Recent Articles

19 year old female known case of primary hypothyroidism on levothyroxine replacement, type one diabetes on insulin pump with good glycemic control and stable thyroid function, developed diabetic gastroparesis with worsening response to oral levothyroxine therapy. Her symptoms of hypothyroidism and her thyroid function improved dramatically by intravenous levothyroxine three times weekly for 4 weeks then she restarted on her usual dose of oral levothyroxine. Intravenous levothyroxine three times weekly for 4 weeks followed by oral levothyroxine therapy maintained her euthyroid, improved hypothyroidism and gastroparesis symptoms till the date of editing of this report (more than 15 months.).

Foreign body (FB) aspiration is an uncommon but potentially life-threatening event, while the majority of accidental aspiration events occur in children, adults represent up to 25% of cases. When the diagnosis is not established immediately, retained FBs may lead to recurrent pneumonias, bronchiectasis, recurrent hemoptysis, pneumothorax, lung abscesses, pneumo-mediastinum, or other complications. Extraction of aspirated FBs should be undertaken as soon as possible to alleviate acute symptoms and prevent long term complications. FB aspiration is slightly more common in males. The vast majority of adult patients with FB aspiration have obvious risk factors for aspiration including neurological deficits with swallowing difficulties or altered mental status, neuromuscular disease, intoxication, or have an iatrogenic cause. Still, 10% of adult patients with FB aspiration have no known risk factors. Our case is 35 y old male patient who was brought to Accident and Emergency department after being found unresponsive in the street, on arrival to hospital his GCS was 9/15 with pin points pupils , spontaneous breathing and hemodynamic stable . CT brain was unremarkable Patient failed to respond to repeated doses of naloxone and his GCS dropped with episode of apnea so was intubated and mechanically ventilated. Follow up chest x-ray show opacification of the right lung, and ABG reveled hypoxia with respiratory acidosis in spite high ventilator settings, So CT chest was the best option which reveled bronchial obstruction mostly due to foreign body. Urgent bronchoscopy was done and unexpectedly obstruction was due to chewing gum pieces, aspiration of four large pieces of chewing gum, following that patient remained in the ICU for 2 days where chest x-ray show significant improvement and he was weaned and extubated successfully.

Tin mining pond water irrigated fields can cause potential contamination with heavy metals to soil and vegetables, thus pose a threat to human beings. The current study was designed to investigate the contamination of the soil with toxic heavy metals and their accumulation in edible vegetable crops. The heavy metals Pb, Cu, Cd, Zn, Cr, Fe, Mn and As were analyzed for their bioaccumulation factors to provide baseline data regarding environmental safety and the suitability of tin mining pond water for irrigation in the future. The contamination factor (CF) of these metals in the soil were calculated and indicated levels of metal contamination in the order of Cd > Zn > Pb > Cr > Cu > As ˃ Fe ˃ Mn. The concentrations of Pb, Cd, Cr, As, and Mn in the edible vegetables were above the safe limit prescribe by FAO/WHO, 2007 and EU, 2002 in all studied vegetables. The results indicated a potential pathway of human exposure to slow poisoning by heavy metals due to the utilization of vegetables grown on heavy metal contaminated soil that was irrigated with tin mining pond water sources. Amongst the studied vegetables, cabbage was safe from other metal except for As and Cr that were observed to exceeds tolerable limit. The irrigation source was identified as the source of the soil pollution in this study. Thus, the consumption of these vegetables might poses substantial health risk to consumers for this reason we therefore, emphasizes the need for proper remediation of the wastewater to reduce the health risk and the extent of heavy metals contamination.

This paper reviews the cognitive mechanisms underlying visual search in complex visual images. Visual search is a type of task that we are constantly engaged in our everyday lives. Here, the current paper introduces the current literature that suggests that there are two different processing routes that support visual search in human observers: Bottom-up and Top-down processing. Bottom-up processing allows the visual system to process the sensory information from the visual image as it is, whereas top-down processing guides the visual system to efficiently allocate attention to a part of the image to facilitate the search process. The two processing routes via bottom-up and top-down processing work in concert during complex visual search, guiding our search behavior to be more efficient and adaptive. In closing remark, this review also briefly discusses how the current knowledge about the roles of bottom-up and top-down processing in visual search can contribute to development of computer vision and artificial intelligent.

