Multicriteria GIS-based assessment of biomass energy potentials in Nigeria.

The understanding of the geographical variability of biomass energy is an essential requirement for the optimal location of biomass energy conversion plants. This research presents a multicriteria GIS-based assessment of biomass energy potentials and the appropriate siting of biomass plants in Nigeria. The study applies the weighted overlay multicriteria decision analysis method. Crop and forest areas, settlement (energy supply areas), shrub/grasslands, barren land, water bodies, distance from water sources, road accessibility, topography, and aspect are the criteria that were considered for locating a biomass facility in this study. The results suggest that the theoretical, technical, and economical energy potentials of crop residues are highest in the North-East region of Nigeria and estimated at 1,163.32, 399.73, and 110.56 PJ/yr, respectively, and lowest in the South-East at 52.36, 17.99, and 4.98 PJ/yr, respectively. The theoretical, technical, and economical energy potentials of forest residues are highest in the North-West, estimated at 260.18, 156.11, and 43.18 PJ/yr, respectively, and lowest in the South-East at 1.79, 1.08, and 0.30 PJ/yr, respectively. Although most areas were identified to be suitable for siting biomass plants across Nigeria, the most suitable areas are located in the northern part of the country and include Niger, Zamfara, the Federal Capital Territory, Nassarawa, Kano, Kebbi, Kaduna, and Borno State. The study supports the Nigerian bio-energy policy that proposes to effectively utilize Nigeria's non-fuelwood as a substitute for the felling of trees. This is very important to strengthen its commitment at the COP26 International Climate Conference, which is to conserve and restore its forest. Furthermore, this study will serve as a good reference for policymakers to make well-informed decisions on tackling the energy insecurity in Nigeria.

Use of multi-strain probiotics in linseed meal based diet for Labeo rohita fingerlings / Uso de probióticos multi-cepas na dieta à base de farinha de linhaça para alevinos de Labeo rohita

Unavailability of probiotics in fish digestive system fingerlings is unable to digest and absorb their food properly. The current research was conducted to investigate the influence of probiotics added Linseed meal based (LMB) diet on hematology and carcass composition of Labeo rohita juveniles. Hematological parameters are essential diagnostics used to estimate the health status of fish. The usage of probiotics for fish health improvement is becoming common due to the higher demand for environment-friendly culture system in water. Linseed meal was used as a test ingredient to prepare six experimental test diets by adding probiotics (0, 1, 2, 3, 4 and 5 g/kg) and 1% indigestible chromic oxide for seventy days. According to their live wet weight, five percent feed was given to fingerlings twice a day. Fish blood and carcass samples (Whole body) were taken for hematological and carcass analysis at the end of the experiment. The highest carcass composition (crude protein; 18.72%, crude fat; 8.80% and gross energy; 2.31 kcal/g) was observed in fish fed with test diet II supplemented with probiotics (2 g/kg). Moreover, maximum RBCs number (2.62× 106mm-3), WBCs (7.84×103mm-3), PCV (24.61), platelets (63.85) and hemoglobin (7.87) had also been reported in the fish fingerlings fed on 2 g/kg of probiotics supplemented diet. Results indicated that probiotics supplementation has a critical role in improvement of fingerlings' body composition and hematological indices. Present findings showed that probiotics supplementation at 2 g/kg level in linseed by-product-based diet was very useful for enhancing the overall performance of L. rohita fingerlings.

