Congenital orbital teratoma Aiyub, Shereen; Chan, WengOnn; Szetu, John ...
Indian Journal of Ophthalmology/Indian journal of ophthalmology,
12/2013, Volume:
61, Issue:
12
Journal Article
Peer reviewed
Open access
We present a case of mature congenital orbital teratoma managed with lid-sparing exenteration and dermis fat graft. This is a case report on the management of congenital orbital teratoma. A full-term ...baby was born in Fiji with prolapsed right globe which was surrounded by a nonpulsatile, cystic mass. Clinical and imaging features were consistent with congenital orbital teratoma. Due to limited surgical expertise, the patient was transferred to Adelaide, Australia for further management. The patient underwent a lid-sparing exenteration with frozen section control of the apical margin. A dermis fat graft from the groin was placed beneath the lid skin to provide volume. Histopathology revealed mature tissues from each of the three germ cell layers which confirmed the diagnosis of mature teratoma. We describe the successful use of demis fat graft in socket reconstruction following lid-sparing exenteration for congenital orbital teratoma.
Most studies on community perceptions toward malaria have been undertaken in high-endemic countries, and studies from low-endemic countries have only recently been published. Similar information is ...also needed for hypoendemic countries such as Indonesia, to cope with the persistence of foci-endemic malaria in these regions. An applied qualitative method, Rapid Assessment Procedures, was employed during a 3-month intensive data collection period in Jepara district, Central Java province. Data were retrieved from 38 free-listings, 28 in-depth interviews, seven focus group discussions and unstructured observation. Qualitative thematic content analysis was applied. In this community, malaria (known as
katisen or
panas tis) was considered a common but minor illness. Insufficient understanding of malaria signs and symptoms in the subvillages likely leads to delay in illness recognition and treatment; not surprisingly self-treatment is common and the dosage most likely below the recommended dose. The health center was used but when it did not work, most people would shift back to traditional services due to cost considerations. Low understanding and acceptance of the causal link between the mosquito and malaria, likely leading to poor comprehension of preventive activities, as well as confusion of malaria with dengue fever, were identified. In conclusion, this study highlights a consistent gap between the common understanding and the biomedical description of malaria. If case management continues to be the main strategy in malaria control program, the emic perspective of the people must be well-integrated into the program. Likewise, interventions to improve home-treatment should also be developed.
Rapid assessment methods of resilience for natural and agricultural systems Torrico, Juan C.(University of Applied Sciences Cologne Institute for Technology in the Tropics); Janssens, Marc J.J.(University of Bonn)
Anais da Academia Brasileira de Ciências,
12/2010, Volume:
82, Issue:
4
Journal Article
Peer reviewed
Open access
The resilience, ecological function and quality of both agricultural and natural systems were evaluated in the mountainous region of the Atlantic Rain Forest of Rio de Janeiro through Rapid ...Assessment Methods. For this goal new indicators were proposed, such as eco-volume, eco-height, bio-volume, volume efficiency, and resilience index. The following agricultural and natural systems have been compared according: (i) vegetables (leaf, fruit and mixed); (ii) citrus; (iii) ecological system; (iv) cattle, (v) silvo-pastoral system, (vi) forest fragment and (vii) forest in regeneration stage (1, 2 and 3 years old). An alternative measure (index) of resilience was proposed by considering the actual bio-volume as a function of the potential eco-volume. The objectives and hypotheses were fulfilled; it is shown that there does exist a high positive correlation between resilience index, biomass, energy efficiency and biodiversity. Cattle and vegetable systems have lowest resilience, whilst ecological and silvo-pastoral systems have greatest resilience. This new approach offers a rapid, though valuable assessment tool for ecological studies, agricultural development and landscape planning, particularly in tropical countries.
