Physiology and Anatomy

To report two cases of right crossed non-fused renal ectopia diagnosed in male patients about 30 years of age who arrived to emergency Centre’s with symptoms of renal colic. We report two cases of male patients who arrived to an emergency centre complaining of colic lumbar pain. Crossed renal ectopia was finally revealed by means of intravenous urogram after several analytical and imaging examinations. Right crossed non-fused renal ectopia is an uncommon congenital anomaly with a higher incidence in males. It is much more common to find a crossed fused renal ectopia of the orthotopic kidney. In contrast, if there is no fusion it may be located on the lower portion of the normal kidney, which is not the case in this instance. This malformation is not usually accompanied by other congenital anomalies. Most of cases are spontaneously solved and they do not require an intercurrent surgical intervention.

The Democratic Republic of Congo has for thirty years, five operational mobile telephonic companies. No descriptive survey was conducted to assess the real risk for mental health of Call Center workers. The main objective was to contribute to the knowledge of the characteristics of job strain among teleoperators in Kinshasa. Specifics objectives were : 1) to describe the socio-demographical characteristics of Call Center workers ; 2) to identify the job strain among teleoperators ; 3) to measure the relation between job strain and work time within the Call Center ; 4) to measure association between job strain and socio-demographical characteristics. The study was conducted in five Call Center s in Kinshasa, a sample convenience of 110 people was recruited pursuant to individual consent as per the Helsinki Declaration. They were informed of terms of reference regarding their participation and the research objective. Data were collected using standardised Karasek Questionnaire French version validated by the Sumer Inquiry 2003.Spss 20 software was used to analyze data and the khi-square to measure the association between variables. This version evaluates three dimensions: psychological demand, decisional latitude and social support. One hundred and ten people were surveyed averaging 30 years. Most of them were male, university graduates and unmarried. 75.5% of participants presented job strain, 60% have spent six months or more in Call Center s. There was a significant relation between working time within Call Center s and inherent job strain. Six months was a minimum time during which psychological factors negatively impacted teleoperators’ mental health. This study focused on Call Center teleoperators, demonstrated that teleoperators were affected by job strain (high psychological demands and low decisional latitude). The susceptible minimum exposure time to trigger the disease was evaluated at six months or more. Teleoperators were predominantly male, graduated, youngsters and unmarried.

The informal (Juakali) sector in Kenya lack occupational health and safety services and workers unknowingly exposed to health hazards. Worldwide, occupational noise is a significant cause of adult onset-hearing loss and 16% of disabling hearing loss in adults. . The aim of the study was to identify the health effects of noise to the Juakali artisans in King'orani area by identifying key sources of noise, assessing hearing threshold levels, examining auditory health effects of noise and the prevalence of noise induced hearing loss. This was through administration of a structured questionnaire, noise level measurements, and pure tone eudiometry to stratified, randomly selected subjects. Data was coded cleaned and analyzed using SPSS version 21.0. Out of 124 participants involved in the study, prevalence of NIHL was 59.7% with 31.5% having mild, 18.5% moderate, and 5.7% had severe, and 4% had profound impairments. The level of impairment increased with the duration and level of exposure to noise above 90 dB. Those involved in operation of pneumatic tools were the most affected compared to those involved in other activities as food vendors and hawkers. Exposure level and duration was greatly associated with auditory effects such as Tinnitus, headache, poor concentration, and sleep disorders. In conclusion NIHL, headaches, tinnitus, poor concentration and sleep disturbances are related to prolonged exposure to high level of noise above 90dB with a positive correlation coefficient of 0.248 at p<0.05. Therefore, review of OSHA 2007 to effectively regulate the informal sector, awareness campaign on effects of noise exposure, establishment of Hearing monitoring canters, special subsidies and provision of PPEs will be able to arrest the otherwise forgotten irreversible disability causing Hazard the Juakali artisans are exposed to.

Most of the brain disorders are diagnosed by analyzing the EEG signals. In this paper an efficient approach for detecting the presence of epileptic seizures in EEG signals using fuzzy KNN classifier is presented. Epilepsy is a disease due to temporary alternation in brain functions due to abnormal electrical activity of a group of brain cells and is termed as seizure. The analysis is performed in three stages. In the first step the biorthogonal Discrete wavelet transform is used for decompose the EEG signal into delta, theta, alpha, beta and gamma subbands. In the second step the statistical features are extracted from each subband and finally classification of the EEG signal that is epileptic seizure exists or not has been done using fuzzy KNN clasifier. This method is applied for two different groups of EEG signals: 1) healthy (Normal) EEG dataset; 2) epileptic dataset during a seizure interval .The experimental results show that the proposed method efficiently detects the presence of epileptic seizure in EEG signals and also showed a reasonable accuracy in detection.