A indisponibilidade de probióticos em alevinos do sistema digestivo de peixes faz com que ele seja incapaz de digerir e absorver seus alimentos adequadamente. A presente pesquisa foi conduzida para investigar a influência de probióticos adicionados à dieta à base de farelo de linhaça (LMB) na hematologia e na composição da carcaça de juvenis de Labeo rohita. Os parâmetros hematológicos são diagnósticos essenciais usados para estimar o estado de saúde dos peixes. O uso de probióticos para a melhoria da saúde dos peixes está se tornando comum devido à maior demanda por sistemas de cultivo em água que não agridam o meio ambiente. Farinha de linhaça foi usada como ingrediente para preparar seis dietas de teste experimentais adicionando probióticos (0, 1, 2, 3, 4 e 5 g/kg) e 1% de óxido crômico indigestível por 70 dias. De acordo com seu peso úmido vivo, 5% de alimento eram dados aos alevinos duas vezes ao dia. Amostras de sangue e carcaça de peixes (corpo inteiro) foram coletadas para análise hematológica e de carcaça no final do experimento. A maior composição da carcaça (proteína bruta, 18,72%; gordura bruta, 8,80%; e energia bruta, 2,31 kcal/g) foi observada em peixes alimentados com a dieta teste II suplementada com probióticos (2 g/kg). Além disso, os números máximos de RBCs (2,62×106 mm-3), WBCs (7,84×103 mm-3), PCV (24,61), plaquetas (63,85) e hemoglobina (7,87) também foram relatados em alevinos alimentados com 2 g/kg de dieta suplementada com probióticos. Os resultados indicaram que a suplementação de probióticos tem um papel crítico na melhoria da composição corporal dos alevinos e índices hematológicos. As descobertas atuais mostraram que a suplementação de probióticos no nível de 2 g/kg em dieta à base de subproduto de linhaça foi muito útil para melhorar o desempenho geral de alevinos de L. rohita.

Use of multi-strain probiotics in linseed meal based diet for Labeo rohita fingerlings

Abstract Unavailability of probiotics in fish digestive system fingerlings is unable to digest and absorb their food properly. The current research was conducted to investigate the influence of probiotics added Linseed meal based (LMB) diet on hematology and carcass composition of Labeo rohita juveniles. Hematological parameters are essential diagnostics used to estimate the health status of fish. The usage of probiotics for fish health improvement is becoming common due to the higher demand for environment-friendly culture system in water. Linseed meal was used as a test ingredient to prepare six experimental test diets by adding probiotics (0, 1, 2, 3, 4 and 5 g/kg) and 1% indigestible chromic oxide for seventy days. According to their live wet weight, five percent feed was given to fingerlings twice a day. Fish blood and carcass samples (Whole body) were taken for hematological and carcass analysis at the end of the experiment. The highest carcass composition (crude protein; 18.72%, crude fat; 8.80% and gross energy; 2.31 kcal/g) was observed in fish fed with test diet II supplemented with probiotics (2 g/kg). Moreover, maximum RBCs number (2.62× 106mm-3), WBCs (7.84×103mm-3), PCV (24.61), platelets (63.85) and hemoglobin (7.87) had also been reported in the fish fingerlings fed on 2 g/kg of probiotics supplemented diet. Results indicated that probiotics supplementation has a critical role in improvement of fingerlings body composition and hematological indices. Present findings showed that probiotics supplementation at 2 g/kg level in linseed by-product-based diet was very useful for enhancing the overall performance of L. rohita fingerlings.

Resumo A indisponibilidade de probióticos em alevinos do sistema digestivo de peixes faz com que ele seja incapaz de digerir e absorver seus alimentos adequadamente. A presente pesquisa foi conduzida para investigar a influência de probióticos adicionados à dieta à base de farelo de linhaça (LMB) na hematologia e na composição da carcaça de juvenis de Labeo rohita. Os parâmetros hematológicos são diagnósticos essenciais usados para estimar o estado de saúde dos peixes. O uso de probióticos para a melhoria da saúde dos peixes está se tornando comum devido à maior demanda por sistemas de cultivo em água que não agridam o meio ambiente. Farinha de linhaça foi usada como ingrediente para preparar seis dietas de teste experimentais adicionando probióticos (0, 1, 2, 3, 4 e 5 g/kg) e 1% de óxido crômico indigestível por 70 dias. De acordo com seu peso úmido vivo, 5% de alimento eram dados aos alevinos duas vezes ao dia. Amostras de sangue e carcaça de peixes (corpo inteiro) foram coletadas para análise hematológica e de carcaça no final do experimento. A maior composição da carcaça (proteína bruta, 18,72%; gordura bruta, 8,80%; e energia bruta, 2,31 kcal/g) foi observada em peixes alimentados com a dieta teste II suplementada com probióticos (2 g/kg). Além disso, os números máximos de RBCs (2,62×106 mm-3), WBCs (7,84×103 mm-3), PCV (24,61), plaquetas (63,85) e hemoglobina (7,87) também foram relatados em alevinos alimentados com 2 g/kg de dieta suplementada com probióticos. Os resultados indicaram que a suplementação de probióticos tem um papel crítico na melhoria da composição corporal dos alevinos e índices hematológicos. As descobertas atuais mostraram que a suplementação de probióticos no nível de 2 g/kg em dieta à base de subproduto de linhaça foi muito útil para melhorar o desempenho geral de alevinos de L. rohita.

