W Indian Med J
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Variations in somato-genetic patterns in muscle-fibre biology, biochemical metabolic pathways and pulmonary physiology are hypothesized to have been concentrated by natural selection over the centuries in the Afrocentric peoples displaced from West Africa to the New World. These phenotypic and genotypic characteristics are attributed to provide the athletic prowess so well documented in African-Americans. Not the least of coincidence seems to be the influence of the compensatory mechanisms on oxygen transport and its availability to the tissues, in response to the sickle cell gene. The reduced availability coupled with reduced myoglobin in the preponderant fast-twitch muscle fibres which are adapted for rapid energy (ATP) regeneration, all give a NET outcome of muscle anatomical and biochemical advantages which support outstanding performances in athleticism.
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Comparative Study
Ultrasound and white blood cell counts in suspected acute appendicitis.
The use of radiological studies as diagnostic tools in patients with suspected acute appendicitis has increased recently. In this setting, abdominal ultrasonography is viewed as a possible means of avoiding unnecessary surgery. This retrospective study of patients who underwent laparotomy for suspected acute appendicitis was undertaken to determine the sensitivity and specificity of ultrasound in diagnosing acute appendicitis and the frequency of leucocytosis in patients in whom the diagnosis was confirmed by histology. ⋯ Ultrasound showed 92% specificity and 29% sensitivity for the pre-operative diagnosis of appendicitis. The positive predictive value of ultrasonography (83%) was higher than that of leucocytosis (69%). The sensitivity and specificity of ultrasound and leucocytosis in this study indicate limited utility as preoperative diagnostic tools.
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The development of policies in health and healthcare should incorporate ethical premises as well as thoughtful consideration of the values pertinent to the particular society and the goals to be achieved by specific policies. Social inequalities, changing values, and emergent challenges to traditional beliefs, add complexities that require a thorough analysis to compile policies that are fair and equitable. This article provides some recommendations for clinicians, health administrators, policy makers and technocrats who often grapple with complex health issues.
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To evaluate the clinical characteristics and costs incurred for patients who stayed for a prolonged period in a surgical intensive care unit (ICU). ⋯ The study highlighted the need for a step-down unit and a protocol to transfer eligible patients to such a unit.