Molecular phylogeny reveals distinct evolutionary lineages of the banded krait, Bungarus fasciatus (Squamata, Elapidae) in Asia.

The banded krait, Bungarus fasciatus is a widespread elapid snake, likely to comprise several distinct species in different geographic regions of Asia. Therefore, based on molecular phylogenetics and comparative morphology data, we present an overview of the systematic composition of the species to delimit potential biogeographic boundaries. Our phylogenetic analyses, based on four mitochondrial genes, reveal the existence of at least three evolutionary lineages within B. fasciatus, corresponding to Indo-Myanmar, Sundaic and eastern Asian lineages. We are convinced that there are at least three taxonomic entities within the nomen B. fasciatus and restrict the distribution of B. fasciatus sensu stricto to the Indo-Myanmar region. We also provide additional natural history data of the taxon from eastern India. Finally, we advocate further studies to establish the degree of reproductive isolation among these diverging evolutionary lineages and to reassess the systematic status of this species complex especially the Sundaic and eastern Asian lineages.

The value of transvaginal sonography in detecting endometrial pathologies in postmenopausal women with or without bleeding.

AIM: The aim of this study was to estimate the incidence of endometrial pathologies and compare the findings in postmenopausal women with or without bleeding who had endometrial thickness ≥5 mm. METHODS: Between January 2010 and December 2012 medical records of postmenopausal patients who underwent endometrial biopsy were reviewed retrospectively. 91 patients who presented with postmenopausal bleeding (Group A) with an endometrial thickness equal to or greater than 5 mm and 44 patients with an incidental finding of increased endometrial thickness (≥5 mm) on ultrasound without bleeding (Group B) were included in the study. RESULTS: The mean endometrial thickness of patients in group A (9.3±4.6) was significantly lower than women in group B (11±4.6). Seven (7.7%) cases of endometrial hyperplasia and 6 (6.6%) cases of endometrial carcinoma were detected in women with bleeding, 2 (4.5%) cases of endometrial hyperplasia and no cases of endometrial carcinoma were diagnosed in group B women. The prevalence of endometrial carcinoma associated with endometrial thickness in group A women whereas we cannot see this relation in group B women. The mean endometrial thickness was highest in women with the histopathologic diagnosis of polyps in this group. CONCLUSION: In postmenopausal women with bleeding, the risk of endometrial carcinoma increases with increasing endometrial thickness; however, the use of endometrial thickness as a screening test for endometrial carcinoma may not be effective in women without bleeding. 6.5 mm cut-off seems to be acceptable thickness for polyp detection in postmenopausal women with bleeding.

Khat chewing among Agaro secondary school students, Agaro, southwestern Ethiopia.

A cross-sectional study using a self-administered questionnaire was carried out to determine the prevalence of khat chewing among secondary school students in Agaro, southwestern Ethiopia in 1991. Two-hundred-forty-eight students randomly selected from grade 9 to 12 were included in the study with current prevalence of 64.9%. Khat chewing was found to be associated with being Muslim and male. The most frequent users were also in the age group of 15 to 22 years. The association between khat chewing and grade attended was statistically significant. The health and socioeconomic problems associated with the use of khat are discussed and possible interventions suggested.

Subacute and acute epidemic conjunctivitis due to neisseria gonorrhoeae SSP

An outbreak of acute conjunctivitis with profuse exudation was observed between November 1987 and June 1988 in Konso; North Omo. There were 9;075 registered cases and seven months later; 20 cases with mild; subacute conjunctivitis were observed. Neisseria gonorrhoeae and Neisseria gonorrhoeae subsp. kochii were the causative agents; while Haemophilus spp. behaved as opportunistic infection. The condition is resistant to topical antibiotics; but the outbreak could be controlled by mass treatment with single dose oral ampicillin and probenecid. Severe sequelae were observed in 36 patients treated with this regimen. This is the first isolation of N. gonorrhoeae subsp. kochii outside Egypt; and the first recorded outbreak of Neisseria gonorrhoeae conjunctivitis affecting thousands of patients in more than 40 years

Community-wide outbreak of Neisseria gonorrhoeae conjunctivitis in Konso district, North Omo administrative region.

We describe a large outbreak of severe pustular conjunctivitis due to Neiserria gonorrhoeae. Over 9,000 cases occurred during 8 months in 1987-1988 in one district in North Omo, Ethiopia. Both sexes and all age groups were affected, particularly children under 5 years of age; only a small minority were neonates. Despite a highly successful cure rate for individual cases, the outbreak continued for a number of months. Several epidemiologic approaches were used to monitor the outbreak and identify the mechanism of transmission. The epidemic curve suggested person-to-person transmission. Routine surveillance data showed that there was no concurrent genital gonorrhea outbreak and genital transmission could not explain a community-wide outbreak. In the setting of intense crowding and relative lack of water, peak transmission of illness coincided with two periods following the rains, suggesting that flies were important in transmission. A case-control study identified lack of face-washing as a household risk factor. Eighty seven of one-hundred and forty six (59%) control houses with children were judged to contain children with clean faces, while only 102 of 216 (47%) case households contained children with clean faces (p less than .05). Our recommendations include measures to improve personal hygiene.