Patterns of Health Care Utilization during Breast Cancer Diagnosis and Treatment: A Cross Sectional Study in Bangladesh.

Female breast cancer can be diagnosed easily; but due to inappropriate health care utilization, health-seeking is lag behind. The objectives of the study were to find out the pattern of utilization of health care during breast cancer diagnosis and treatment and their health seeking time. We conducted this cross sectional study for one year; from July 2017 to June 2018 among 200 newly diagnose patients with breast cancer whose were selected randomly from National Institute of Cancer Research and Hospital, Dhaka, Bangladesh from the listed patients who attended at the outpatient department of chemotherapy day care center for treatment. Delay in reporting, wrong reporting, double reporting, delay in hospital admission, long queue for administrative work and delay to reach cancer specialist play a role in utilization of health care. Results showed that health care service delivery and utilization was found to be significant by (p<0.05) associated with the provider delay (p=0.010), total delay (p=0.017), delay to consult with cancer specialist (p<0.0001). By logistic regression it analyzed that utilization of health care there had 2 times more likely to cause provider delay (OR=2.5; 95% CI 1.087-5.762) p=0.03. Utilization of health care influenced stage of cancer with delay help seeking and diagnostic institution also. As low middle income country, like Bangladesh, delays in seeking consultation, late presentation and the availability of breast cancer management for all patients, represent major challenges.

Use of multi-strain probiotics in linseed meal based diet for Labeo rohita fingerlings.

Unavailability of probiotics in fish digestive system fingerlings is unable to digest and absorb their food properly. The current research was conducted to investigate the influence of probiotics added Linseed meal based (LMB) diet on hematology and carcass composition of Labeo rohita juveniles. Hematological parameters are essential diagnostics used to estimate the health status of fish. The usage of probiotics for fish health improvement is becoming common due to the higher demand for environment-friendly culture system in water. Linseed meal was used as a test ingredient to prepare six experimental test diets by adding probiotics (0, 1, 2, 3, 4 and 5 g/kg) and 1% indigestible chromic oxide for seventy days. According to their live wet weight, five percent feed was given to fingerlings twice a day. Fish blood and carcass samples (Whole body) were taken for hematological and carcass analysis at the end of the experiment. The highest carcass composition (crude protein; 18.72%, crude fat; 8.80% and gross energy; 2.31 kcal/g) was observed in fish fed with test diet II supplemented with probiotics (2 g/kg). Moreover, maximum RBCs number (2.62× 106mm-3), WBCs (7.84×103mm-3), PCV (24.61), platelets (63.85) and hemoglobin (7.87) had also been reported in the fish fingerlings fed on 2 g/kg of probiotics supplemented diet. Results indicated that probiotics supplementation has a critical role in improvement of fingerlings' body composition and hematological indices. Present findings showed that probiotics supplementation at 2 g/kg level in linseed by-product-based diet was very useful for enhancing the overall performance of L. rohita fingerlings.

Pattern of Neonatal Danger Signs and its Related Factors in a Tertiary Level Hospital.

