The Number and Determinants of Nutrient foramina among dry human femur bones from the East African population: A Cross-section study

Background: Nutrient foramina form important landmarks on the femur and other bones as the portal of entry for nutrient arteries. Nutrient arteries are important sources of blood supply for growing bones; and their variations may be due to congenital or acquired causes. These variations are important in anatomical comparisons, orthopaedic surgical practice and forensic medicine. Aims: This study aimed at establishing the number and determinants of the nutrient foramina among dry human femur bones from the East African population. Materials and methods: This was a cross-section study of 333 dry femur bones from the East African population, at the Galloway osteological collection of Makerere University college of health sciences. The number of nutrient foramina on the shaft of each femur, the corresponding demographic, clinical and morphometric characteristics were documented. Data were entered in an Excel sheet and exported to STATA 14 for analysis. Univariate, bivariate and multivariable analyses were performed to obtain the summary statistics and the measures of association. At all levels of analysis, a p-value of less than 0.05 was considered statistically significant. Results: Of the 333 femurs, 291 (87.4%) were from males; and 137(50.15%) were right femurs. The age ranged from 20 to 75 years with a mean age of 35 (SD± 12) years. Nutrient foramina ranged from one to four; mean of 1.4 (SD±0.5) and median of 1 (IQR: 1 to 2). Of the 333 femurs, 199 (59.8%) had one foramen, 129 (38.7%) had two foramina, four femurs had three foramina and one femur had four foramina. There was a statistically significant association between the number of nutrient foramina and the femur’s: mid-shaft circumference (p=0.014; 95%CI: 0.003 to 0.028), nationality (p=0.016; 95%CI: -0.284 to -0.030) and sex (p=0.012; 96%CI: -0.405 to -0.050). Conclusion: Nutrient foramina among femurs from the East African population range from one to four per femur, with predominantly one foramen. The key determinants of the number of foramina are: mean mid-shaft circumference, nationality and sex. These findings are significant in anatomical comparisons; forensic and orthopaedic practices. KEY WORDS: Nutrient foramina, dry human femur, East African population, morphometric characteristics.

In-silico Study of the Developed Hydroxychloroquine-based ACE2 Inhibitor Molecules Against COVID-19: Molecular Modeling and Docking

In the present study, we will verify the action of hydroxychloroquine-based derivatives on ACE2 which is considered to be the main portal of entry of the SARS-CoV-2 virus and constitutes an exciting target given its relative genetic stability compared to viral proteins. Thus, 81 molecules derived from hydroxychloroquine by substitutions at 4 different positions were generated in-silico and then studied for their affinity for ACE2 by molecular docking. Only 4 molecules were retained because of their affinity and bioavailability demonstrated by molecular dynamics and molecular docking calculations using COSMOtherm and Materials Studio software.

Meningoencephalomyelitis in domestic cats: 3 cases of Pasteurella multocida infection and literature review

Neurologic diseases are common in domestic cats, and infectious agents are suspected to be the primary cause in 30–45% of cases. Among infectious etiologies, those of bacterial origin are only sporadically characterized in the literature, with few of these reports correlating gross and histologic findings with confirmatory bacteriologic identification. Here, we describe bacterial meningitis and meningoencephalomyelitis associated with Pasteurella multocida in 3 domestic cats. Purulent exudate expanding the cerebral meninges was grossly evident in 2 of the cases. In all 3 cases, histologic changes included multifocal suppurative-to-necrosuppurative meningitis and/or meningoencephalomyelitis of variable severity. Intralesional colonies of gram-negative, short rod-shaped to coccobacillary bacteria were evident histologically in only 1 case. P. multocida was confirmed by routine bacteriologic culture in all cases. Based on our cases, we hypothesize that the upper respiratory system serves as the main portal of entry for P. multocida, leading to invasion of the central nervous system and possible systemic hematogenous dissemination. A case series of meningoencephalomyelitis associated with P. multocida infection in cats has not been reported previously, to our knowledge. We also review briefly other causes of meningoencephalomyelitis in cats.

