ISSN 1556-6757







Volume 3, Issue 1, 2009


Quantifying cost avoidance possibilities by investing in the minimally-invasive mid-urethral sling
surgical treatment of stress urinary incontinence
  D. Wayne Taylor and Elisabeth Fowler


Urinary incontinence is one of the most prevalent, untreated chronic conditions for individuals living in Canada. The impact of incontinence on an individual’s quality of life is significant as it negatively affects a person’s physical, psychological, sexual, social and overall quality of life (QOL). Due to the stigma associated with this condition, many individuals do not seek treatment for their incontinence, even though 80% of incontinence cases can be managed or cured. A variety of treatment options exist for those living with incontinence. Women in Canada choosing to undergo treatment via surgery face long wait times of up to two years. An increase in funding for the treatment of incontinence is desperately needed; however, treating incontinence may also provide significant savings to government funders in the long run due to delayed admissions to long term care facilities. This report investigated possible cost savings to the Ontario Ministry of Health and Long Term Care if future admissions to long-term care facilities were delayed by 6
months, 1 year, or 4 years, and assuming that 10%, 25% and 40% of those living with stress urinary incontinence (SUI) are reached and treated with the minimally invasive mid-urethral sling (TVT). The sensitivity analysis performed found that a modest investment on the part of the Ministry in the treatment of SUI ($3.6-$14.5 million) could reap significant rewards ($29.8 million – $1.1 billion) through delayed admissions to long term care facilities. Calculated as
a return on investment (ROI) the net savings produce an ROI ranging from 8:1 up to 74:1. These are conservative financial gain calculations as they do not take into consideration indirect savings that may accrue to the health care system or improved quality of life. Treatment and management of SUI as proposed will help thousands of women living with incontinence remain independent, able and productive members of society. 
Full Article

Learning objectives in logbooks as indicators of problems in teaching hospitals
Stefan Stieger, Andrea Praschinger, Kurt Kletter, and Franz Kainberger


Logbooks are used to grade, document, and establish the structure of clinical clerkships, but a logbook can also be used as an instrument to maintain uniform teaching between medical universities and teaching hospitals. In this study, logbooks of 109 students were collected and learning objectives (n = 141) were analyzed upon the achieved skill levels. Analyses revealed differences in teaching between university and a single teaching hospital. In this teaching hospital students missed more learning objectives and had lower amounts of upgrades onto a
higher skill level than demanded by the logbook. As we have shown, logbooks can even be used as an aide to maintain uniform teaching in medical universities and teaching hospitals 
Full Article

Comparison of colorimetric and chemiluminescent ELISAs for the detection of antibodies to Blastomyces dermatitidis  Wayne O. Hatch and Gene M. Scalarone


The infectious disease, blastomycosis, caused by Blastomyces dermatitidis can be present as an acute pulmonary infection that resolves on its own to full blown dissemination if not treated properly. Many immunodiagnostic assays have been developed to aid in the diagnosis of blastomycosis. Here, the enzyme-linked immunosorbent assay (ELISA) is discussed and a variation of the indirect procedure is evaluated that uses a chemiluminescent substrate in
its ability to detect antibodies to B. dermatitidis. In conclusion, the chemiluminescent ELISA provides slight improvements in detection of antibodies to B. dermatitidis (p=0.001).
Full Article



Ascorbic acid, Carotenoids, Total Phenolic content and Antioxidant activity of various genotypes of Brassica Oleracea encephala.  Sharique Ahmed and Seerat Hussain Beigh


The disease preventing potential of naturally occurring substances in the diets is a major area of scientific interest. Recently antioxidants and secondary metabolites have attracted a great deal of attention for their effect in preventing disease due to oxidative stress, which leads to degeneration of cell membranes and many pathological diseases including cancer. In the current study, green leafy vegetable extracts of six genotypes of kale (Brassica oleracea
acephala) were evaluated for total phenol, carotenoids, Vitamin C content and antioxidant activities. Ascorbic acid ranged from 142 mg per 100g in Wappal hakh to 164 mg per 100-g fr wt in knol khol. Wild genotypes Wappal and Pumb, had significantly high phenolic content (285 and 227 mg per 100 g fr wt) and possessed highest antioxidant activities (840 and 780 umol FRAP petr g fr wt) than cultivated genotypes. A positive and strong correlation (R2=0.807) between total phenolic content and antioxidant activity suggests that kale especially “Wappal and pumb” have
enormous potential to enhance the antioxidant potential of our daily food supply. Full Article


Antibacterial and antifungal analysis of crude extracts from the leaves of Callistemon viminalis.
Chenielle Delahaye, Lois Rainford, Alison Nicholson, Sylvia Mitchell, John Lindo, and Mohammed Ahmad


Antimicrobial resistance is a major cause of significant morbidity and mortality globally. Ethnomedicine provides avenues for identification of compounds with antimicrobial properties and potential new antibiotics. Callistemon viminalis is an ethnomedicinal plant used in Jamaica to treat intestinal illnesses. Methanol, hexane and aqueous extracts of Callistemon viminalis were tested against eight common bacteria and a single fungus of medical importance using a quantitative agar well diffusion test and tube dilution assay. All plant extracts showed antimicrobial activities against the selected microorganisms; the methanol extracts were most effective. The aqueous extract on the other hand, was very effective as a bactericidal agent against the intestinal pathogens. These results support the ethnomedicinal claim that C. viminalis is an effective treatment for bacterial causes of intestinal illnesses. Full Article