Foram avaliadas, em região montanhosa da Mata Atlântica do Rio de Janeiro a resiliência, função ecológica e qualidade tanto do sistema agrícola como natural, através dos métodos de avaliação rápida ("rapid assessment methods"). Para este fim, foram propostos novos indicadores como eco-volume, eco-altura, bio-volume, eficiência volumétrica e índice de resiliência. Os seguintes sistemas agrícolas e naturais foram comparados: (i) hortaliças (folhas, frutos e mistos); (ii) citros; (iii) sistema ecológico; (iv) gado; (v) sistema silvo-pastoral; (vi) fragmento florestal; (vii) floresta em estágio de recuperação (1, 2 e 3 anos de idade). Uma forma alternativa de resiliência foi proposta considerando o bio-volume real como uma função do eco-volume potencial. Os objetivos e hipóteses foram alcançados; demonstrou-se que existe uma correlação altamente positiva entre índice de resiliência, energia da biomassa, eficiência energética e biodiversidade. Pecuária e sistemas de hortaliças apresentaram as mais baixas resiliências enquanto sistemas ecológico e silvo-pastoral tiveram maiores resiliências. Esta nova estratégia oferece uma rápida e valiosa ferramenta de avaliação para estudos ecológicos, desenvolvimento agrícola e planejamento paisagístico, especialmente em países tropicais.
We sampled 92 wetlands from four different basins in the United States to quantify observer repeatability in rapid wetland condition assessment using the Delaware Rapid Assessment Protocol (DERAP). ...In the Inland Bays basin of Delaware, 58 wetland sites were sampled by multiple observers with varying levels of experience (novice to expert) following a thorough training workshop. In the Nanticoke (Delaware/Maryland), Cuyahoga (Ohio), and John Day (Oregon) basins, 34 wetlands were sampled by two expert teams of observers with minimal protocol training. The variance in observer to observer scoring at each site was used to calculate pooled standard deviations (SDpool), coefficients of variation, and signal-to-noise ratios for each survey. The results showed that the experience level of the observer had little impact on the repeatability of the final rapid assessment score. Training, however, had a large impact on observer to observer repeatability. The SDpool in the Inland Bay survey with training (2.2 points out of a 0-30 score) was about half that observed in the other three basins where observers had minimal training (SDpool = 4.2 points). Using the results from the survey with training, we would expect that two sites assessed by different, trained observers who obtain DERAP scores differing by more than 4 points are highly likely to differ in ecological condition, and that sites with scores that differ by 2 or fewer points are within variability that can be attributed to observer differences.
A 67-year-old former gold miner with rheumatoid arthritis, treated with steroids and methotrexate, presented to eye casualty with a painful right eye. Examination revealed an anterior uveitis and ...despite an initial response to topical steroids, the intraocular inflammation worsened with anterior and posterior uveitis development. Re-examination showed a white mass in the peripheral nasal retina initially suspected of being active Toxoplasmosis infection and anti-toxoplasmosis treatment commenced. After improvement and tapering of this treatment, the intraocular inflammation reoccurred. Cytopathological examination of a pars plana vitrectomy obtained vitreous sample that showed a non-diagnostic non-infectious chronic vitritis. The vitreoretinal surgeons elected to do a direct biopsy of the white subretinal mass in the peripheral nasal area. This revealed, quite unexpectedly, an abscess containing pigmented phaeohyphomycosis fungi. This case report documents the multidisciplinary approach that assisted in clinching a final diagnosis and the role of sub-retinal biopsy in this unprecedented scenario.
The aim of present study was to compare the efficacy and safety of fixed combination of brimonidine and timolol with individual components used as monotherapy in patients of primary open angle ...glaucoma. Patients were randomly assigned to receive brimonidine or timolol or brimonidine-timolol fixed combination, with 30 patients in each group. The mean reduction in intraocular pressure in brimonidine, timolol, and brimonidine-timolol group were 4.29 ± 1.97 mm Hg, 4.34 ± 1.21 mm Hg, and 5.54 ± 1.87 mm Hg respectively at 2 weeks and 4.86 ± 1.16 mm Hg, 5.42 ± 1.50 mm Hg, and 7.36 ± 2.58 mm Hg respectively at 6 weeks. When values of mean reduction in intraocular pressure were compared between brimonidine-timolol fixed combination with brimonidine and timolol, it was found to be statistically significant ( P < 0.05) at 2 weeks and highly significant (0.001) at 6 weeks. The overall frequency of adverse effects was similar in all three groups.
