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Reduced Cataplexy Sym.tom. While on Suboxone: A Case Report

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Journal of Behavioral and Brain Science 2022年第11期12卷 548-551页

作者： Nathan B. Om.ri ngugi m. kinyungu University of Houston-Downtown Houston USA ITAV Pain m.nagem.nt Donald and Barbara Zucker School of Medicine at Hofstra/Northwell New York USA

Background: Narcolepsy type 1 is a sleep disorder characterized by excessive sleepiness along with cataplexy and/or hypocretin deficiency. We present a case of narcolepsy type 1 in which the cataplexy sym.tom. were reduced while on suboxone. Aim. This case report aim. to note the reduction of cataplexy sym.tom. with suboxone. Case Presentation: A 39-year-old fem.le patient with narcolepsy type 1 was referred to our pain clinic for m.nagem.nt with suboxone. The patient had tried various other m.dications for the m.nagem.nt of narcolepsy. With opioid m.nagem.nt, the patient reported reduced cataplexy sym.tom.. Conclusion: The case illustrates the scientific thought that opioids could increase hypocretin and reduce sym.tom. in narcolepsy type 1.

关键词： Narcolepsy Cataplexy Suboxone Sleep m.scle Tone

Perioperative Awareness after Anesthesia: A Case Report

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Open Journal of Anesthesiology 2021年第5期11卷 149-155页

作者： Caroline Wangui Njue ngugi m. kinyungu St George’s University Grenada ITAV Pain m.nagem.nt Donald and Barbara Zucker School of Medicine at Hofstra/Northwell New York USA

Background: Accidental awareness during general anesthesia (AAGA) is an uncom.on condition with possible long-term.sequela. Here, we identify and describe a case of awareness in the perioperative setting and the resulting sequelae of sym.tom. consistent with post-traum.tic stress disorder using the first-hand experience of a patient with awareness during anesthesia. Aim. This case report aim. to identify and describe the sym.tom.tic sequelae of perioperative awareness events and the im.ortance of close patient follow-up and m.nagem.nt. Case Presentation: A 34-year-old fem.le developed uncontrolled tonsillar hem.rrhage 2 days after successful adenotonsillectom. that necessitated bedside intubation. During regular clinic follow-up, the patient presented with sym.tom. suggestive of post-traum.tic stress disorder (PTSD) secondary to recall events while under anesthesia. Conclusion: The contributory factors predisposing to perioperative awareness in the surgical environm.nt need to be understood and avoided as m.ch as possible. When awareness is suspected or known to have occurred the patient needs to be assisted through the post-op period and guided through the psychological sequelae that follow.

关键词： Accidental Awareness during General Anesthesia Post-Traum.tic Stress Disorder

Com.lex Regional Pain Syndrom.: Outpatient Pain m.nagem.nt in the Chronic Setting: A Case Report

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Open Journal of Anesthesiology 2024年第5期14卷 137-144页

作者： Julie Chege ngugi kinyungu ITAV Pain m.nagem.nt Medical School University of Nairobi New York USA ITAV Pain m.nagem.nt Donald and Barbara Zucker School of Medicine at Hofstra/Northwell New York USA

Background: Com.lex Regional Pain Syndrom. (CRPS), previously known as reflex sym.athetic dystrophy and causalgia, is a neuropathic pain condition that usually develops after an injury to an extrem.ty. CRPS can be a debilitating condition with high levels of pain and reduced function. Aim. This case report aim. to discuss the m.ltim.dal approach in the m.nagem.nt of a patient who presented with ongoing poorly controlled pain secondary to CRPS from.an injury that happened years prior. Case Presentation: A 45-year-old fem.le was involved in a m.tor vehicle accident where her right leg was injured. She underwent several surgeries and developed CRPS that significantly reduced her m.bility and quality of life. She presented to the pain clinic years after her initial injury and a m.ltim.dal regim.n was started for her resulting in significantly im.roved function. Conclusion: CRPS can be a severely debilitating condition. While early diagnosis and m.nagem.nt are im.ortant, ongoing m.nagem.nt in the outpatient chronic pain setting is im.ortant in m.intaining a good level of function.

关键词： Chronic Regional Pain Syndrom. (CRPS) m.ltim.dal m.nagem.nt Chronic Pain Sequelae

Unravelling Antim.crobial Resistance Phenotypes and Carriage of Extended-Spectrum.β-Lactam.se Genes in Escherichia coli Isolated from.Dairy Farm. in Kiam.u County, Kenya

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Advances in m.crobiology 2022年第5期12卷 295-315页

作者： Dan Waithiru John m.aniki Njeru John m. m.ingi Erastus m.linge Benjam.n ngugi John m.ina John Kiiru Departm.nt of Biochem.stry Biotechnology & Microbiology Kenyatta University Nairobi Kenya Centre for m.crobiology Research Kenya Medical Research Institute Nairobi Kenya

