Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low-or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.

The gastrointestinal helminths identified include Ancylostoma sp., Ascaris sp., Baylisascaris sp., Toxascaris sp., Toxocara sp., Strongyloides sp. and Entamoeba sp. was the only protozoa encountered. Ascaris sp., had the highest prevalence of 22.6%, followed by Ancylostoma sp. with a rate of 20.8%. Baylisascaris sp., and Strongyloides sp. both had a prevalence rate of 13.2% each, while Entamoeba sp. yielded the lowest prevalence (3.8%). Regular monitoring of parasitic diseases and the use of selective treatments would be effective for the control of the gastrointestinal helminths for the wellbeing of animals, safety of zoo keepers and tourists in the zoo.

This study investigates the link between infrastructure and structural transformation in Africa as well as the mediating role of financial development on the nexus. We employ data from 24 African countries for the period 2003 to 2019 and adopt the system Generalized Method of Moments (sGMM) estimation technique. Our empirical results suggest that infrastructure and financial development foster structural transformation. However, our results show varying effects of ICT, electricity, and transport on sectoral value-added. Specifically, ICT infrastructure spurs the agricultural and manufacturing sectors value-added, electricity infrastructure aids all sectoral value-added, and transport infrastructure is important to the development of the manufacturing and services subsectors. Also, the agricultural and manufacturing sectors benefit more than the services sectors from financial-sector development. Overall, we find that infrastructure stimulates structural transformation. The net effect of the interaction of financial development and infrastructure on structural transformation appears to be zero, suggesting that financial development does not augment the nexus between infrastructure and structural transformation in Africa.

A 36-year-old man presented with a 6-month history of a painful 3×4 cm mass in the perineum. There was no associated history of trauma, erectile dysfunction, penile deformity or urinary symptoms, and he was not a cyclist. On examination a tender fixed mass was found in the region of the crus of the left corpora cavernosum. A diCerential diagnosis at this stage included rhabdomyosarcoma or other mesenchymal neoplastic growths, including an epitheloid sarcoma [1]. Ultrasonography confirmed a perineal mass with invasion into the crus of the left corpus cavernosum (Fig. 1). Subsequent CT was not helpful. A wedge biopsy of the mass revealed hyalinized fibrous tissue in which occasional blood vessels were cuCed by chronic inflammatory cells. There was extension of the fibrous tissue into the superficial erectile tissue consistent with Peyronie's disease. The patient was treated for 9 months with tamoxifen, with resolution of the pain and a reduction in the size of the mass, and with preservation of erectile function. penoscrotal junction. A urethrogram revealed a normalcalibre urethra but with an area of calcification on its dorsal surface. Urethroscopy revealed that this abnorComments mality was not within the urethral wall. At exploration via a midline penoscrotal incision, the corpus sponPeyronie's disease was described in 1743, yet its aetiology remains unknown. The plaque is located on the giosum was mobilized to provide access to a hard midline mass at the junction of the crura within the septum of dorsal surface of the penis in 66% of cases, laterally in 20%, ventrally in 6% and within the septum in 6% the tunica albuginea. The histology of this lesion revealed bone in a Peyronie's plaque (Fig. 2). Postoperatively, the [2,3]. The reported location of the plaque is fairly evenly distributed along the pendulous part of the penis, in erectile diBculties persisted, with a slight left deviation of the erect penis, although he could still obtain and several series [2-4]. Peyronie's disease has never been described in the crus of the penis. These two cases show maintain erections suBcient for penetration and therefore did not want further surgery.that the plaque can occur in any part of the tunica 537

Sketch oftheftlter to remove guinea worm-carrying waterfleasfrom drinking water A group of medical students with no previous engineering experience built a sturdy demonstration filter to remove water fleas (Cyclops), which carry guinea worm disease, from drinking water.