Firearm injuries to the spine commonly present with acute neurology caused by direct penetration or indirectly from concussive effects of bullet impact on the vertebral column. We report a case of delayed neurologic presentation of retained intra-spinal bullet in a 42 year-old African who had chronic low back pain and sciatica with a past history of gunshot injury to the spine and radiograph revealed a bullet at the L4-5 disc level. Intra-operative exploration showed a fibrous mass around the bullet compressing on the L4 existing nerve root and L5 traversing nerve root. Removal of the retained bullet resulted in a good clinical outcome with complete resolution of symptoms.

Soil-transmitted helminth (STH) infections, mainly caused by Ascaris lumbricoides, Trichuris trichiura, and hookworms, are among the most common intestinal parasites that infect humans. The infections are widely distributed throughout tropical and subtropical countries, including Malaysia, particularly in underprivileged communities. Microscopic and culture techniques have been used as a gold standard for diagnostic techniques. However, these methods yield low sensitivity and specificity, laborious and time-consuming. Therefore, simple, rapid, and accurate alternative methods are needed for the simultaneous detection of STH infections. Although advanced technologies such as real-time multiplex PCR have been established, the use of this technique as a routine diagnostic is limited due to the high cost of the instrument. Therefore, a single-round multiplex conventional PCR assay for rapid detection of four STH species in the fecal sample was developed in this study. To perform the single-round multiplex PCR, each pair of species-specific primers was selected from target genes, including Ancylostoma duodenale (Internal Transcribed Spacer 2; accession No. AJ001594; 156 base pair), Necator americanus (ITS 2; accession No. AJ001599; 225 base pair), Ascaris lumbricoides (Internal Transcribed Spacer 1; accession No. AJ000895; 334 base pair) and Trichuris triciura (partial ITS 1, 5.8s rRNA and partial ITS 2; accession No. AM992981; 518 base pair). The results showed that the newly designed primers could detect the DNA of STH at low concentrations (0.001 ng/μl) with no cross-amplification with other species. This assay enables the differentiation of single infections as well as mixed infections. It could be used as an alternative and is a convenient method for the detection of STHs, especially for the differentiation of N. americanus and A. duodenale.

Introduction: Indonesia is one of the countries whose inhabitants use well water for drinking and cooking purposes. In East Java, 48.90% of the population uses well water for their daily needs. Well water contained heavy metals had bad effects on health such as cancer, damage of liver, kidneys, and others. The objective of this study was to evaluate the concentration of heavy metals in well water and relate them to a potential health outcomes. Methods: The method used in this study was analytical descriptive. Data used was secondary from East Java Environmental Office. A total of 101 samples were collected from 33 locations. There were 5 heavy metals analyzed, namely cadmium, chromium, lead, manganese, and zinc. Equipment using ICPMS and AAS. Data analyzed with descriptive statistics by SPSS. Data obtained were compared to the WHO Standard for Drinking Water Quality. Results: Concentration for cadmium was 0.002 mg/l, followed by manganese at 1.80 mg/l and zinc at 0.020 mg/l. Besides, all water samples had levels of chromium and lead below the detection limit. Conclusion: All heavy metals had concentrations below the maximum allowable standard, except for five water samples from three locations with levels of manganese which was above the maximum standard. Long term effects of manganese include neurological problems, intelligence, and low birth weight. Further studies need to be done to determine the source of manganese contamination. It is recommended that bottled water is used for drinking purposes in an area where heavy metal concentration is above the allowable limit.