Search

This case note offers insights into a decision of the International Court of Justice on the legal dispute between Chile and Bolivia over the nature and use of the Silala waters and its implications for international water law. It begins with two positive notes, namely, the recognition of the unity of the Silala waters (natural and artificially enhanced flows) and the use of science and expert evidence to resolve the dispute. It then addresses two other issues that the Court should and could have dealt with more adequately, being disputes on the 'current use' and 'acquired rights' under the ambit of the equitable and reasonable utilization principle and the obligation to notify and consult planned measures. The case note concludes that the Court failed to settle the underlying legal issues sufficiently and to better guide the parties on their rights and obligations. [ABSTRACT FROM AUTHOR]

Abstract: Background: Clinical pharmacists (CP) providing medication therapy management (MTM) services have shown significant positive therapeutic outcomes by identifying and resolving patients’ drug therapy problems (DTPs). Objective: Thus, the aim of the study is to evaluate and characterise the type of interventions provided by CPs through MTM services in emergency and ambulatory settings in Gondar University Hospital (GUH), northwest Ethiopia. Methods: This is a prospective cross‐sectional study carried out in emergency and ambulatory settings during February–July 2015 at GUH, Ethiopia. The CP interventions documented through MTM services were collected and analysed using SPSS version 22. A p‐value ≤0.05 was considered to be statistically significant. Results: A total of 182 patients with 335 interventions were recorded, of which the majority were from the ambulatory ward (63.1%) particularly, cardiovascular patients (25.8%). CPs identified at least one DTP per patient, such as ‘need for additional drug therapy’ (30.5%) and ‘unnecessary drug therapy’ (29.5%). The interventions provided by CPs were providing information (32.5%), start/stop medications (25.7%), alteration of duration, frequency and dosage (11.6%). Of 335 interventions, 257 (76.7%) were accepted by physicians. CP interventions were about four times more likely to be accepted by physicians in patients with comorbidities (adjusted odds ratio = 3.70, 95% CI = 1.959–6.99) than those with no comorbidity. Conclusion: CP interventions through MTM documentations revealed identification of patient drug‐related problems and have shown acceptance by the majority of physicians. We recommend the use of MTM services in other wards of the GUH. [ABSTRACT FROM AUTHOR]

Background: To understand the population dynamics and propose more effective preventive strategies, defining the population structure of the circulating Mycobacterium tuberculosis strains is important., Methods: A total of 177 M. tuberculosis complex isolates from pulmonary tuberculosis (TB) cases in southwest Ethiopia were genotyped by spoligotyping. Of the strains included in this study, 126 were pan-susceptible strains while the remaining 51 isolates were resistant to one or more first-line anti-TB drugs. The genotyping results were compared to the international spoligotyping (SITVIT) database of the Pasteur Institute of Guadeloupe and the newly revised publicly available international multi-marker database (SITVITWEB/SPOLDB4). An online tool Run TB-Lineage was also used to predict the major lineages using a conformal Bayesian network analysis., Results: The spoligotyping of the 177 isolates resulted in 69 different spoligotype patterns of which 127 (71.8%) were clustered into 19 spoligoclusters (with clustering rate of 61.02%). Each cluster contains 2-29 isolates. Of the isolates with corresponding SIT in SITVIT/SDB4, the predominant strains identified were SIT 37 of the T3 subfamily with 29 isolates followed by SIT 53 of the T1 subfamily with 20 isolates. SIT 777 of the H4 subfamily and SIT 25 of the CAS1_DELHI subfamily each consisting of six isolates were identified. Eighty spoligotype patterns were orphan as they were not recorded in the SITVIT2/SPDB4 database. Further classification of the isolates on the basis of major lineages showed that 82.5% and 14.1% of the isolates belonged to Euro-American and East African Indian lineages, respectively, while 2.8% of the isolates belonged to Mycobacterium africanum and 0.6% to Indo-Oceanic., Conclusion: The ill-defined T and H clades were predominant around Jimma. The substantial number of orphans recorded in the study area warrants for additional studies with genotyping methods with better resolution and covering whole areas of southwest Ethiopia., (© 2018 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.)