Considering very limited information in the pattern of neonatal danger signs with associated risk factors in our perspective, the aim of the study was to understand the country-context pattern of neonatal danger signs and its related factors in a tertiary level hospital. This cross-sectional study was conducted among 259 mothers and their neonates in Dhaka Medical College Hospital, Dhaka, Bangladesh from 01 January 2015 to 31 December 2015. Data were collected by face to face interview from mother by pre-tested semi structure questionnaire which was adopted from WHO-UNICEF list of newborn danger signs. Measurement of weight was taken from hospital record. Observation of danger signs were done by following check list. Data analysis was done by SPSS 20.0. Of all, majority (41.6%) was in the age group of 20-24 years & was educated up to secondary level (42.47%). More than half of the participants (54.1%) had family income >10,000 BDT. Sixty percentage of mother took ANC visit <3 times during their pregnancy period. About 42.1% had ≥1 co-morbidities. Hospital was the predominate place of birth with 48.3% caesarean delivery. At least one neonatal danger sign was present in 20.1% while 39.4% had at least 2 danger signs. Rest of the child had ≥2 danger signs at a time. The distribution of danger signs were not feeding since birth or stop feeding 206(79.5%), severe chest in drawing 145(56.1%) respiratory rates 60 or more 126(48.6%), convulsion 72(27.8%), yellow soles 68(26.3%). Factors like 'fail to identify with an expert health assistant', trial of delivery at home, delivery at home, older neonatal age (8-28 days), presence of injury at birth, and cutting of umbilical cord by blade during delivery were associated with higher number of danger signs (p<0.05 in all cases). About 80% neonate in our setting had ≥1 sign and had association with fail to identify with an expert health assistant', trial of delivery at home, delivery at home, older neonatal age, presence of injury at birth, and cutting of umbilical cord by blade during delivery.

Study on Clinical Presentation and Outcome of Septic Abortion and Its Relationship with Person Inducing Abortion.

Abortion is a global problem. Maternal mortality and morbidity is still high due to uncontrolled abortion mainly induced abortion which may turn to septic abortion. A total of 50 cases of septic abortion cases admitted in Dhaka Medical College Hospital were included in this study. This cross sectional study was designed to find out the clinical presentation and outcome of septic abortion from January 2010 to January 2011. Out of 50 cases of septic abortion admitted where 44(88%) were induced abortion. Majority of the cases were parous (2-3 parity 32%; 4-6 parity 38%; and 6+ parity 4%) and housewives 42(84%), living with their husbands 49(98%), hailing from urban, semi urban and urban slums. Nineteen (38%) having no education and 21(42%) had primary education. Most of the women 20(45.45%) wanted no more child, decided to terminate pregnancy not to overburden their families or due to disturbed marital relationship. The termination of pregnancy was carried out in first trimester 20(40%) and between (13-16) weeks it was 17(34%). Complications of septic abortion still remain a lethal threat to the life and health of women. The death rate was found 6(12%). And the leading causes of death were generalized peritonitis with septicaemia 3(50%), septicaemia with renal failure 2(33.30%), septic abortion with Disseminated Intravascular Coagulation 1(16.70%). Effective and widespread contraceptive use and continuing health and sex education remain pivotal if the incidence of septic abortion and their complications are to be reduced.

Status of Baby Friendly Hospital Initiative in Neonatal Units.

Neonatal unit is more vulnerable and critical ward than any others. To assure breastfeeding in neonatal unit is one of the ways to reduce child morbidity and mortality. Baby friendly hospital initiative is the best method in hospital setting to assure breastfeeding. This cross-sectional descriptive study was conducted from July 2014 to December 2014 to find out the Status of Baby Friendly Hospital Initiative (BFHI) in neonatal unit of different public hospitals. The study area was consisting of several tertiary level hospitals in Dhaka city. Study was done in those hospital where declared as Baby Friendly Hospital Initiative. Total 137 data was collected from care givers (70) and healthcare providers (67). From hospital data it was found that all children discharged for last month were exclusively breastfed. Written breastfeeding policy was present in all hospitals but out of 67 staffs only 28(41.48%) staffs received training which was not fulfillment of the requirement of Global Criteria of UNICEF/WHO (BFHI External Assessment and Reassessment). In step 5 only 21(31.34%) staffs show or offered help for breastfeeding. In step 6 and 9 there were 100% fulfill the requirements, no teats and pacifier was found, no use of foods or drinks except medications. Nurses were co-operative but due to lack of training and motivation they were not fully aware about the importance of breastfeeding.

Evidence-based surgical training in orthopaedics: how many arthroscopies of the knee are needed to achieve consultant level performance?