The placement of a patient undergoing chronical hemodialysis needs a double blood access[1]. This could be perment (arteriovenous fistula, vascular prothesis) or non permanent (short term catheter, long term catheter…)We have thus led a survey whose objective is to identify the survival factors and risk complicated ones especially for aged people.The multicenter study was conducted in December 2013 in six hemodialysis centers in the Oriental region. 102 patients have been under observation. The incidence of aged people in comparison with the whole hemodialysed people was 24%.The average age was 72+5.5 years. The sex ratio male/female was 1.04. 83% had a maintained physical autonomy. Only 14.7% of our patients had health insurance: a weak rate in comparison with the national average. High blood pressure and diabetes were the underlying etiologies behind dialysis.31% of nephropathies were of unknown origin. Toxic habits, tuberculosis, embolic stroke constituted the most antecedents in our patients. Renal failure was found uncontrolled in 55.9% of our observed patients and consequently urgent intervention was recommended for 54.9%.Half of our patients benefited from 2 dialysis sessions per week.The other half underwent three sessions a week. Renal failure was associated to a positive hepatitis C serology in 6.9% of our patients and only 1% had hepatitis B serology.85% of our patients had anemia among whom 56.9% were under erythropoietine EPO. 33% of our patients suffred from heart disease. The average number of vascular approaches was 1.5 and 59.9% were held the team of vascular surgery in Oujda. The catheters were the most used as a first vascular access (55.9%) , then came arteriovenous fistula for 44.1% of our patients.33.9% of the patients benefited from a second vascular approach that was for 85% of arteriovenous fistula, whereas, the remaining 15% used catheters. Only 17 patients benefited from a third vascular approach, thas is say 16%, most of whom were arteriovenous fistula. That is say. A fourth vascular approach was held for 4 patients having exclusively arteriovenous fistula.31.4 % of patients reported complications: Dysfunction was the most frequent immediate complication (5.9%), followed by thrombosis (3.9%), then comes hemorrhage (2.9%). Aneurysm was the most frequent tardive complication (13.7%) followed by dysfunction found in 5.9%. Thrombosis was found only in 2.9% of patients. Finaly, only one patient had infection of the vascular approach. On the basis of this one targetted research, we have come to notice that : Age, dialysis term, number of sessions per week, viral status B/C are predictive factors of complications for aged people.The optimal dialysis treatment at this age, not only involves nephrologists but also recommends a convenient surgical access.

A ureteric bud anomalies occurrence in the world’s population is very common. One in every thousands babies born usually have some form of ureteric bud congenital anomaly. However these congenital anomalies can vary from individual to individual due to science stating that during embryological development, the ureteric bud is responsible for the collecting system, which includes the major and minor calyces of the kidney, the ureter and the bladder. Congenital anomalies can vary to the abnormal development in any of these stated parts. A ureteric bud anomalies occurrence in the world’s population is very common. One in every thousands babies born usually have some form of ureteric bud congenital anomaly. However these congenital anomalies can vary from individual to individual due to science stating that during embryological development, the ureteric bud is responsible for the collecting system, which includes the major and minor calyces of the kidney, the ureter and the bladder. Congenital anomalies can vary to the abnormal development in any of these stated parts.

We report a case of a complete testicular epididymal dissociation discovered during surgery for cryptorchidism. The epididymis was found in the scrotum and the testis in the inguinal canal. This malformation is very rare, it has been reported sporadically, the incidence in patients with cryptorchidism may be higher. Epididymal anomalies seem to play an important role in the emergence of fertility disorders.

Cardiac evidence of Lyme disease are relatively infrequent, occurring within weeks after the infectious tick bite (median of 21 days), and resulting at this stage from a direct borrelial infection of the myocardium, as indicated by reports of spirochete isolation from pericardium and myocardium. Lyme carditis typically presents with a fluctuating degree of atrioventricular block that spontaneously resolves in several days. The management of Lyme carditis does not differ from the treatment of Lyme disease without carditis.

Penile duplication is a very rare common congenital anomaly. It occurs alone, but the more prominent examples are usually associated with anomalies of the remnants of the genito-urinary tract and the lower gastrointestinal tract. The quantity of the anomaly ranges from a partial duplication of the glans to two separate penis situated at some distance from each other. A demonstrated classification is presented. The cause is unidentified but is best explained by an early disturbance in the embryologic development of the hindgut and ventral abdomen. Treatment must be personalized and consists of various processes to restore normal appearance and function.

Objective: Analyze the body weight, serum insulin, blood glucose, A1C and Insulin resistance in Escitalopram treated type 2 diabetic subjects (T2DM). Study design: Observational study Place and Duration: Department of Medicine, Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad from June 2015 to August 2016. Methodology: A sample of 50 diagnosed cases of T2DM subjects taking Escitalopram 10 mg/kg were selected according to pre-defined criteria. Physical examination was performed. After 3 months of Escitalopram intake, the blood samples were taken for biochemical analysis. Body weight, blood pressure, fasting serum insulin, fasting and random blood glucose, A1C and Insulin resistance (HOMA-IR%) were estimated. Statistix 10.0 (USA) software for data analysis (95% Confidence interval). Results: Mean ± SD of age was noted as 51.5± 6.5 years (p=0.51). Body weight (kg) at baseline and three months decreased from 79.8±11.6 to 76.0±9.4 kg (p=0.031). Fasting insulin, fasting glucose and insulin resistance (HOMA-IR) at baseline and after 3 months were noted as 133.0±21.7 vs. 128.0±11.7 mg/dl (p=0.0001), 16.0±5.50 vs. 13.5± 3.5 ?IU/ml (p=0.0001) and 7.15 vs. 6.09% (p=0.0001) respectively. Conclusion: Escitalopram improves fasting insulin, fasting glucose and insulin resistance and decreases body weight in type 2 DM subjects.