BACKGROUND: This paper reports the baseline characteristics and outcomes of 266 Namibian patients in the Global Registry of Rheumatic Heart Disease OBJECTIVE: To describe clinical findings and outcomes in a cohort of children and adults with rheumatic heart disease in Namibia METHODS: Prospective study of all patients with rheumatic heart disease at Windhoek Central Hospital between January 2010 and November 2012 RESULTS: A total of 266 patients were enrolled; median age was 22 years, 72.6% were <30 years old and 60.5% female. The majority (62.8%) had moderate-severe disease; 48.9% were in congestive cardiac failure. Secondary antibiotic prophylaxis was used by 34.2%. Warfarin was used by 75.3% («=64/85) with clinical indications. Forty-seven (17.6%) had previous valve interventions, of whom 40 (15.0%) had mechanical valve replacements. Over a 2-year follow-up period 19.1% of patients died. Severe valve involvement at enrolment was independently associated with mortality (24.6% v. 5.1% in those without severe disease; hazard ratio 4.9; 95% confidence interval 1.50 -15.98). Sixty-five (29.8%) of the 218 without previous intervention had valvular intervention after enrolment CONCLUSIONS: In Namibia rheumatic heart disease affects young people who present with severe disease and have a high case fatality rate. Rates of secondary prevention were low. These findings have informed the National Programme for Prevention and Control of Rheumatic Heart Disease in Namibia

ABSTRACT Introduction CROES-Clavien system (CCS) for grading complications in percutaneous nephrolithotomy (PCNL) is a step towards standardization of outcomes. We categorized complications based on CCS and predicted risk factors across the entire cohort and individually for pediatric (P: ≤18 years), adult (A: 19-65 years) and geriatric (G: ≥65 years) subgroups to assess the risk factors in each subset. We assessed association of complications with length of hospitalization (LOH) and operation time (OT). Materials and Methods Retrospective record review of unilateral PCNL performed between January 2009-September 2015 at a tertiary care center in India, performing around 150 PCNL per year. Results Out of 922 (P=61; A=794; G=67) PCNL, 259 (28.09%) complications occurred with CCS I, II, III and IV constituting 152 (16.49%), 72 (7.81%), 31 (3.36%) and 4 (0.43%) respectively and its distribution was similar across the subsets and majority (224; 24.3%) were minor (CCS-1, 2). Placement of a nephrostomy (47.4%; 18/38) in Group P, supracostal access, ≥2 punctures, higher GSS, nephrostomy, staghorn stones, ≥2 stones, stone size in Group A and hydronephrosis and prolonged OT in Group G were significantly associated with complications. On logistic regression, need of nephrostomy (adj. OR - 4.549), OT (adj. OR - 1.364) and supracostal access (adj. OR - 1.471) significantly contributed to complications in the study population. LOH was found to be significantly associated with complications (p<0.001). Conclusions Contrary to the belief that extremes of ages are associated with complications of prone PCNL, we found age does not alter the incidence or grade of complications and LOH.

Wound healing activity of the bark extracts of Acacia leucophloea Willd., Fabaceae, was investigated by excision and incision wound healing models in Wistar male rats. Ethanolic extract based ointment of A. leucophloea bark (2 and 5% (w/w)) was formulated and evaluated for its wound healing in Wistar male rats. In comparision with a standard wound healing ointment betadine. A. leucophloea ethanolic extract ointment exhibited marked wound healing activity and significantly enhanced the wound contraction and the period of epithelialization as assessed by wound contraction rate, tensile strength, increasing of DNA, collagen and protein synthesis and histopathological examination. The formulated ointment might well find use as skin repair agent without hazard to human health based on these results.