The presence of natural organic matter (NOM) in source water has posed many challenges for conventional water treatment facilities. Small organic acids, such as humic acid, present in NOM, have a high potential to influence the performance of water treatment processes. Uncontrolled application of agricultural chemicals leads to the simultaneous presence of toxic substances. In this work, batch adsorption experiments were conducted to examine the biosorption of HA onto chemically activated coffee husk. The biosorption process was studied as a function of operating conditions, such as contact time, pH of the solution, HA concentration, adsorbent dose and agitation speed parameters. Experimental results showed that the adsorption has an equilibrium time of 60 min with a maximum adsorption of 93.7%. The optimum pH for maximum HA adsorption was found to be 5.5, with a maximum adsorption of 94.3%. . As the dose of adsorbent increased from 1 to 25 g/L, the concentration of HA was observed to reduce from 10 to 1.67 mg/L which is below the WHO (World Health Organization) guideline value of 2 mg/L. The amount of HA adsorbed increased with increasing the initial adsorbent concentration from 0.5 to 20 mg/L. The adsorption kinetics well fitted the pseudo-second order model with the correlation coefficient R2 = 0.997 and Ks = 0.078. The experimental sorption equilibrium can be represented by the Langmuir isotherm (R2 = 0.998, SSE = 0.006). An average desorption capacity of 87.3% was observed. The study shows that chemically activated coffee husk can be a potential candidate to be used as a biosorbent in the removal of NOM from aqueous solutions.

Deaths and injury from road accidents on the highways of Ghana seem to be on the rise. Along these highways are advertising billboards with attractive, but often very seductive images of females. These images, according to advertisers, are meant to catch the maximum attention within the shortest possible time. Drivers use a large proportion of their visual sensory input, hence visually conspicuous items, such as billboards, are likely to interfere with visual processing tasks. Though few researches have been conducted on billboards and the occurrence of road accidents, as well as driver distractions, none actually focused on the visual elements as far as image mental distractions are concerned. From the positivist paradigm, the study investigated the roles visual elements on billboards play in the occurrence of road accidents. It focused on how these images add to the numerous road accidents. Standard designed survey questionnaires were administered to 200 drivers who ply the Kumasi- Accra highway route on regular basis. The data was analysed with SPSS using descriptive and Crosstab analysis methods. The study revealed that the distractions from these images were factors for these road accidents that lead to injury and death. The study also shows a connection between advertising billboard images and road accidents and how these advertising billboard images have a negative influence on driver-performance. It is therefore being recommended that stakeholders begin to focus on the kinds of billboards being mounted along the highways.

Candida prosthetic valve endocarditis (CPVE) is most commonly seen in persons who inject drugs intravenously or have indwelling catheters, pacemakers, or prosthetic joints that can serve as a nidus for candida suprainfection and seed the valve. Current treatment guidelines for CPVE include valve replacement and long-term antifungal therapy with intravenously administered Amphotericin B and parenteral or oral therapy with 5-fluorocytosine. Despite treatment, CPVE is characterized by a high recurrence rate (up to 36%) and a 5-year survival of less than 50%. I review my past experience in treating recalcitrant CPVE with transfer factor (TF) immunotherapy and conclude that TF can be a valuable adjuvant in the treatment of CPVE that does not respond to conventional interventions.

The study assesses relative efficiency and performance characteristics of the major ports in gulf countries using data envelopment analysis (DEA). Ports play key role in economic activities of these countries. The study reveal that technical efficiency of the ports in the region varies widely with mean constant and variable return to scale of 67.5 and 91 percent, respectively. Port Jabel Ali in UAE is identified as the benchmark for most of the inefficient ports indicating that the inefficient ports of the region should follow operational strategies of Port Jabel Ali. Also, all the inefficient ports of the region demonstrate increasing return to scale implying that their performance may improve with the scale of operation. Policy makers may consider investment to enhance operational scope of these ports.

PURPOSE: To report case of isolated orbital cysticercosis METHODS: Patients with drooping of eyelid were referred to our hospital. Patients were evaluated and investigated to find the cause of ptosis. RESULTS: Two patients with acute unilateral ptosis were referred to our hospital. Patients were investigated, blood test, stool tests and MRI were done to rule out the causes. In both the patients ptosis was due to involvement of LPS muscle by cysticercus larva. All the patients gave history of excessive consumption of cabbage and pork. The mainstay of treatment included oral albendazole (15 mg/kg/day) and oral prednisolone (1mg/kg/day) for 4 weeks. After 4 weeks, oral albendazole was stopped and oral prednisolone was slowly tapered over the next one month. The effect of above treatment was seen after few days with regression of swelling and improvement of signs and symptoms. CONCLUSION: Orbital cysticercus stands as one of the major causes of ptosis in the lower socioeconomic status people who are consuming mainly unhygienic leafy vegetables such as cabbage, burgers and undercooked pork. Therefore, these patients should be vigorously evaluated on scans (MRI and CT) so that early diagnosis can be made and treatment can be given to prevent the permanent visual loss or dissemination to brain.

The post caesarean fistula and sinus can take place due to tuberculosis , Crohn’s disease , deep pelvic infections or non absorbable sutures and even gauzes. A thirty year old woman ( P1 ,L1 ) who presented with multiple discharging sinuses at left lower abdomen since five months . She underwent lower segment caesarean section 10 months ago. On local examination , there were three linear scars two cm below the previous horizontal scar . The Ultrasound of local site revealed irregular loculated collections of size 3 × 2 cm in subcutaneous plane. We excised the sinus tracts ,but after two month came with reccurence . We did re- exploration and the sinus tract of size 9 cm was excised. Sinuses reccur even without retained foreign body or chronic disease. The management does not differ with the size of sinus.