Despite being one of the most common orthopaedic operations, it is still not known how many arthroscopies of the knee must be performed during training in order to develop the skills required to become a Consultant. A total of 54 subjects were divided into five groups according to clinical experience: Novices (n = 10), Junior trainees (n = 10), Registrars (n = 18), Fellows (n = 10) and Consultants (n = 6). After viewing an instructional presentation, each subject performed a simple diagnostic arthroscopy of the knee on a simulator with visualisation and probing of ten anatomical landmarks. Performance was assessed using a validated global rating scale (GRS). Comparisons were made against clinical experience measured by the number of arthroscopies which had been undertaken, and ROC curve analysis was used to determine the number of procedures needed to perform at the level of the Consultants. There were marked differences between the groups. There was significant improvement in performance with increasing experience (p < 0.05). ROC curve analysis identified that approximately 170 procedures were required to achieve the level of skills of a Consultant. We suggest that this approach to identify what represents the level of surgical skills of a Consultant should be used more widely so that standards of training are maintained through the development of an evidenced-based curriculum.

The role of simulation in developing surgical skills.

Surgical training has followed the master-apprentice model for centuries but is currently undergoing a paradigm shift. The traditional model is inefficient with no guarantee of case mix, quality, or quantity. There is a growing focus on competency-based medical education in response to restrictions on doctors' working hours and the traditional mantra of "see one, do one, teach one" is being increasingly questioned. The medical profession is subject to more scrutiny than ever before and is facing mounting financial, clinical, and political pressures. Simulation may be a means of addressing these challenges. It provides a way for trainees to practice technical tasks in a protected environment without putting patients at risk and helps to shorten the learning curve. The evidence for simulation-based training in orthopedic surgery using synthetic models, cadavers, and virtual reality simulators is constantly developing, though further work is needed to ensure the transfer of skills to the operating theatre.

Clinical outcomes of bilateral single-stage unicompartmental knee arthroplasty.

BACKGROUND: Deciding whether to treat patients with bilateral arthritis with two-stage or bilateral single-stage arthroplasties is a cause of considerable debate in orthopaedic surgery. METHODS: A total of 394 cemented Unicompartmental Knee Arthroplasties (UKA) were performed in this unit between 2006 and 2010. A retrospective review identified 38 patients (76 knees) who underwent bilateral Single-Stage Sequential UKA, performed by a single surgeon. RESULTS: The mean BMI was 29.8 and the majority of patients were ASA grade 2. The mean duration of follow-up was 30 months. The mean total tourniquet time was 83 min. The mean post-operative haemoglobin was 11.8 and no patient required blood transfusion. The mean time to mobilisation was 18 h and the average length of stay was 3.5 days. This compares favourably with an institutional average length of stay of two days for a single UKA. There was a significant improvement in the mean pre- to post-operative OKS (from 14 to 34, p<0.0001). One patient required operative fixation of a tibial plateau fracture after sustaining a mechanical fall two months following surgery. There were no other major complications, including thrombo-embolic events or deep infections. Two patients required excision of a superficial suture granuloma. CONCLUSIONS: Bilateral Single-Stage Sequential UKAs provide significant improvement in patient function and can be performed safely with a low complication rate. Patients can benefit from a single hospital admission and anaesthetic whilst the shorter total in-patient stay reduces costs incurred by the hospital. LEVEL OF EVIDENCE: IV.

Initiation of liver transplantation in bangladesh: report on the first two successful cases.

Liver transplantation (LT) is the treatment of choice for patients with end-stage liver disease (ESLD). Chronic liver disease due to many causes is prevalent in a significant percentage of the Bangladeshi population. Until recently, liver transplantation facilities were not available, and ESLD patients were dying without treatment. Liver transplantation is a complex procedure that requires integrated and organized approach by a multidisciplinary team. The initiation of liver transplantation in Bangladesh has faced many difficulties. These difficulties have been encountered and overcome in phases. We have successfully performed the first two living-donor liver transplantations (LDLTs) in Bangladesh. The recipient of the first LDLT was a 42-year man with cryptogenic cirrhosis, and the second one was a male of 35 years, suffering from HBV cirrhosis. Both the recipients and donors are doing well and relishing the prospect of a normal life. These two successful liver transplantations are milestones in the development of liver transplantation services in Bangladesh.

Current concepts of the management of anterior cruciate ligament injuries in children.