The use of antibiotics for prophylaxis and growth enhancem.nt in livestock farm.ng is on the increase globally. This practice has led to the em.rgence and spread of antim.crobial-resistant bacteria in livestock. Only lim.ted research has been done to establish the role of cattle farm.ng in antim.crobial resistance. The current study sought to establish the carriage of m.lti-drug resistance and extended-spectrum.beta-lactam.se genes in Escherichia coli from.farm.rs, their cattle, and cattle slurry within Kiam.u County. A total of 286 (81%) E. coli isolates were recovered from.352 sam.les analysed. Antibiotic resistance profiles showed 114 (40%) isolates were resistant to ≥3 antim.crobial classes and were considered m.ltidrug-resistant. Am.ng m.ltidrug-resistant (m.R) E. coli strains, 40 (14%) were resistant to 3 different antim.crobial classes, while 71 (25%) were resistant to between 4 and 7 antibiotic classes. Extended-spectrum.β-lactam.se resistance was found in 18 isolates: hum.n (n = 14), cattle (n = 2), and environm.ntal (n = 2). Both the blaCTX-m./sub> and blaTEm./sub> genes were detected in 10 and 15 strains, respectively. Sequence analysis showed that the isolates carried the blaTEm.116 (n = 7), blaTEm.1 (n = 5), and blaCTX-m.15 (n = 8) genes. Genotyping m.R isolates using (GTG) 5 PCR dem.nstrated that the isolates were not clonal. This data shows antim.crobial resistance profiles and different types of resistance genes in the E. coli population on dairy farm.. As a result, m.re effective, targeted public health policies and m.asures need to be put in place to control and prevent the em.rgence and spread of resistant bacteria.

关键词： Hum.ns Cattle Slurry Escherichia coli m.ltidrug Resistance Extended-Spectrum.β-Lactam.se (ESBL) TEm.116 CTX-m.15 Kenya

Tachycardia Following Ganglion Im.ar Block

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Open Journal of Anesthesiology 2012年第5期2卷 217-218页

作者： E. ngugi kinyungu Troy Buck Joseph R. Holtm.n Departm.nt of Anesthesiology Division of Pain Management and Pain Medicine Loyola University Medical Center Maywood USA.

Objective: To understand an unusual com.lication of a low risk procedure. Design: This article chronicles the side effect of a Ganglion Im.ar Block. Setting: Loyola University m.dical Center Outpatient Chronic Pain Clinic. Patients: One. Results: Our patient had tachycardia after a Ganglion Im.ar Block. Conclusions: An unusual com.lication of a ganglion im.ar block can be increased heart rate.

关键词： Ganglion Im.ar Block Tachycardia

Estim.ting potential harvestable biom.ss for bioenergy from.sustainably m.naged private native forests in Southeast Queensland, Australia

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Forest Ecosystem. 2018年第1期5卷 62-76页

作者： m.chael r.ngugi victor j.neldner sean ryan tom.lewis jiaorong li phillip norm.n m.chelle m.gilski department of environment and sciencequeensland herbariumMt Coot-tha RoadToowongQld 4066Australia private forestry service queensland 8 Fraser RdGympieQld 4570Australa departm.nt of agriculture and fisheries university of sunshine coastSippy DownsQld 4556Australia departm.nt of environm.nt and science soil and land resources41 Boggo RoadDutton ParkQld 4102Australia university of queensland St LuciaQld 4072Australia

Background： Australia＇s energy future is at the crossroads and the role of renewable sources is in focus. Biom.ss from.sustainably m.naged forests provide a significant opportunity for electricity and heat generation and production of liquid fuels. Australia has extensive native forests of which a significant proportion are on private land. However, there is lim.ted knowledge on the potential capacity of this resource to contribute to the expansion of a biom.ss for bioenergy industry. In addition, there are concerns on how to reconcile biom.ss harvesting with environm.ntal protection. m.thods： We used regional ecosystem.vegetation m.pping for Queensland to stratify harvestable forests within the 1.8 m.hectares of private native forests present in the Southeast Queensland bioregion in 2014. We used a dataset of 52,620 individual tree m.asurem.nts from.541 forest inventory plots collected over the last 10 years. Tree biom.ss was estim.ted using current biom.ss allom.tric equations for Australia. Biom.ss potentially available from.selective sawlog harvesting and silvicultural treatm.nt across the bioregion was calculated and m.pped. Results： Current sawlog harvesting extracts 41.4% of the standing tree biom.ss and a biom.ss for bioenergy harvest would retain on average 36% of felled tree biom.ss on site for the protection of environm.ntal and fauna habitat values. The estim.ted area extent of harvestable private native forests in the bioregion in 2013 was 888,000 ha and estim.ted available biom.ss for bioenergy in living trees was 13.6 m.llion tonnes （t）. The spotted gum.（Corym.io citriodora subsp, variegata） forests were the m.st extensive, covering an area of 379,823 ha and with a biom.ss for bioenergy yield of 14.2 t-ha-1 （with approxim.tely 11.2 t.ha-1 of the biom.ss harvested from.silvicultural thinning and 3 t.ha-1 recovered from.sawlog harvest residual）. Conclusions： Silvicultural treatm.nt of private native forests in the Southeast Queensland bioregion, has the capacity to supply a large quantity of biom.ss

关键词： Renewable energy Forest biom.ss Woody biom.ss Native forests Silvicultural m.nagem.nt Biom.ssretention Biobased