Abstract Background The purpose of this paper was to examine the context of injection drug use in Kabul, Afghanistan among injection drug users (IDUs) utilising and not utilising needle and syringe ...programmes (NSPs). Methods Following identification of themes from eight focus group discussions, free-lists were used for further exploration with both NSP using ( n = 30) and non-NSP using ( n = 31) IDUs. Results All participants were male, had been injecting for 5 years (mean), and most (95%) had been refugees in the past decade. Main reasons for sharing syringes were convenience and lack of availability and did not vary based on NSP use. Drug users perceived alienation from the community, evidenced by names used for drug users by the community which convey social stigma and moral judgment. Health risks were the principal stated risk associated with drug use, which was mentioned more frequently by NSP users. Harm reduction services available in Kabul are perceived to be insufficient for those in need of services, resulting in under utilisation. The limited scope and distribution of services was frequently cited both as an area for improvement among NSP using IDU or as a reason not to use existing programmes. Conclusions While some positive differences emerged among NSP-using IDU, the current context indicates that both rapid scale-up and increased variety of services, particularly in the realm of addiction treatment, are urgently needed in this setting.
A rapid ethnographic assessment of delivery of mental health services to patients at a Level I trauma center in a major metropolitan hospital undergoing a COVID-19 surge was conducted to assess the ...challenges involved in services delivery and to compare the experience of delivering services across time. Study participants were patients and providers who interacted with or otherwise were observed by three clinicians engaged in the delivery of care within the Emergency Department (ED) and Trauma Center at Harborview Medical Center from the COVID-19-related “surge” in April to the end of July 2020. Data were collected and analyzed in accordance with the Rapid Assessment Procedures-Informed Clinical Ethnography (RAPICE) protocol. Community and institutional efforts to control the spread of the coronavirus created several challenges to providing mental health services in an acute care setting during the April surge. Most of these challenges were successfully addressed by standardization of infection control protocols, but new challenges emerged including an increase in expenses for infection control and reduction in clinical revenues due to fewer patients, furloughs of mental health services providers and peer specialists in the ED, services not provided or delayed, increased stress due to fear of furloughs or increased workload of those not furloughed, and increases in patients seen with injuries due to risky behavior, violence, and substance use. These findings illustrate the rapidly shifting nature of the pandemic, its impacts on mental health services, and the mitigation efforts of communities and healthcare systems.
An effectual emergency response effort is contingent upon the quality and timeliness of information provided to both the decision making and coordinating functions; conditions that are hard to ...guarantee in the urgent climate of the response effort. The purpose of this paper is to present a validated Humanitarian Data Model (HDM) that can assist in the rapid assessment of disaster needs and subsequent decision making. Substandard, inconsistent information can lead to poorly informed decisions, and subsequently, inappropriate response activities. Here we present a novel, organized, and fluid information management workflow to be applied during the rapid assessment phase of an emergency response. A comprehensive, peer-reviewed geospatial data model not only directs the design of data collection tools but also allows for more systematic data collection and management, leading to improved analysis and response outcomes.
This research involved the development of a comprehensive geospatial data model to guide the collection, management and analysis of geographically referenced assessment information, for implementation at the rapid response phase of a disaster using a mobile data collection app based on key outcome parameters. A systematic review of literature and best practices was used to identify and prioritize the minimum essential data variables.
The data model was critiqued for variable content, structure, and usability by a group of subject matter experts in the fields of humanitarian information management and geographical information systems.
Consensus found that the adoption of a standardized system of data collection, management, and processing, such as the data model presented here, could facilitate the collection and sharing of information between agencies with similar goals, facilitate the better coordination of efforts by unleashing the power of geographic information for humanitarian decision support.
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