Recent reports have suggested an increase in the number of anterior cruciate ligament (ACL) injuries in children, although their true incidence is unknown. The prognosis of the ACL-deficient knee in young active individuals is poor because of secondary meniscal tears, persistent instability and early-onset osteoarthritis. The aim of surgical reconstruction is to provide stability while avoiding physeal injury. Techniques of reconstruction include transphyseal, extraphyseal or partial physeal sparing procedures. In this paper we review the management of ACL tears in skeletally immature patients.

The Global Economic Cost of Osteoarthritis: How the UK Compares.

Aims. To examine all relevant literature on the economic costs of osteoarthritis in the UK, and to compare such costs globally. Methods. A search of MEDLINE was performed. The search was expanded beyond peer-reviewed journals into publications by the department of health, national orthopaedic associations, national authorities and registries, and arthritis charities. Results. No UK studies were identified in the literature search. 3 European, 6 North American, and 2 Asian studies were reviewed. Significant variation in direct and indirect costs were seen in these studies. Costs for topical and oral NSAIDs were estimated to be £19.2 million and £25.65 million, respectively. Cost of hip and knee replacements was estimated to exceed £850 million, arthroscopic surgery for osteoarthritis was estimated to be £1.34 million. Indirect costs from OA caused a loss of economic production over £3.2 billion, £43 million was spent on community services and £215 million on social services for osteoarthritis. Conclusions. While estimates of economic costs can be made using information from non-published data, there remains a lack of original research looking at the direct or indirect costs of osteoarthritis in the UK. Differing methodology in calculating costs from overseas studies makes direct comparison with the UK difficult.

Failure of asnis iii 5.0 mm cannulated screw: a case report.

We describe a case of an ASNIS III 5.0 mm partially threaded cannulated screw unthreading itself as it was being inserted during fracture fixation of a humerus. The majority of complications associated with cannulated screws involve breaking of the screw, as opposed to unthreading. We believe that the self tapping design of the screw, in combination with the cannulated design, creates a potential area of weakness when used on hard bone.

Removal and recovery of uranium from aqueous solutions by Ca-alginate immobilized Trichoderma harzianum.

The ability of Ca-alginate immobilized Trichoderma harzianum has been explored for removal and recovery of uranium from aqueous streams. Ca-alginate as polymeric support was selected after screening different matrices. Immobilization of Trichoderma harzianum to Ca-alginate improved the stability as well as uranium biosorption capacity of biosorbent at 28+/-2 degrees C and 200 rpm. The suitability of packed bed column operations was illustrated by obtaining break through curves at different bed heights, flow rates and inlet uranium concentrations. The adsorption column containing 1.5 g dry weight of immobilized material has purified 8.5L of bacterial leach liquor (58 mg/LU) before break through occurred and the biosorbent became saturated after 25 L of influent. Sorbed uranium was recovered in 200 ml of 0.1N HCl resulting in 98.1-99.3% elution by 0.1N HCl, which regenerated the biosorbent facilitating the sorption-desorption cycles for better economic feasibility without any significant alteration in sorption capacity/elution efficiency.

Malignant hemangiopericytoma in the gluteal region: a rare entity.

We present here a case of malignant hemangiopericytoma in a 40-year-old female who presented with a history of slowly growing mass in left gluteal region for about 1.5 years. She was evaluated and a mass of 10 x 7.5 x 5.5 cm 3 was found on computed tomography. The tumor was resected and was sent for histopathological evaluation. Grossly the tumor was encapsulated and on cut section it was nodular. Microscopy showed spindle cells forming cords and sheets separated by thin delicate stroma consisting largely of thin-walled vessels revealed by reticulin stain. Pleomorphism and mitotic figures were seen. It was diagnosed as a case of malignant hemangiopericytoma of gluteal region. The patient underwent radiotherapy and did apparently well. She is on regular follow-up because long-term follow-up is essential in all cases as recurrence can occur several years after treatment.

Leiomyoma of scrotum.

Leiomyoma is a benign tumor of smooth muscles. Leiomyoma originating from the scrotum is a rare entity. We report here a case of 50-year-old male who presented with a 4-cm lump in the left side of scrotum. Clinically, it was provisionally diagnosed as sebaceous cyst and was excised. The histopathology showed findings consistent with leiomyoma. There was no cytological atypia or mitosis. The final diagnosis of solitary leiomyoma of scrotum was given. The patient was followed up regularly and is doing fine for last 4 months.