Dementia narratives of emergency department nurses

The Emergency Department is often the main portal of entry for acutely ill elderly patients with dementia requiring healthcare. Emergency nurses assume responsibility for managing both critical illnesses and Behavioural and Psychological Symptoms of Dementia. Using narrative methodology and photographic images provided by participants, two emergency department nurses were interviewed to understand their experiences caring for patients with dementia. A Critical Social Theory lens facilitated an examination of how dominant discourse about work environment, power relations, and the healthcare system shape their stories of dementia. Findings indicated that nurses’ experiences are shaped by frustrations, threaten person-centred care, and are associated with limited time and knowledge and competing work demands when caring for patients with dementia. Study recommendations include the need for policy that supports culture change in the emergency department, investment in professional development of emergency department nurses, and infrastructure supports such as Geriatric Emergency Management nurses and nurse’s aides

Dementia narratives of emergency department nurses

The Emergency Department is often the main portal of entry for acutely ill elderly patients with dementia requiring healthcare. Emergency nurses assume responsibility for managing both critical illnesses and Behavioural and Psychological Symptoms of Dementia. Using narrative methodology and photographic images provided by participants, two emergency department nurses were interviewed to understand their experiences caring for patients with dementia. A Critical Social Theory lens facilitated an examination of how dominant discourse about work environment, power relations, and the healthcare system shape their stories of dementia. Findings indicated that nurses’ experiences are shaped by frustrations, threaten person-centred care, and are associated with limited time and knowledge and competing work demands when caring for patients with dementia. Study recommendations include the need for policy that supports culture change in the emergency department, investment in professional development of emergency department nurses, and infrastructure supports such as Geriatric Emergency Management nurses and nurse’s aides

Suicide prevention, public health, and the chiropractic profession: a call to action

Background Suicide is a major public health concern that has wide-reaching implications on individuals, families, and society. Efforts to respond to a public health concern as a portal-of-entry provider can reduce morbidity and mortality of patients. The objective of this commentary is a call to action to initiate dialogue regarding suicide prevention and the role the chiropractic profession may play. Discussion This public health burden requires doctors of chiropractic to realize current strengths and recognize contemporaneous deficiencies in clinical, research, and policy environments. With this better understanding, only then can the chiropractic profession strive to enhance knowledge and promote clinical acumen to target and mitigate suicide risk to better serve the public. Conclusion We implore the profession to transition from bystander to actively engaged in the culture of suicide prevention beholden to all aspects of the biopsychosocial healthcare model. The chiropractic profession’s participation in suicide prevention improves the health and wellness of one’s community while also impacting the broader public health arena.

C-reactive protein predicts complications in community-associated S. aureus bacteraemia: a cohort study

Background Staphylococcus aureus (S. aureus) bacteraemia is increasingly acquired from community settings and is associated with a mortality rate of up to 40% following complications. Identifying risk factors for complicated S. aureus bacteraemia would aid clinicians in targeting patients that benefit from expedited investigations and escalated care. Methods In this prospective observational cohort study, we aimed to identify risk factors associated with a complicated infection in community-onset S. aureus bacteraemia. Potential risk factors were collected from electronic medical records and included: - patient demographics, symptomology, portal of entry, and laboratory results. Results We identified several potential risk factors using univariate analysis. In a multiple logistic regression model, age, haemodialysis, and entry point from a diabetic foot ulcer were all significantly protective against complications. Conversely, an unknown entry point of infection, an entry point from an indwelling medical device, and a C-reactive protein concentration of over 161 mg/L on the day of admission were all significantly associated with complications. Conclusions We conclude that several factors are associated with complications including already conducted laboratory investigations and portal of entry of infection. These factors could aid the triage of at-risk patients for complications of S. aureus bacteraemia.