24 weeks gestation or 500 g; early neonatal deaths ie 0-7 days old) at the University Hospital of the West Indies, between January 2002 and December 2008, were reviewed retrospectively, using the annual perinatal audit records. The annual autopsy rates were calculated and the reasons why autopsies were not done examined. RESULTS: The average stillbirth (SB) autopsy rate was 59.6% (range 51.9 - 76.7%), while that for early neonatal deaths (ENDs) was 47.9% (range 34.4 - 63.2), with an overall average perinatal autopsy rate of 54.0% (range 42.2 - 62.2). Autopsies were requested in 79.3% and 51.7% of SBs and ENDs, respectively. Of those requested, 81.7% were done (75.2% stillbirths; 92.5% ENDs). In the ENDs, failure to request an autopsy was predominantly noted in premature infants weighing < 1000 g (75.2% of those not requested). In stillbirths, the reasons for failure to request were largely unknown with failure to gain permission accounting for only 20.3% of these cases. CONCLUSIONS: The average annual perinatal autopsy rate at the University Hospital of the West Indies between 2002 and 2008 was 54.0%. This is below the internationally recommended rate of 75%. Failure to request an autopsy was the most significant factor contributing to this. The reasons for this are not entirely clear and require further study.

OBJETIVOS: Las altas tasas autopsia perinatal son necesarias para los protocolos institucionales de tratamiento, y el establecimiento de políticas a nivel nacional. Este estudio examina las tasas de autopsia perinatal y los factores que afectan estas tasas, en el Hospital Universitario de West Indies. MÉTODO: Todas las muertes perinatales (mortinatos > 24 semanas de gestación o 500 g; muertes neonatales tempranas, es decir, 0-7 días de nacido) en el Hospital Universitario de West Indies, entre el 2002 de enero y el 2008 de diciembre, fueron sometidas a examen retrospectivo, usando los registros de auditoría perinatales anuales.Las tasas de autopsia anuales fueron calculadas y se analizaron las razones por las que no se hicieron autopsias. RESULTADOS: La tasa de autopsia promedio de mortinatos (MN) fue 59.6% (rango 51.9-76.7%), mientras que la tasa de autopsia promedio de las muertes neonatales tempranas (MNT) fue 47.9% (rango 34.4-63.2), con una tasa promedio general de autopsia perinatal de 54.0% (rango 42.2-62.2). Se requirieron autopsias en 79.3% y 51.7% de los MN y las MNT respectivamente. De las autopsias requeridas, se realizaron 81.7% (75.2% mortinatos; 92.5% MNT). En relación con las MNT, la no solicitud de autopsia se notó predominantemente en infantes prematuros de peso < 1000 g (75.2% de aquéllos no solicitados). Con respecto a los mortinatos, se desconoce en gran medida las razones por las que no se hizo una solicitud, excepto el no haber obtenido permiso, lo cual explica sólo el 20.3% de los casos. CONCLUSIONES: La tasa de autopsia perinatal promedio anual en el Hospital Universitario de West Indies entre 2002 y 2008 fue 54.0%. Esta cifra se halla por debajo de la tasa internacionalmente recomendada de 75%. La no solicitud de una autopsia fue el factor más significativo que contribuyó a ello. Las razones para esto no están completamente claras y requieren estudio posterior.

Origin of honeybees (Apis mellifera L.) from the Yucatan peninsula inferred from mitochondrial DNA analysis.

Honeybees (Apis mellifera L.) sampled at sites in Europe, Africa and South America were analysed using a mitochondrial DNA restriction fragment length polymorphism (RFLP) marker. These samples were used to provide baseline information for a detailed analysis of the process of Africanization of bees from the neotropical Yucatan peninsula of Mexico. Radical changes in mitochondrial haplotype (mitotype) frequencies were found to have occurred in the 13-year period studied. Prior to the arrival of Africanized bees (1986) the original inhabitants of the Yucatan peninsula appear to have been essentially of southeastern European origin with a smaller proportion having northwestern European ancestry. Three years after the migration of Africanized bees into the area (1989), only very low levels of maternal gene flow from Africanized populations into the resident European populations had occurred. By 1998, however, there was a sizeable increase in the proportion of African mitotypes in domestic populations (61%) with feral populations having 87% of mitotypes classified as African derived. The results suggest that the early stages of Africanization did not involve a rapid replacement of European with African mitotypes and that earlier studies probably overestimated the prevalence of African mitotypes.